Nagaya Teruo, Yoshida Hideyo, Takahashi Hidekatsu, Kawai Makoto
Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan.
Ann Epidemiol. 2008 Feb;18(2):113-8. doi: 10.1016/j.annepidem.2007.07.107.
To investigate interactive effects of cigarette smoking and body mass index (BMI, measured in kilograms per square meter) on the risk for type 2 diabetes mellitus (DM).
We conducted a follow-up study in 16,829 apparently healthy men 30 to 59 years of age. At baseline, 23.1%, 24.6%, 24.0%, and 28.4% of the men were 'never' smokers, ex-smokers, light smokers (<or=20 cigarettes/d), and heavy smokers (>20 cigarettes/d), respectively. BMI was expediently categorized into quartiles (Q1: <21.3; Q2: 21.3-22.9; Q3: 23.0-24.7; and Q4: >24.7 kg/m2). Incident DM was identified by a fasting serum glucose level of 7.00 mmol/L or higher or the criterion 'under treatment for DM.' The risk ratio for incident DM, hazard ratio (HR) and the 95% confidence interval (CI), according to smoking and BMI, were estimated by using Cox proportional hazard models. Age, drinking, exercise, and education were computed as confounders.
During mean follow-up of 7.4 years, 869 men developed DM. In Q4 of BMI, heavy smoking raised the risk against 'never smoking' (multivariate-adjusted HR (95%CI): 1.37 [1.05-1.80]), but neither light smoking nor ex-smoking did. In Q1 of BMI, light and heavy smoking reduced the risk (multivariate-adjusted HR (95% CI): 0.45 (0.23-0.88) and 0.74 (0.41-1.33), respectively).
Smoking and BMI interactively influence risk for DM and the interaction is considerably complex. Heavy smoking moderately increases the risk for DM in obese men. But, light smoking reduces the risk in lean men.
研究吸烟与体重指数（BMI，以每平方米千克数衡量）对2型糖尿病（DM）发病风险的交互作用。
我们对16829名30至59岁表面健康的男性进行了一项随访研究。在基线时，分别有23.1%、24.6%、24.0%和28.4%的男性为“从不”吸烟者、曾经吸烟者、轻度吸烟者（≤20支/天）和重度吸烟者（>20支/天）。BMI被方便地分为四分位数（Q1：<21.3；Q2：21.3 - 22.9；Q3：23.0 - 24.7；Q4：>24.7 kg/m²）。新发DM通过空腹血清葡萄糖水平≥7.00 mmol/L或“正在接受DM治疗”这一标准来确定。根据吸烟情况和BMI，使用Cox比例风险模型估计新发DM的风险比、风险比（HR）和95%置信区间（CI）。将年龄、饮酒、运动和教育程度作为混杂因素进行计算。
在平均7.4年的随访期间，869名男性患上了DM。在BMI的Q4中，重度吸烟增加了相对于“从不吸烟”的风险（多变量调整后的HR（95%CI）：1.37 [1.05 - 1.80]），但轻度吸烟和曾经吸烟则没有。在BMI的Q1中，轻度和重度吸烟均降低了风险（多变量调整后的HR（95%CI）分别为：0.45（0.23 - 0.88）和0.74（0.41 - 1.33））。
吸烟与BMI对DM风险存在交互影响，且这种交互作用相当复杂。重度吸烟适度增加肥胖男性患DM的风险。但是，轻度吸烟降低瘦男性患DM的风险。
