Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Diabetes. 2019 May;11(5):402-409. doi: 10.1111/1753-0407.12868. Epub 2018 Nov 11.
The relationship of cotinine-verified vs self-reported smoking status with the incidence of metabolic syndrome (MetS) is not known. This study investigated the effect of urinary cotinine-verified vs self-reported smoking status on incident MetS.
In all, 47 379 participants without MetS enrolled in the Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study between 2011 and 2012 (baseline) were included in this study and followed-up in 2014; median follow-up duration was 25 months. Cotinine-verified current smoking was defined as urinary cotinine concentrations >50 ng/mL. According to cotinine-verified smoking status at baseline and follow-up, individuals were divided into four groups: never, new, former, and sustained smokers.
The incidence of MetS in the never, former, new, and sustained smoking groups was 9.9%, 19.4%, 21.4%, and 18.7%, respectively. Multivariate Cox hazard regression analyses revealed that the relative risk (RR) for incident MetS in cotinine-verified former smokers was significantly increased compared with that in cotinine-verified never smokers (RR 1.27; 95% confidence interval [CI] 1.16-1.37), especially in individuals exhibiting weight gain (≥2 kg). These results were consistent with those of self-reported smoking status. Baseline cotinine-verified current smoking (RR 1.09; 95% CI 1.03-1.15) and self-reported former (RR 1.10; 95% CI 1.02-1.18) and current (RR 1.15; 95% CI 1.07-1.23) smoking were also significantly associated with incident MetS.
This large observational study showed that cotinine-verified and self-reported former smoking during follow-up increased the risk for incident MetS, especially in individuals exhibiting weight gain (≥2 kg). This suggests that weight control in former smokers would be very important to reduce the development of MetS.
目前尚不清楚可替宁验证的与自我报告的吸烟状况与代谢综合征（MetS）发病率之间的关系。本研究旨在探讨尿可替宁验证的与自我报告的吸烟状况对代谢综合征发病的影响。
本研究共纳入 2011 年至 2012 年期间参加健康研究（Kangbuk Samsung Health Study）和三星健康队列研究（Kangbuk Samsung Cohort Study）且无代谢综合征的 47379 名参与者。这些参与者在基线时进行了随访，中位随访时间为 25 个月。可替宁验证的当前吸烟定义为尿可替宁浓度＞50ng/ml。根据基线和随访时的可替宁验证的吸烟状况，将个体分为四组：从不、新、前和持续吸烟者。
从不、前、新和持续吸烟组的代谢综合征发生率分别为 9.9%、19.4%、21.4%和 18.7%。多变量 Cox 风险回归分析显示，与可替宁验证的从不吸烟者相比，可替宁验证的前吸烟者发生代谢综合征的相对风险（RR）显著增加（RR 1.27；95%置信区间 [CI] 1.16-1.37），尤其是体重增加（≥2kg）的患者。这些结果与自我报告的吸烟状况一致。基线可替宁验证的当前吸烟（RR 1.09；95% CI 1.03-1.15）和自我报告的前（RR 1.10；95% CI 1.02-1.18）和当前（RR 1.15；95% CI 1.07-1.23）吸烟也与代谢综合征的发生显著相关。
本大规模观察性研究表明，随访期间的可替宁验证的和自我报告的前吸烟会增加代谢综合征的发病风险，尤其是体重增加（≥2kg）的患者。这表明控制前吸烟者的体重对于降低代谢综合征的发生非常重要。
