Patja K, Jousilahti P, Hu G, Valle T, Qiao Q, Tuomilehto J
Department of Epidemiology and Health Promotion, National Public Health Institute, Helsinki, Finland. kristina.patja@anang
J Intern Med. 2005 Oct;258(4):356-62. doi: 10.1111/j.1365-2796.2005.01545.x.
To examine the association of cigarette smoking with the risk of type 2 diabetes and to find out whether the association is modified by obesity and physical activity.
A prospective study comprising 41,372 men and women aged 25--64 years without a history of diabetes, coronary heart disease or stroke at baseline. Data on incident cases of diabetes were ascertained through the nationwide Drug Register and the Hospital Discharge Register. During the mean follow-up of 21 years 2770 subjects were diagnosed with type 2 diabetes. The Cox proportional hazards model was used to estimate the effect of smoking and other factors on the risk of type 2 diabetes.
Smoking had a graded association with the risk type 2 diabetes, and it remained significant after controlling for age and major risk factors. The multifactorial-adjusted (age, study year, education, body mass index (BMI), systolic blood pressure, physical activity and coffee and alcohol drinking) hazard ratio was 1.22 [95% confidence interval (CI) 1.04--1.43] amongst men smoking less than 20 cigarettes per day and 1.57 (95% CI 1.34--1.84) amongst men smoking 20 cigarettes per day or more. In women the corresponding hazard ratios were 1.46 (95% CI 1.21--1.76) and 1.87 (95% CI 1.36--2.59) respectively. Smoking increased the risk of type 2 diabetes at all levels of BMI and physical activity.
Smoking is a risk factor for type 2 diabetes independently of BMI and physical activity. Prevention of smoking should be encouraged as a part of efforts to reduce the risk of type 2 diabetes, and it will result in other health benefits, too.
研究吸烟与2型糖尿病风险之间的关联，并探究这种关联是否会受到肥胖和体育活动的影响。
一项前瞻性研究，纳入了41372名年龄在25至64岁之间、基线时无糖尿病、冠心病或中风病史的男性和女性。通过全国药物登记册和医院出院登记册确定糖尿病发病病例的数据。在平均21年的随访期间，有2770名受试者被诊断为2型糖尿病。采用Cox比例风险模型来估计吸烟及其他因素对2型糖尿病风险的影响。
吸烟与2型糖尿病风险呈分级关联，在控制年龄和主要风险因素后，这种关联仍然显著。多因素调整（年龄、研究年份、教育程度、体重指数（BMI）、收缩压、体育活动以及咖啡和酒精摄入量）后的风险比在每天吸烟少于20支的男性中为1.22[95%置信区间（CI）1.04 - 1.43]，在每天吸烟20支或更多的男性中为1.57（95%CI 1.34 - 1.84）。在女性中，相应的风险比分别为1.46（95%CI 1.21 - 1.76）和1.87（95%CI 1.36 - 2.59）。在所有BMI和体育活动水平下，吸烟都会增加2型糖尿病的风险。
吸烟是2型糖尿病的一个风险因素，独立于BMI和体育活动。应鼓励预防吸烟，将其作为降低2型糖尿病风险努力的一部分，并且这也会带来其他健康益处。
