Wada Takashi, Urashima Mitsuyoshi, Fukumoto Tsutomu
Health-care Center, Shimbashi Medical Check-up Office, Tokyo.
Intern Med. 2007;46(14):1079-82. doi: 10.2169/internalmedicine.46.0026. Epub 2007 Jul 17.
Metabolic syndrome (MetS) develop by accumulation of excess central obesity occurring insulin resistance. In 2005, the Japanese Society of Internal Medicine, in collaboration with seven other Japanese societies defined the diagnostic criterion for Japan-specific MetS. Smoking also causes insulin resistance to develop. To clarify whether smoking is correlated with MetS and how long MetS remains after smoking cessation we undertook a retrospective study.
The subjects comprised of 22,892 Japanese who visited the Health-Care Center at Jikei University Hospital in Tokyo for medical check-ups. The participants completed a simple, self-administered questionnaire on their lifestyle including smoking information. MetS was diagnosed with the above criterion. The odds ratio (OR) with a 95% confidential interval (95%CI) of MetS was calculated using multiple logistic regression analysis adjusted by age and gender.
Compared with never smokers (n=9,434: 41%), the odds ratio (95% CI) of MetS onset for current smokers (n=7,634: 33%) and past smokers (n=5,824: 25%) were 1.20 (1.07-1.35) and 1.21 (1.08-1.37). In the current smokers, the odds ratio of MetS increased with the smoking number, and it significantly occurred by smoking > or = 20 cigarettes per day. After quitting, the longer cessation period is related to the lesser chance of developing of MetS. But, MetS remained for at least 10 years and over in the subjects who smoked 20 or more cigarettes per day, and for over 20 years in the subjects who smoked 40 cigarettes and more.
Not only current smoking habits but also past smoking may contribute to the occurrence of MetS.
代谢综合征(MetS)是由过量的中心性肥胖积累导致胰岛素抵抗而发展形成的。2005年,日本内科医学会与其他七个日本学会合作,定义了日本特定的MetS诊断标准。吸烟也会导致胰岛素抵抗的发展。为了阐明吸烟是否与MetS相关,以及戒烟后MetS会持续多久,我们进行了一项回顾性研究。
研究对象包括22892名前往东京慈惠会医科大学医院保健中心进行体检的日本人。参与者完成了一份关于他们生活方式的简单自填问卷,包括吸烟信息。根据上述标准诊断MetS。使用经年龄和性别调整的多元逻辑回归分析计算MetS的比值比(OR)及95%置信区间(95%CI)。
与从不吸烟者(n = 9434:41%)相比,当前吸烟者(n = 7634:33%)和既往吸烟者(n = 5824:25%)发生MetS的比值比(95%CI)分别为1.20(1.07 - 1.35)和1.21(1.08 - 1.37)。在当前吸烟者中,MetS的比值比随吸烟量增加而升高,每天吸烟≥20支时显著升高。戒烟后,戒烟时间越长,发生MetS的几率越小。但是,每天吸烟20支及以上的受试者中,MetS至少持续10年以上,每天吸烟40支及以上的受试者中,MetS持续超过20年。
不仅当前吸烟习惯,既往吸烟也可能导致MetS的发生。