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韩国新诊断糖尿病患者中吸烟习惯改变对全因死亡率和心血管疾病的影响。

Effects of smoking habit change on all-cause mortality and cardiovascular diseases among patients with newly diagnosed diabetes in Korea.

机构信息

Department of Family Medicine, Seoul National University Hospital, Seoul, 03080, Republic of Korea.

Department of Family Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea.

出版信息

Sci Rep. 2018 Mar 28;8(1):5316. doi: 10.1038/s41598-018-23729-0.

Abstract

This study aimed to investigate the effects of smoking habit change on the risks of all-cause mortality and cardiovascular diseases (CVDs) among patients with newly diagnosed diabetes using the Korean National Sample Cohort data. Survival regression analyses for the risks of all-cause mortality and CVDs were performed. Quitters without body mass index (BMI) change (adjusted hazard ratio [aHR], 0.68; 95% confidence interval [CI], 0.46-1.00) and quitters with BMI loss (aHR, 1.76; 95% CI, 1.13-2.73) showed significantly reduced and substantially the increased risk of all-cause mortality, respectively, compared with sustained smokers. Smoking reduction after diabetes diagnosis may have potential positive effects. However, definite benefits on the health outcomes were not identified in this study. Participants who started smoking after diabetes diagnosis had higher risks of all-cause mortality and CVDs than those who were never smokers or ex-smokers, although not statistically significant. In conclusion, smoking cessation after diabetes diagnosis could reduce the risks of all-cause mortality and cardiovascular events among patients with newly diagnosed diabetes when accompanied by proper weight management. Therefore, physicians should advice patients with newly diagnosed type 2 diabetes on the importance of smoking cessation in combination with long-term weight management to maximize the benefits of smoking cessation.

摘要

本研究旨在利用韩国国家样本队列数据,探讨新诊断糖尿病患者吸烟习惯改变对全因死亡率和心血管疾病(CVDs)风险的影响。对全因死亡率和 CVDs 的风险进行生存回归分析。与持续吸烟者相比,不改变体重指数(BMI)的戒烟者(调整后的危险比[aHR],0.68;95%置信区间[CI],0.46-1.00)和 BMI 下降的戒烟者(aHR,1.76;95%CI,1.13-2.73)的全因死亡率风险显著降低且显著增加。与糖尿病诊断后开始吸烟的患者相比,无论是否有 BMI 变化,戒烟都可能对健康结果产生潜在的积极影响。然而,本研究并未确定对健康结果有明确的益处。与从不吸烟者或已戒烟者相比,糖尿病诊断后开始吸烟的参与者全因死亡率和 CVDs 的风险更高,但无统计学意义。总之,对于新诊断为糖尿病的患者,在适当的体重管理的同时戒烟可以降低全因死亡率和心血管事件的风险。因此,医生应该告知新诊断为 2 型糖尿病的患者戒烟的重要性,同时结合长期的体重管理,以最大限度地发挥戒烟的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aa39/5871763/9c98dbd05685/41598_2018_23729_Fig1_HTML.jpg

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