Wannamethee S G, Shaper A G, Perry I J
Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London NW3 2PF, U.K.
Diabetes Care. 2001 Sep;24(9):1590-5. doi: 10.2337/diacare.24.9.1590.
To examine the effects of cigarette smoking, giving up smoking, and primary or secondary pipe or cigar smoking on the risk of type 2 diabetes.
A prospective study followed 7,735 men aged 40-59 years from general practices in 24 British towns for an average of 16.8 years. Incident cases of physician-diagnosed diabetes were ascertained by repeated postal questionnaires and systematic reviews of primary care records.
A total of 290 incident cases of diabetes were found in 7,124 men with no history of diabetes, coronary heart disease, or stroke. Cigarette smoking was associated with a significant increase in risk of diabetes, even after adjustment for age, BMI, and other potential confounders. The benefit of giving up smoking was only apparent after 5 years of smoking cessation, and risk reverted to that of never-smokers only after 20 years. The risk of diabetes in those who switched from smoking cigarettes to pipe or cigars remained equal to the risk in continuing cigarette smokers. Men who gave up smoking during the first 5 years of follow-up showed significant weight gain and subsequently higher risk of diabetes than continuing smokers.
Cigarette smoking is an independent and modifiable risk factor for type 2 diabetes. Smoking cessation is associated with weight gain and a subsequent increase in risk of diabetes, but in the long term, the benefits of giving up smoking outweigh the adverse effects of early weight gain.
研究吸烟、戒烟以及原发性或继发性吸食烟斗或雪茄对2型糖尿病风险的影响。
一项前瞻性研究对来自英国24个城镇普通诊所的7735名40 - 59岁男性进行了平均16.8年的随访。通过重复邮寄问卷和对初级保健记录的系统审查来确定医生诊断的糖尿病新发病例。
在7124名无糖尿病、冠心病或中风病史的男性中，共发现290例糖尿病新发病例。即使在调整了年龄、体重指数（BMI）和其他潜在混杂因素后，吸烟仍与糖尿病风险显著增加相关。戒烟的益处仅在戒烟5年后才显现出来，且只有在20年后风险才恢复到从不吸烟者的水平。从吸烟转为吸食烟斗或雪茄者的糖尿病风险仍与持续吸烟者的风险相当。在随访的前5年戒烟的男性体重显著增加，随后患糖尿病的风险高于持续吸烟者。
吸烟是2型糖尿病的一个独立且可改变的风险因素。戒烟与体重增加以及随后糖尿病风险增加有关，但从长期来看，戒烟的益处超过了早期体重增加的不利影响。
