Ismail A A, Gill G V, Lawton K, Houghton G M, MacFarlane I A
Division of Tropical Medicine, Liverpool School of Tropical Medicine, UK.
Diabet Med. 2000 Feb;17(2):119-23. doi: 10.1046/j.1464-5491.2000.00230.x.
Previous studies have suggested that the self-reporting of smoking amongst diabetic patients is unreliable, and that objective markers such as breath carbon monoxide (CO) or urinary cotinine are needed. As these studies have been mostly in young Type 1 diabetic patients, the reliability of smoking history has been assessed in a large group of older Type 2 diabetic patients.
Two hundred and ninety-nine Type 2 diabetic patients were investigated for smoking habits by unstructured questionnaire, breath CO, and urinary ratio.
Mean age of the group was 63 (range 30-80) years and 41% were female. Direct questioning suggested 77 (26%) to be smokers, and of these 852 had raised (>1 microg/mg) urinary cotinine-creatinine , and 71% raised (>8 p.p.m.) breath CO. Assuming urinary cotinine-creatinine as the 'gold standard', the sensitivity, specificity and positive predictive values for questionnaire were 97%, 95% and 85%, respectively; and for breath CO they were 74%, 98%, and 93%.
It is concluded that at least in this population of Type 2 diabetic patients, a structured smoking history appeared to identify current smokers with good accuracy.
以往研究表明，糖尿病患者自我报告的吸烟情况不可靠，需要诸如呼出气一氧化碳（CO）或尿可替宁等客观指标。由于这些研究大多针对年轻的1型糖尿病患者，因此本研究在一大群老年2型糖尿病患者中评估了吸烟史的可靠性。
采用非结构化问卷、呼出气CO和尿比值对299例2型糖尿病患者的吸烟习惯进行调查。
该组患者的平均年龄为63岁（范围30 - 80岁），41%为女性。直接询问显示77例（26%）为吸烟者，其中85例尿可替宁-肌酐升高（>1微克/毫克），71%呼出气CO升高（>8 ppm）。以尿可替宁-肌酐作为“金标准”，问卷的敏感性、特异性和阳性预测值分别为97%、95%和85%；呼出气CO的敏感性、特异性和阳性预测值分别为74%、98%和93%。
得出的结论是，至少在这群2型糖尿病患者中，结构化的吸烟史似乎能很好地准确识别当前吸烟者。
