Ko G T, Chan J C, Tsang L W, Critchley J A, Cockram C S
Department of Medicine and Therapeutics, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT, Hong Kong.
Postgrad Med J. 2001 Apr;77(906):240-3. doi: 10.1136/pmj.77.906.240.
Smoking is a major cardiovascular risk factor and cause of death. Diabetes mellitus is also associated with an increased mortality and morbidity. Evidence concerning whether smoking increases the incidence of diabetes remains conflicting. Glycaemic status and smoking habits were analysed in 3718 Chinese subjects in order to assess the possible association between smoking and risk of diabetes in the Chinese population. The World Health Organisation 1998 criteria were used for the diagnosis of glucose intolerance. Smoking was defined as current cigarette smoking or ex-smoking without regard to daily consumption. The smoking habits of the studied subjects were correlated with glycaemic status. There were 3003 (80.8%) women and 715 (19.2%) men. The mean age (SD) was 38.4 (12.8) years (median 35.0, range 12-88 years). Of the 3718 subjects, 786 (21.1%) had diabetes, 708 (19.1%) had impaired glucose tolerance, and 2224 (59.8%) had normal results. Of the 3003 women, only 87 (2.9%) were smokers. The female smokers were younger, heavier, and had higher alcohol consumption than non-smokers. The prevalence of diabetes was similar between female smokers and non-smokers after adjustment for age, body mass index, family history of diabetes, and alcohol. Of the 715 men, 175 (24.5%) were smokers. The male smokers were younger, had lower blood pressure, and higher alcohol consumption. After adjustment for age, body mass index, family history of diabetes and alcohol, the male smokers had lower blood pressure, higher one hour plasma glucose, and more diabetes. Using logistic regression analysis (stepwise forward) with age, body mass index, alcohol, smoking, and family history of diabetes as independent variables to predict the risk of having diabetes, age and body mass index are independently associated with diabetes in both men and women. In addition, smoking is independently associated with the risk of diabetes in men, the odds ratio (95% confidence interval, CI) being 1.705 (1.106 to 2.630). Family history of diabetes is independently associated with the risk of diabetes in women, and the odds ratio (95% CI) is 1.643 (1.314, to 2.053). In conclusion, it was found that smoking is independently associated with diabetes after adjustment for age, body mass index, alcohol, and family history of diabetes in Hong Kong Chinese men, the odds ratio being 1.7. The prevalence of smoking in Hong Kong Chinese women is low and its association with diabetes is inconclusive.
吸烟是主要的心血管危险因素和死因。糖尿病也与死亡率和发病率的增加相关。关于吸烟是否会增加糖尿病发病率的证据仍存在矛盾。对3718名中国受试者的血糖状况和吸烟习惯进行了分析，以评估吸烟与中国人群糖尿病风险之间可能存在的关联。采用世界卫生组织1998年标准诊断葡萄糖耐量异常。吸烟定义为当前吸烟或已戒烟，不考虑每日吸烟量。将研究对象的吸烟习惯与血糖状况进行关联分析。有3003名（80.8%）女性和715名（19.2%）男性。平均年龄（标准差）为38.4（12.8）岁（中位数35.0，范围12 - 88岁）。在3718名受试者中，786名（21.1%）患有糖尿病，708名（19.1%）葡萄糖耐量受损，2224名（59.8%）结果正常。在3003名女性中，仅有87名（2.9%）吸烟。女性吸烟者比不吸烟者更年轻、体重更重且饮酒量更高。在对年龄、体重指数、糖尿病家族史和饮酒情况进行调整后，女性吸烟者和不吸烟者的糖尿病患病率相似。在715名男性中，175名（24.5%）吸烟。男性吸烟者更年轻，血压更低，饮酒量更高。在对年龄、体重指数、糖尿病家族史和饮酒情况进行调整后，男性吸烟者血压更低，1小时血浆葡萄糖更高，糖尿病患者更多。以年龄、体重指数、饮酒、吸烟和糖尿病家族史作为自变量采用逻辑回归分析（逐步向前法）预测患糖尿病的风险，年龄和体重指数在男性和女性中均与糖尿病独立相关。此外，吸烟在男性中与糖尿病风险独立相关，比值比（95%置信区间，CI）为1.705（1.106至2.630）。糖尿病家族史在女性中与糖尿病风险独立相关，比值比（95%CI）为1.643（1.314至2.053）。总之，研究发现，在对年龄、体重指数、饮酒和糖尿病家族史进行调整后，香港中国男性中吸烟与糖尿病独立相关，比值比为1.7。香港中国女性吸烟率低，其与糖尿病的关联尚无定论。
