Ishtiaque Iqra, Shafique Kashif, Ul-Haq Zia, Shaikh Abdul Rauf, Khan Naveed Ali, Memon Abdul Rauf, Mirza Saira Saeed, Ishtiaque Afra
University Medical and Dental College, Faisalabad, Pakistan.
School of Public Health, Dow University of Health Sciences, Karachi, Pakistan ; Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, United Kingdom.
PLoS One. 2014 Jan 17;9(1):e85652. doi: 10.1371/journal.pone.0085652. eCollection 2014.
Water-pipe (WP) smoking is on rise worldwide for the past few years, particularly among younger individuals. Growing evidence indicates that WP smoking is as harmful as cigarette smoking. To date, most of the research has focused on acute health effects of WP smoking, and evidence remains limited when it comes to chronic health effects in relation to long-term WP smoking. Therefore, the aim of this study was to examine the association between WP smoking and albuminuria in apparently healthy individuals. This analysis was conducted on data of a population-based cross-sectional study--the Urban Rural Chronic Diseases Study (URCDS). The study sample was recruited from three sites in Pakistan. Trained nurses carried out individual interviews and obtained the information on demographics, lifestyle factors, and past and current medical history. Measurements of complete blood count, lipid profile, fasting glucose level, and 24-hour albuminuria were also made by using blood and urine samples. Albumin excretion was classified into three categories using standard cut-offs: normal excretion, high-normal excretion and microalbuminuria. Multiple logistic regression models were used to examine the relationship between WP smoking and albuminuria. The final analysis included data from 1,626 health individuals, of which 829 (51.0%) were males and 797 (49.0%) females. Of 1,626 individuals, 267 (16.4%) were current WP smokers and 1,359 (83.6%) were non-WP smokers. WP smoking was significantly associated with high-normal albuminuria (OR = 2.33, 95% CI 1.68-3.22, p-value <0.001) and microalbuminuria (OR = 1.75, 95% CI 1.18-2.58, p-value 0.005) after adjustment for age, sex, BMI, social class, hypertension, and diabetes mellitus. WP smoking was significantly associated with high-normal albuminuria and microalbuminuria when analysis was stratified on hypertension and diabetes mellitus categories. WP smoking has a strong association with albuminuria in apparently healthy individuals. More research is warranted to evaluate the temporality of this association between WP smoking and albuminuria.
在过去几年里，水烟吸食在全球范围内呈上升趋势，尤其是在年轻人当中。越来越多的证据表明，吸食水烟与吸食香烟一样有害。迄今为止，大多数研究都集中在水烟吸食对健康的急性影响上，而对于长期吸食水烟的慢性健康影响，证据仍然有限。因此，本研究的目的是调查在看似健康的个体中，水烟吸食与蛋白尿之间的关联。该分析是基于一项基于人群的横断面研究——城乡慢性病研究（URCDS）的数据进行的。研究样本来自巴基斯坦的三个地点。经过培训的护士进行个人访谈，并获取有关人口统计学、生活方式因素以及过去和当前病史的信息。还通过采集血液和尿液样本对全血细胞计数、血脂谱、空腹血糖水平和24小时蛋白尿进行了测量。使用标准临界值将白蛋白排泄分为三类：正常排泄、高正常排泄和微量白蛋白尿。采用多元逻辑回归模型来研究水烟吸食与蛋白尿之间的关系。最终分析纳入了1626名健康个体的数据，其中829名（51.0%）为男性，797名（49.0%）为女性。在1626名个体中，267名（16.4%）为当前水烟吸食者，1359名（83.6%）为非水烟吸食者。在对年龄、性别、体重指数、社会阶层、高血压和糖尿病进行调整后，水烟吸食与高正常白蛋白尿（比值比=2.33，95%置信区间1.68 - 3.22，p值<0.001）和微量白蛋白尿（比值比=1.75，95%置信区间1.18 - 2.58，p值0.005）显著相关。当按高血压和糖尿病类别进行分层分析时，水烟吸食与高正常白蛋白尿和微量白蛋白尿显著相关。在看似健康的个体中，水烟吸食与蛋白尿有很强的关联。有必要进行更多研究来评估水烟吸食与蛋白尿之间这种关联的时间性。
