高强度吸烟与黑人群体中糖尿病发病的相关性：杰克逊心脏研究。
High-Intensity Cigarette Smoking Is Associated With Incident Diabetes Mellitus In Black Adults: The Jackson Heart Study.
机构信息
Tougaloo College, Tougaloo, MS.
Department of Data Sciences, University of Mississippi Medical Center, Jackson, MS.
出版信息
J Am Heart Assoc. 2018 Jan 12;7(2):e007413. doi: 10.1161/JAHA.117.007413.
BACKGROUND
Previous reports on whether smoking is associated with insulin resistance and diabetes mellitus have yielded inconsistent findings. We aimed to evaluate the relationship between cigarette smoking and incident diabetes mellitus in the Jackson Heart Study.
METHODS AND RESULTS
Jackson Heart Study participants enrolled at baseline without prevalent diabetes mellitus (n=2991) were classified by self-report as current smokers, past smokers (smoked ≥400 cigarettes/life and no longer smoking), or never smokers. We quantified smoking intensity by number of cigarettes smoked daily; we considered ≥20 cigarettes per day (1 pack) "high-intensity." We defined diabetes mellitus as fasting glucose ≥126 mg/dL, hemoglobin A1c ≥6.5% or International Federation of Clinical Chemistry units HbA1c 48 mmol/mol, or use of diabetes mellitus medication. We estimated the adjusted associations of smoking status, intensity, and dose (pack-years) with incident diabetes mellitus using Poisson regression models. At baseline there were 361 baseline current (1-10 cigarettes per day [n=242]; ≥20 [n=119]), 502 past, and 2128 never smokers. From Visit 1 to Visit 3 (mean 8.0±0.9 years), 479 participants developed incident diabetes mellitus. After adjustment for covariates, baseline current smokers who smoked less than a pack/d and past smokers had similar rates of incident diabetes mellitus compared with never smokers (incidence rate ratios 1.04, 95% confidence interval, 0.69-1.58 and 1.08, 95% confidence interval, 0.82-1.42, respectively). Baseline current high-intensity smokers had a 79% (95% confidence interval, 1.14-2.81) higher incidence of diabetes mellitus compared with never smokers. Smoking dose (per 10 pack-years) was also associated with a higher incidence of diabetes mellitus (incidence rate ratios 1.10, 95% confidence interval, 1.03-1.19) in adjusted models.
CONCLUSIONS
High-intensity cigarette smoking and smoking pack-years are associated with an increased risk of developing diabetes mellitus in blacks.
背景
先前关于吸烟是否与胰岛素抵抗和糖尿病有关的报告得出的结论并不一致。我们旨在评估在 Jackson Heart 研究中，吸烟与新发糖尿病之间的关系。
方法和结果
在基线时没有患糖尿病的 Jackson Heart 研究参与者（n=2991），根据自我报告分为当前吸烟者、曾经吸烟者（吸烟≥400 支/生命且不再吸烟）或从不吸烟者。我们通过每天吸烟的支数来量化吸烟强度；我们认为每天吸烟≥20 支（1 包）为“高强度”。我们将糖尿病定义为空腹血糖≥126mg/dL、血红蛋白 A1c≥6.5%或国际临床化学联合会单位 HbA1c≥48mmol/mol，或使用糖尿病药物。我们使用泊松回归模型估计吸烟状况、强度和剂量（包年）与新发糖尿病之间的调整关联。基线时有 361 名当前吸烟者（每天 1-10 支[ n=242]；≥20 支[ n=119]）、502 名曾经吸烟者和 2128 名从不吸烟者。从第 1 次访视到第 3 次访视（平均 8.0±0.9 年），有 479 名参与者发生了新发糖尿病。调整协变量后，每天吸烟量小于 1 包的当前吸烟者和曾经吸烟者与从不吸烟者相比，新发糖尿病的发生率相似（发生率比 1.04，95%置信区间 0.69-1.58 和 1.08，95%置信区间 0.82-1.42）。基线时高强度当前吸烟者发生糖尿病的风险比从不吸烟者高 79%（95%置信区间 1.14-2.81）。吸烟剂量（每 10 包年）也与调整模型中糖尿病发病率的升高相关（发生率比 1.10，95%置信区间 1.03-1.19）。
结论
高强度吸烟和吸烟包年与黑人发生糖尿病的风险增加有关。
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