Coventry University, Faculty of Health and Life Sciences, Coventry, UK.
School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
Lancet Diabetes Endocrinol. 2015 Jun;3(6):423-430. doi: 10.1016/S2213-8587(15)00082-0. Epub 2015 Apr 29.
Smoking increases the risk of developing type 2 diabetes. However, several population studies also show a higher risk in people 3-5 years after smoking cessation than in continuing smokers. After 10-12 years the risk equates to that of never-smokers. Small cohort studies suggest diabetes control deteriorates temporarily during the first year after quitting. We examined whether or not quitting smoking was associated with altered diabetes control in a population study, for how long this association persisted, and whether or not this association was mediated by weight change.
We did a retrospective cohort study (Jan 1, 2005, to Dec 31, 2010) of adult smokers with type 2 diabetes using The Health Improvement Network (THIN), a large UK primary care database. We developed adjusted multilevel regression models to investigate the association between a quit event, smoking abstinence duration, change in HbA1c, and the mediating effect of weight change.
10 692 adult smokers with type 2 diabetes were included. 3131 (29%) quit smoking and remained abstinent for at least 1 year. After adjustment for potential confounders, HbA1c increased by 0·21% (95% CI 0·17-0·25; p<0·001; [2·34 mmol/mol (95% CI 1·91-2·77)]) within the first year after quitting. HbA1c decreased as abstinence continued and became comparable to that of continual smokers after 3 years. This increase in HbA1c was not mediated by weight change.
In type 2 diabetes, smoking cessation is associated with deterioration in glycaemic control that lasts for 3 years and is unrelated to weight gain. At a population level, this temporary rise could increase microvascular complications.
National Institute for Health Research School for Primary Care Research.
吸烟会增加患 2 型糖尿病的风险。然而，一些人群研究也表明，在戒烟后 3-5 年内，风险比继续吸烟者更高。10-12 年后，风险等同于从不吸烟者。小型队列研究表明，在戒烟后的第一年，糖尿病控制会暂时恶化。我们在一项人群研究中检查了戒烟是否与糖尿病控制的改变有关，这种关联持续了多长时间，以及这种关联是否通过体重变化来介导。
我们使用英国大型初级保健数据库——健康改善网络（THIN），对 2005 年 1 月 1 日至 2010 年 12 月 31 日期间患有 2 型糖尿病的成年吸烟者进行了回顾性队列研究。我们开发了调整后的多层次回归模型，以调查戒烟事件、吸烟持续时间、HbA1c 变化之间的关联，以及体重变化的中介作用。
共纳入 10692 名成年 2 型糖尿病吸烟者。3131 人（29%）戒烟并至少持续 1 年。在调整了潜在混杂因素后，戒烟后第一年 HbA1c 增加了 0.21%（95%CI 0.17-0.25；p<0.001；[2.34 mmol/mol（95%CI 1.91-2.77）]）。随着戒烟的继续，HbA1c 下降，并在 3 年后与持续吸烟者相当。这种 HbA1c 的升高与体重变化无关。
在 2 型糖尿病中，戒烟与血糖控制恶化有关，这种恶化持续 3 年，与体重增加无关。在人群层面上，这种暂时的上升可能会增加微血管并发症。
英国国家健康研究所初级保健研究学院。
