Meisinger C, Döring A, Thorand B, Löwel H
GSF National Research Center for Environment and Health, Institute of Epidemiology, Neuherberg, Germany.
Diabetologia. 2006 Aug;49(8):1770-6. doi: 10.1007/s00125-006-0298-0. Epub 2006 May 19.
AIMS/HYPOTHESIS: We examined sex-specific associations between cigarette smoking and incident type 2 diabetes mellitus in Germany.
SUBJECTS, MATERIALS AND METHODS: The study was based on 5,470 men and 5,422 women (aged 25-74 years) without diabetes who participated in one of the three population-based MONICA Augsburg surveys between 1984 and 1995. Incident cases of type 2 diabetes were assessed using follow-up questionnaires. Hazard ratios (HRs) were estimated from Cox proportional hazard models.
Up to 31 December 2002 a total of 409 cases of incident type 2 diabetes among men and 263 among women were registered. The number of cigarettes and the nicotine and tar consumption per day were associated with a significantly increased risk of type 2 diabetes among men, but not among women; this could be due to the low power of the study in women. After multivariable adjustment, the HRs for type 2 diabetes compared with never-smokers were 1.48, 2.03 and 2.10 for men smoking 1 to 14, 15 to 19 and > or =20 cigarettes/day (p for trend <0.0001) and 1.25, 1.34 and 1.37 for women smoking 1 to 9, 10 to 19 and > or =20 cigarettes/day (p for trend 0.0985). Compared with never-smokers, the HRs for increasing tar intake in men (1-167, 168-259 and > or =260 mg/day) were 1.45, 2.32 and 2.07 (p for trend <0.0001); the respective HRs in women (1-89, 90-194 and > or =195 mg/day) were 1.18, 1.57 and 1.24 (p for trend 0.1159).
CONCLUSIONS/INTERPRETATION: Cigarette smoking is an important modifiable risk factor of type 2 diabetes particularly in men from the general population.
目的/假设：我们研究了德国吸烟与2型糖尿病发病之间的性别特异性关联。
对象、材料与方法：该研究基于1984年至1995年间参加奥格斯堡三项基于人群的莫妮卡（MONICA）调查之一的5470名男性和5422名女性（年龄25 - 74岁），这些人均无糖尿病。使用随访问卷评估2型糖尿病的发病病例。通过Cox比例风险模型估计风险比（HRs）。
截至2002年12月31日，共登记了409例男性和263例女性2型糖尿病发病病例。男性每天吸烟数量、尼古丁和焦油摄入量与2型糖尿病风险显著增加相关，而女性则不然；这可能是由于该研究中女性样本量不足。多变量调整后，男性每天吸烟1至14支、15至19支和≥20支者与从不吸烟者相比，2型糖尿病的HR分别为1.48、2.03和2.10（趋势p值<0.0001），女性每天吸烟1至9支、10至19支和≥20支者的HR分别为1.25、1.34和1.37（趋势p值0.0985）。与从不吸烟者相比，男性焦油摄入量增加（每天1 - 167毫克、168 - 259毫克和≥260毫克）的HR分别为1.45、2.32和2.07（趋势p值<0.0001）；女性相应的HR（每天1 - 89毫克、90 - 194毫克和≥195毫克）分别为1.18、1.57和1.24（趋势p值0.1159）。
结论/解读：吸烟是2型糖尿病的一个重要可改变风险因素，尤其在普通人群中的男性中。
