Stein James H, Asthana Asha, Smith Stevens S, Piper Megan E, Loh Wei-Yin, Fiore Michael C, Baker Timothy B
Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States of America.
PLoS One. 2014 Jun 3;9(6):e98278. doi: 10.1371/journal.pone.0098278. eCollection 2014.
Weight gain after smoking cessation may increase diabetes mellitus and impaired fasting glucose (IFG) risk. This study evaluated associations between smoking cessation and continued smoking with incident diabetes and IFG three years after a quit attempt. The 1504 smokers (58% female) were mean (standard deviation) 44.7 (11.1) years old and smoked 21.4 (8.9) cigarettes/day. Of 914 participants with year 3 data, the 238 abstainers had greater weight gain, increase in waist circumference, and increase in fasting glucose levels than the 676 continuing smokers (p ≤ 0.008). In univariate analyses, Year 3 abstinence was associated with incident diabetes (OR = 2.60, 95% CI 1.44-4.67, p = .002; 4.3% absolute excess) and IFG (OR = 2.43, 95% CI 1.74-3.41, p<0.0001; 15.6% absolute excess). In multivariate analyses, incident diabetes was associated independently with older age (p = 0.0002), higher baseline body weight (p = 0.021), weight gain (p = 0.023), baseline smoking rate (p = 0.008), baseline IFG (p<0.0001), and baseline hemoglobin A1C (all p<0.0001). Smoking more at baseline predicted incident diabetes among eventual abstainers (p<0.0001); weighing more at baseline predicted incident diabetes among continuing smokers (p = 0.0004). Quitting smoking is associated with increased diabetes and IFG risk. Independent risk factors include older age, baseline body weight, baseline glycemic status, and heavier pre-quit smoking. These findings may help target smokers for interventions to prevent dysglycemia.
Clinicaltrials.gov NCT00332644.
戒烟后体重增加可能会增加患糖尿病和空腹血糖受损（IFG）的风险。本研究评估了戒烟与继续吸烟与戒烟尝试三年后新发糖尿病和IFG之间的关联。1504名吸烟者（58%为女性）的平均（标准差）年龄为44.7（11.1）岁，每天吸烟21.4（8.9）支。在914名有第3年数据的参与者中，238名戒烟者比676名继续吸烟者体重增加更多、腰围增加更多、空腹血糖水平升高更多（p≤0.008）。在单因素分析中，第3年戒烟与新发糖尿病（OR = 2.60，95%CI 1.44 - 4.67，p = 0.002；绝对超额风险4.3%）和IFG（OR = 2.43，95%CI 1.74 - 3.41，p<0.0001；绝对超额风险15.6%）相关。在多因素分析中，新发糖尿病独立与年龄较大（p = 0.0002）、基线体重较高（p = 0.021）、体重增加（p = 0.023）、基线吸烟率（p = 0.008）、基线IFG（p<0.0001）和基线糖化血红蛋白（所有p<0.0001）相关。基线时吸烟更多可预测最终戒烟者发生糖尿病（p<0.0001）；基线时体重更重可预测继续吸烟者发生糖尿病（p = 0.0004）。戒烟与糖尿病和IFG风险增加相关。独立危险因素包括年龄较大、基线体重、基线血糖状态和戒烟前吸烟量较大。这些发现可能有助于针对吸烟者进行干预以预防血糖异常。
Clinicaltrials.gov NCT00332644。
