Śliwińska-Mossoń Mariola, Milnerowicz Halina
Department of Biomedical and Environmental Analysis, Wrocław Medical University, Wrocław, Poland.
Diab Vasc Dis Res. 2017 Jul;14(4):265-276. doi: 10.1177/1479164117701876. Epub 2017 Apr 8.
Diabetes is one of the most common metabolic disorders and emerges secondary to an interaction between genetic, environmental and lifestyle factors. This work provides an overview of the impact of smoking on the development of vascular complications in this condition and also provides an overview of the potential role of smoking in predisposition to diabetes. There are many studies documenting the impact of smoking on health (not focused on patients with diabetes), suggesting that the health exposure in these individuals is at least comparable to that observed in the general population. Distinct studies of smoking in patients with diabetes have unambiguously confirmed an increased prevalence and a higher risk of early death associated with the development of macrovascular complications. Smoking is also associated with premature development of microvascular complications and may contribute to the pathogenesis of type 2 diabetes. It has been shown that smoking is a predictor of the progression of glucose intolerance at both the transition from normoglycaemia to impaired glucose tolerance status and the increased risk of developing diabetes. The mechanisms explaining the relationship between smoking and the development of diabetes are not fully understood, although a number of hypotheses have been put forward. Current evidence indicates that smoking cessation is not only important to prevent macrovascular complications in diabetes, but also has a role in limiting microvascular disease and may also facilitate glycaemic management in this condition.
糖尿病是最常见的代谢紊乱疾病之一，继发于遗传、环境和生活方式因素之间的相互作用。本文综述了吸烟对糖尿病患者血管并发症发生发展的影响，以及吸烟在糖尿病易感性中的潜在作用。有许多研究记录了吸烟对健康的影响（并非聚焦于糖尿病患者），表明这些个体的健康暴露至少与普通人群中观察到的相当。对糖尿病患者吸烟情况的不同研究明确证实，与大血管并发症的发生相关，其患病率增加且早死风险更高。吸烟还与微血管并发症的过早发生有关，并可能促成2型糖尿病的发病机制。研究表明，吸烟是从正常血糖过渡到糖耐量受损状态以及患糖尿病风险增加时糖耐量异常进展的预测指标。尽管已经提出了一些假说，但解释吸烟与糖尿病发生之间关系的机制尚未完全明确。目前的证据表明，戒烟不仅对预防糖尿病的大血管并发症很重要，而且在限制微血管疾病方面也有作用，还可能有助于这种情况下的血糖管理。
