Magis D, Geronooz I, Scheen A J
Service de Diabétologie, Nutrition et Maladies métaboliques, Département de Médecine, Université de Liège.
Rev Med Liege. 2002 Sep;57(9):575-81.
Smoking is a major risk factor for cardiovascular disease. It is associated with endothelial dysfunction and lipid disorders similar to those found in the insulin resistance syndrome. Studies have thus tried to demonstrate a relationship between smoking and insulin resistance, and between smoking and type 2 diabetes mellitus. Even if their results may sometimes differ, smoking does seem to be associated with an impaired insulin sensitivity that is proportional to tobacco consumption. Nicotine replacement therapies seem also to generate a certain, though lower, degree of insulin resistance. If there is no major weight gain after smoking cessation, the latter is accompanied by a progressive return to normal insulin sensitivity. Several large epidemiological studies recently demonstrated that smoking could increase the risk of type 2 diabetes mellitus, with a relative risk between 1.5 and 3.0. Finally, among type 2 diabetic patients, smoking has a harmful effect on metabolic control and long-term complications of the disease, at least partially by increasing the components of the insulin resistance syndrome. All these observations represent further argument to promote smoking cessation in the general population, and more particularly in individuals at risk to develop type 2 diabetes, as well as in the diabetic population.
吸烟是心血管疾病的主要危险因素。它与内皮功能障碍和脂质紊乱有关，类似于胰岛素抵抗综合征中的情况。因此，研究试图证明吸烟与胰岛素抵抗之间的关系，以及吸烟与2型糖尿病之间的关系。即使研究结果有时可能不同，但吸烟似乎确实与胰岛素敏感性受损有关，且这种受损程度与烟草消费量成正比。尼古丁替代疗法似乎也会产生一定程度的胰岛素抵抗，尽管程度较低。如果戒烟后体重没有大幅增加，那么戒烟会伴随着胰岛素敏感性逐渐恢复正常。最近几项大型流行病学研究表明，吸烟会增加2型糖尿病的风险，相对风险在1.5至3.0之间。最后，在2型糖尿病患者中，吸烟对疾病的代谢控制和长期并发症有有害影响，至少部分是通过增加胰岛素抵抗综合征的组成部分来实现的。所有这些观察结果都进一步证明，应在普通人群中，尤其是在有患2型糖尿病风险的个体以及糖尿病患者中推广戒烟。
