Su J, Qin Y, Shen C, Gao Y, Pan E C, Pan X Q, Tao R, Zhang Y Q, Wu M
School of Public Health, Southeast University, Nanjing 210096, China; Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2017 Nov 10;38(11):1454-1459. doi: 10.3760/cma.j.issn.0254-6450.2017.11.003.
To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. From December 2013 to January 2014, a total of 7 763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai'an and Qinghe districts of Huai'an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. The prevalence of current smoking was 45.5% in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers (<0.001). Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% (95: 0.05%-0.49%) and 0.38% (95: 0.23%-0.53%), respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers (<0.05). Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.
探讨吸烟及戒烟与男性2型糖尿病患者血糖控制的关系。2013年12月至2014年1月，通过整群抽样的方法，选取了江苏省苏州市常熟市、淮安市淮安区及清河区接受国家基本公共卫生服务的7763例男性2型糖尿病患者。进行问卷调查和人体测量，并检测空腹血糖（FPG）和糖化血红蛋白（HbA1c）水平。采用多重线性回归模型评估吸烟及戒烟与血糖控制的关系。男性2型糖尿病患者当前吸烟率为45.5%。与不吸烟者相比，FPG和HbA1c水平随每日吸烟量的增加而升高（<0.001）。在接受药物治疗的患者中，吸烟持续时间≥30年且吸烟指数≥40包年的当前吸烟者，HbA1c水平平均升高分别为0.27%（95%：0.05%-0.49%）和0.38%（95%：0.23%-0.53%）。既往吸烟者的FPG和HbA1c水平随戒烟年限明显下降（<0.05）。在未接受药物治疗的患者中，未观察到吸烟持续时间、戒烟年限与FPG和HbA1c水平之间的剂量反应关系。吸烟与男性2型糖尿病患者的血糖控制呈负相关，尤其是在接受药物治疗的患者中。戒烟可能有利于血糖控制。应尽早鼓励糖尿病患者戒烟。
