韩国男性2型糖尿病新发病例戒烟与全因死亡率及特定病因死亡率的关联：一项基于全国人群的队列研究
Association of smoking cessation after new-onset type 2 diabetes with overall and cause-specific mortality among Korean men: a nationwide population-based cohort study.
作者信息
Choi Jae Woo, Han Euna, Kim Tae Hyun
机构信息
College of Pharmacy, Yonsei University, Incheon, South Korea.
Graduate School of Public Health, Yonsei University, Seoul, South Korea
出版信息
BMJ Open Diabetes Res Care. 2020 Jul;8(1). doi: 10.1136/bmjdrc-2020-001249.
INTRODUCTION
This study aimed to examine the association between smoking cessation after new-onset type 2 diabetes and overall and cause-specific mortality risks among Korean men.
RESEARCH DESIGN AND METHODS
The Korean National Health Insurance Service-National Health Screening Cohort database was searched, and 13 377 Korean men aged ≥40 years diagnosed with new-onset type 2 diabetes between 2004 and 2007 were included and followed up until 2013. We defined smoking status changes by comparing participants' answers in the last survey before diagnosis to those in the first survey after diagnosis. We estimated the adjusted HR (AHR) and 95% CI for mortality risk using multivariable Cox proportional hazards regression models.
RESULTS
We identified 1014 all-cause mortality events (cancer, n=406 and cardiovascular disease (CVD), n=184) during an average follow-up duration of 7.2 years. After adjustment for all confounding factors, the reduced risk of all-cause mortality was more significant among short-term quitters (AHR 0.78; 95% CI 0.64 to 0.95), long-term quitters (AHR 0.68; 95% CI 0.54 to 0.85), and never smokers (AHR 0.66; 95% CI 0.56 to 0.78) compared with current smokers (p for trend <0.001). The lower risk of mortality from cancer was significant among the short-term quitters (AHR 0.60; 95% CI 0.44 to 0.83), long-term quitters (AHR 0.67; 95% CI 0.46 to 0.90), and never smokers (AHR 0.50; 95% CI 0.39 to 0.65) compared with current smokers (p for trend <0.001). There was no significant association between changes in smoking status and death from CVD. Smoking cessation after diagnosis in non-obese individuals (AHR 0.73; 95% CI 0.58 to 0.92) and exercisers (AHR 0.54; 95% CI 0.38 to 0.76) was significantly associated with reduced mortality risk than current smoking.
CONCLUSIONS
Smoking cessation after new-onset type 2 diabetes was associated with reduced mortality risk.
引言
本研究旨在探讨韩国男性2型糖尿病新发病例后戒烟与全因死亡率及特定病因死亡率风险之间的关联。
研究设计与方法
检索韩国国民健康保险服务-国民健康筛查队列数据库，纳入2004年至2007年间确诊为2型糖尿病新发病例的13377名年龄≥40岁的韩国男性，并随访至2013年。我们通过比较参与者在诊断前最后一次调查与诊断后第一次调查的回答来定义吸烟状态变化。我们使用多变量Cox比例风险回归模型估计死亡率风险的调整后风险比（AHR）和95%置信区间。
结果
在平均7.2年的随访期内，我们确定了1014例全因死亡事件（癌症，n = 406；心血管疾病（CVD），n = 184）。在对所有混杂因素进行调整后，与当前吸烟者相比，短期戒烟者（AHR 0.78；95%置信区间0.64至0.95）、长期戒烟者（AHR 0.68；95%置信区间0.54至0.85）和从不吸烟者（AHR 0.66；95%置信区间0.56至0.78）的全因死亡风险降低更为显著（趋势p<0.001）。与当前吸烟者相比，短期戒烟者（AHR 0.60；95%置信区间0.44至0.83）、长期戒烟者（AHR 0.67；95%置信区间0.46至0.90）和从不吸烟者（AHR 0.50；95%置信区间0.39至0.65）的癌症死亡风险较低，差异显著（趋势p<0.001）。吸烟状态变化与CVD死亡之间无显著关联。非肥胖个体（AHR 0.73；95%置信区间0.58至0.92）和运动者（AHR 0.54；95%置信区间0.38至0.76）诊断后戒烟与当前吸烟相比，死亡风险显著降低。
结论
2型糖尿病新发病例后戒烟与死亡风险降低相关。
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