Department of Epidemiology and Health Promotion and Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea.
Diabetes Care. 2010 Dec;33(12):2567-72. doi: 10.2337/dc10-0261. Epub 2010 Sep 7.
Mounting evidence suggests that smoking is a cause of type 2 diabetes. We explored the association of cigarette smoking with diabetes incidence and mortality in a large cohort of Koreans.
A 14-year prospective cohort study was performed on 1,236,443 Korean men and women, aged 30-95 years at baseline, who underwent standardized biennial medical examinations provided by the National Health Insurance Corporation (NHIC). Incident diabetes was identified on the basis of outpatient visits, hospitalization, or prescription medication treatment for diabetes, as captured in the NHIC database. Diabetes mortality was obtained through the national statistical office. Cox proportional hazards models were used to investigate associations of smoking with indicators of diabetes and diabetes mortality.
Smoking was significantly associated with increased risk for diabetic outpatient treatment, hospitalization, and mortality among both men and women, and the risk among current smokers increased modestly with the number of cigarettes smoked daily (P(trend) < 0.0001 for all associations). Compared with never smokers, current male smokers who smoked ≥ 20 cigarettes/day had increased risk for incident diabetes defined by outpatient treatment (adjusted hazard ratio 1.55 [1.51-1.60]), incident diabetes defined by ≥ 3 prescription medications for diabetes (1.71 [1.63-1.80]), and death from diabetes (1.60 [1.25-2.06]). The risks for outpatient treatment among smokers were higher in men than in women with evidence for effect modification by sex and age (P(interaction) < 0.0001).
Our study provides longitudinal evidence that smoking increases the risk of incident diabetes and mortality.
越来越多的证据表明，吸烟是 2 型糖尿病的一个病因。我们在一个大型韩国队列中研究了吸烟与糖尿病发病率和死亡率之间的关系。
对基线时年龄为 30-95 岁的 1,236,443 名韩国男女进行了一项为期 14 年的前瞻性队列研究，他们接受了国家健康保险公司（NHIC）提供的标准化两年一次的医学检查。根据 NHIC 数据库中记录的门诊就诊、住院或糖尿病处方药治疗情况，确定新发糖尿病。通过国家统计局获得糖尿病死亡率。使用 Cox 比例风险模型来研究吸烟与糖尿病及糖尿病死亡率指标之间的关系。
吸烟与男女糖尿病门诊治疗、住院和死亡风险显著相关，且当前吸烟者的风险随着每日吸烟量的增加而略有增加（所有关联的 P(trend) < 0.0001）。与从不吸烟者相比，目前每天吸烟≥20 支的男性吸烟者发生门诊治疗定义的新发糖尿病的风险增加（校正后的危害比 1.55 [1.51-1.60]）、≥3 种糖尿病处方药定义的新发糖尿病（1.71 [1.63-1.80]）和死于糖尿病（1.60 [1.25-2.06]）的风险增加。在男性中，吸烟者的门诊治疗风险高于女性，且存在性别和年龄的交互作用（P(交互) < 0.0001）。
我们的研究提供了纵向证据，表明吸烟增加了发生糖尿病和死亡的风险。
