Gupta D, Singh A D, Agarwal R, Aggarwal A N, Joshi K, Jindal S K
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Sarcoidosis Vasc Diffuse Lung Dis. 2010 Jul;27(1):19-26.
While tobacco smoking is commonly believed to be negatively associated with the occurrence of sarcoidosis, the relationship of environmental tobacco smoke (ETS) exposure with sarcoidosis is largely un-explored. We studied the impact of active smoking and ETS exposure on disease severity in newly diagnosed cases of sarcoidosis from India.
Data on demographic variables, smoking habits and exposure to environmental tobacco smoke (ETS) among non-smoker sarcoidosis patients was collected prospectively. Presence of smoking and ETS exposure were compared among cases and controls. Among the sarcoidosis patients, clinical manifestations, radiology, spirometry and histopathological grading of lung biopsy were compared between the smokers vs. non-smokers and ETS exposed vs. not-exposed.
We studied 98 newly diagnosed cases of sarcoidosis and 196 age, sex and religion- matched healthy volunteers. The study group comprised of 62 (63%) men and 36 (37%) women. The prevalence of smoking was similar in cases and controls (12.2% vs. 15.3%, p = 0.48). Among the never smoker patients with sarcoidosis, 20 (23%) reported ETS exposure vis-a-vis 57 (34%) in the matched controls. A conditional logistic regression analyses showed insignificant negative association with active smoking (OR 0.75; 95% CI, 0.35-1.56) or ETS exposure (OR 0.58; 95% CI, 0.32-1.06) after adjusting for age, gender, religion, and education. There were no differences in the clinical manifestations, radiological staging, spirometry and histopathological grading of lung biopsy in any of the group comparisons studied.
Smoking or ETS exposure may not have significant negative association with sarcoidosis. Also, tobacco smoke might not have any effect on the clinical behavior or disease severity in sarcoidosis. The belief that smoking is protective for sarcoidosis is not substantiated in this study and appears to be misfounded.
虽然普遍认为吸烟与结节病的发生呈负相关，但环境烟草烟雾（ETS）暴露与结节病的关系在很大程度上尚未得到探索。我们研究了主动吸烟和ETS暴露对印度新诊断结节病病例疾病严重程度的影响。
前瞻性收集非吸烟结节病患者的人口统计学变量、吸烟习惯和环境烟草烟雾（ETS）暴露数据。比较病例组和对照组中吸烟和ETS暴露的情况。在结节病患者中，比较吸烟者与非吸烟者以及ETS暴露者与未暴露者之间的临床表现、放射学、肺功能测定和肺活检的组织病理学分级。
我们研究了98例新诊断的结节病病例和196名年龄、性别和宗教匹配的健康志愿者。研究组包括62名（63%）男性和36名（37%）女性。病例组和对照组的吸烟率相似（12.2%对15.3%，p = 0.48）。在从不吸烟的结节病患者中，20名（23%）报告有ETS暴露，而匹配对照组中有57名（34%）。在调整年龄、性别、宗教和教育因素后，条件逻辑回归分析显示主动吸烟（OR 0.75；95% CI，0.35 - 1.56）或ETS暴露（OR 0.58；95% CI，0.32 - 1.06）与疾病的负相关不显著。在所研究的任何组间比较中，临床表现、放射学分期、肺功能测定和肺活检的组织病理学分级均无差异。
吸烟或ETS暴露可能与结节病无显著负相关。此外，烟草烟雾可能对结节病的临床行为或疾病严重程度没有任何影响。本研究未证实吸烟对结节病有保护作用这一观点，且该观点似乎是错误的。
