This study aimed to evaluate the association of a healthy lifestyle pattern with mortality risk among patients with type 2 diabetes mellitus (T2DM). Data were derived from a prospective cohort enrolling 13,776 Chinese patients with T2DM. A healthy lifestyle pattern was constructed based on six lifestyle factors, including smoking, alcohol consumption, dietary habit, physical activity, sedentary time, and sleep duration. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality. During a median follow-up of 9.0 years, 2,497 deaths were recorded. Compared to T2DM patients with the lifestyle pattern scoring 0-2, those scoring 5-6 had a 40% lower risk for all-cause mortality (HR = 0.60, 95% CI: 0.52-0.69), 33% lower risk for CVD mortality (HR = 0.67, 95% CI: 0.52-0.69), and 25% lower risk for cancer mortality (HR = 0.75, 95% CI: 0.58-0.97). In addition, we found that the association between the lifestyle pattern and all-cause mortality risk was stronger in females than in males ( P for interaction < 0.05). In conclusion, adherence to a healthy lifestyle pattern is associated with a decreased risk of all-cause, CVD, and cancer mortality, which has important implications for reducing premature mortality in patients with T2DM.

Keywords: Healthy lifestyle; Mortality; Prospective cohort study; Type 2 diabetes mellitus.

本研究旨在评估健康生活方式与2型糖尿病（T2DM）患者死亡风险之间的关联。数据来源于一项前瞻性队列研究，该研究招募了13,776名中国T2DM患者。根据六个生活习惯因素构建了一个健康的生活方式模式，这些因素包括吸烟、饮酒、饮食习惯、体育活动、久坐时间和睡眠时长。使用多变量Cox比例风险模型来估计全因死亡率和特定原因死亡率的风险比（HRs）及95%置信区间（CIs）。在中位随访时间为9.0年的情况下，记录了2,497例死亡病例。与生活方式模式评分为0-2的T2DM患者相比，评分在5-6的患者的全因死亡率风险降低了40%（HR = 0.60，95% CI: 0.52-0.69），心血管疾病（CVD）死亡率风险降低了33%（HR = 0.67，95% CI: 0.52-0.69），癌症死亡率风险降低了25%（HR = 0.75，95% CI: 0.58-0.97）。此外，我们发现生活方式模式与全因死亡率之间的关联在女性中比男性更显著（P值交互作用 < 0.05）。总之，遵循健康的生活方式模式可降低全因、心血管疾病和癌症死亡的风险，在T2DM患者中具有减少过早死亡的重要意义。

关键词： 健康生活方式； 死亡率； 前瞻性队列研究； 2型糖尿病。