Luo Wenshu, Guo Zhirong, Wu Ming, Hao Chao, Zhou Zhengyuan, Yao Xingjuan
Changzhou Center for Disease Control and Prevention, Changzhou, Jiangsu 213022, China; Department of Public Health, Soochow University, Suzhou, Jiangsu 215123, China.
Department of Public Health, Soochow University, Suzhou, Jiangsu 215123, China.
Physiol Behav. 2015 Feb;139:240-3. doi: 10.1016/j.physbeh.2014.11.038. Epub 2014 Nov 18.
The aim of this study was to examine the independent and combined effects of current smoking and obesity on risk of type 2 diabetes (T2DM) in a Chinese cohort. We analyzed the data from a population-based prospective cohort of 3598 participants aged 35-74 years from Jiangsu, China. A Cox proportional hazards regression model was used to calculate the hazard ratio (HR) of T2DM and corresponding 95% confidence interval (CI), and to examine the interaction between current smoking and obesity on risk of T2DM. Compared with non-smokers, the hazard ratio of T2DM for current smokers was 4.16 (2.77-6.24). There was a significant interaction between current smoking and abdominal obesity on T2DM. RERI=2.84 (0.02-5.67), suggesting that there would be 2.84 relative excess risk due to the additive interaction; AP=0.48 (0.20-0.76), indicating that 48% of T2DM exposed to both risk factors was attributable to the additive interaction; and SI was 2.36 (1.15-4.87), suggesting that the risk of T2DM in obese smokers was 2.36 times as high as the sum of risks in the participants exposed to a single risk factor alone. We did not find a significant interaction between smoking and overall obesity on T2DM, but the incidence of T2DM in overall obese smokers was also highest. Both current smoking and abdominal obesity are strong risk factors of T2DM in the Chinese population. This study further demonstrates an additive interaction of current smoking and abdominal obesity on T2DM risk.
本研究旨在探讨在中国队列中，当前吸烟和肥胖对2型糖尿病（T2DM）风险的独立及联合影响。我们分析了来自中国江苏的3598名年龄在35 - 74岁的基于人群的前瞻性队列的数据。采用Cox比例风险回归模型计算T2DM的风险比（HR）及相应的95%置信区间（CI），并检验当前吸烟与肥胖对T2DM风险的交互作用。与不吸烟者相比，当前吸烟者患T2DM的风险比为4.16（2.77 - 6.24）。当前吸烟与腹型肥胖在T2DM方面存在显著交互作用。相对超额危险度（RERI）=2.84（0.02 - 5.67），表明由于相加交互作用会有2.84的相对超额风险；归因比例（AP）=0.48（0.20 - 0.76），表明暴露于两种危险因素的T2DM患者中有48%可归因于相加交互作用；协同指数（SI）为2.36（1.15 - 4.87），表明肥胖吸烟者患T2DM的风险是仅暴露于单一危险因素的参与者风险总和的2.36倍。我们未发现吸烟与全身肥胖在T2DM方面有显著交互作用，但全身肥胖吸烟者中T2DM的发病率也最高。当前吸烟和腹型肥胖都是中国人群中T2DM的强危险因素。本研究进一步证明了当前吸烟与腹型肥胖在T2DM风险上存在相加交互作用。
