CESP U1018, Inserm, 16 Avenue Paul Vaillant Couturier, 94807, Villejuif cedex, France.
Diabetologia. 2014 Jan;57(1):30-9. doi: 10.1007/s00125-013-3058-y. Epub 2013 Sep 25.
AIMS/HYPOTHESIS: The relationships between smoking and glycaemic variables have not been well explored. We compared HbA1c, fasting plasma glucose (FPG) and 2 h plasma glucose (2H-PG) in current, ex- and never-smokers.
This meta-analysis used individual data from 16,886 men and 18,539 women without known diabetes in 12 DETECT-2 consortium studies and in the French Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR) and Telecom studies. Means of three glycaemic variables in current, ex- and never-smokers were modelled by linear regression, with study as a random factor. The I (2) statistic was used to evaluate heterogeneity among studies.
HbA1c was 0.10% (95% CI 0.08, 0.12) (1.1 mmol/mol [0.9, 1.3]) higher in current smokers and 0.03% (0.01, 0.05) (0.3 mmol/mol [0.1, 0.5]) higher in ex-smokers, compared with never-smokers. For FPG, there was no significant difference between current and never-smokers (-0.004 mmol/l [-0.03, 0.02]) but FPG was higher in ex-smokers (0.12 mmol/l [0.09, 0.14]). In comparison with never-smokers, 2H-PG was lower (-0.44 mmol/l [-0.52, -0.37]) in current smokers, with no difference for ex-smokers (0.02 mmol/l [-0.06, 0.09]). There was a large and unexplained heterogeneity among studies, with I (2) always above 50%; I (2) was little changed after stratification by sex and adjustment for age and BMI. In this study population, current smokers had a prevalence of diabetes that was 1.30% higher as screened by HbA1c and 0.52% lower as screened by 2H-PG, in comparison with never-smokers.
CONCLUSION/INTERPRETATION: Across this heterogeneous group of studies, current smokers had a higher HbA1c and lower 2H-PG than never-smokers. This will affect the chances of smokers being diagnosed with diabetes.
目的/假设：吸烟与血糖变量之间的关系尚未得到充分探讨。我们比较了当前吸烟者、曾经吸烟者和从不吸烟者的糖化血红蛋白（HbA1c）、空腹血浆葡萄糖（FPG）和 2 小时血浆葡萄糖（2H-PG）。
本荟萃分析使用了来自 12 个 DETECT-2 联盟研究和法国流行病学胰岛素抵抗综合征研究（DESIR）及电信研究中 16886 名男性和 18539 名无已知糖尿病的女性的个体数据。采用线性回归模型，以研究为随机因素，对当前吸烟者、曾经吸烟者和从不吸烟者的三种血糖变量的平均值进行建模。采用 I²统计量评估研究间的异质性。
与从不吸烟者相比，当前吸烟者的 HbA1c 高 0.10%（95%CI 0.08，0.12）（1.1mmol/mol [0.9，1.3]），曾经吸烟者高 0.03%（0.01，0.05）（0.3mmol/mol [0.1，0.5]）。对于 FPG，当前吸烟者与从不吸烟者之间无显著差异（-0.004mmol/l [-0.03，0.02]），但曾经吸烟者的 FPG 较高（0.12mmol/l [0.09，0.14]）。与从不吸烟者相比，当前吸烟者的 2H-PG 较低（-0.44mmol/l [-0.52，-0.37]），而曾经吸烟者则无差异（0.02mmol/l [-0.06，0.09]）。研究间存在较大且无法解释的异质性，I²始终高于 50%；按性别分层和调整年龄及 BMI 后，I²变化不大。在该研究人群中，与从不吸烟者相比，当前吸烟者经 HbA1c 筛查的糖尿病患病率高 1.30%，经 2H-PG 筛查的糖尿病患病率低 0.52%。
结论/解释：在这个异质性研究群体中，当前吸烟者的 HbA1c 较高，2H-PG 较低，而从不吸烟者则相反。这将影响吸烟者被诊断为糖尿病的机会。
