吸烟和超重之间存在相互作用，会增加心境障碍门诊患者发生高血压、糖尿病和心血管疾病的风险。
Presence of an interaction between smoking and being overweight increases risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders.
机构信息
Division of Education Support and Education for Community Medicine, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
出版信息
Environ Health Prev Med. 2012 Jul;17(4):285-91. doi: 10.1007/s12199-011-0250-x. Epub 2011 Nov 8.
OBJECTIVE
We aimed to evaluate the hypothesis that the presence of an interaction between smoking and being overweight increases the risks of lifestyle-related diseases (hypertension, diabetes mellitus, dyslipidemia, and cardiovascular disease) in outpatients with mood disorders.
METHODS
In this cross-sectional survey, using data from 213 outpatients with mood disorders (95 men, 118 women), we calculated the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for each of hypertension, diabetes, dyslipedemia, and cardiovascular disease, using a binary logistic regression model; we then calculated the adjusted OR values for smokers and non-smokers with body mass indexes (BMIs) of <25 or ≥25 kg/m². Next, we examined the data for the presence of an interaction between smoking and being overweight, using three measures of additive interaction: relative excess risk due to the interaction (RERI), attributable proportion due to the interaction (AP), and the synergy index (S).
RESULTS
Smokers with BMI <25 kg/m² had a significantly lower risk of hypertension (OR 0.27, 95% CI 0.09-0.81) than non-smokers with BMI <25 kg/m² (reference group). Compared with the reference group, overweight non-smokers had a significantly higher risk (2.82, 1.34-6.19) of hypertension, and overweight smokers had a higher risk (4.43, 1.28-15.26) of hypertension and very high risks of diabetes (8.24, 2.47-27.42) and cardiovascular disease (13.12, 1.95-88.41). The highest RERI was derived from the relation with cardiovascular disease. The highest AP and S were derived from the relation with type 2 diabetes. There was no interaction of smoking and being overweight with dyslipidemia.
CONCLUSION
The presence of an interaction between smoking and being overweight exacerbates the risks of hypertension, diabetes, and cardiovascular disease in outpatients with mood disorders.
目的
我们旨在评估以下假设，即吸烟与超重之间存在相互作用会增加心境障碍门诊患者发生与生活方式相关疾病（高血压、糖尿病、血脂异常和心血管疾病）的风险。
方法
在这项横断面调查中，我们使用来自 213 名心境障碍门诊患者（95 名男性，118 名女性）的数据，使用二元逻辑回归模型计算了高血压、糖尿病、血脂异常和心血管疾病的调整后比值比（OR）及其 95%置信区间（CI）；然后，我们计算了 BMI＜25kg/m²的吸烟者和非吸烟者的调整后 OR 值。接下来，我们使用三种相加交互作用的度量标准（交互作用归因超额危险度（RERI）、交互作用归因比例（AP）和协同指数（S））来检查吸烟与超重之间是否存在交互作用的数据。
结果
与 BMI＜25kg/m²的非吸烟者相比，BMI＜25kg/m²的吸烟者发生高血压的风险显著降低（OR 0.27，95%CI 0.09-0.81）。与参考组相比，超重非吸烟者发生高血压的风险显著升高（2.82，1.34-6.19），超重吸烟者发生高血压的风险更高（4.43，1.28-15.26），且发生糖尿病（8.24，2.47-27.42）和心血管疾病（13.12，1.95-88.41）的风险极高。最高的 RERI 来自于与心血管疾病的关系。最高的 AP 和 S 来自于与 2 型糖尿病的关系。吸烟与超重与血脂异常之间没有相互作用。
结论
吸烟与超重之间的相互作用会加剧心境障碍门诊患者高血压、糖尿病和心血管疾病的风险。
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