School of Public Health, Southeast University, Nanjing, China.
Department of Chronic Non-communicable Disease Control, Wujin District Center for Disease Control and Prevention, Changzhou, China.
J Clin Hypertens (Greenwich). 2022 Oct;24(10):1276-1284. doi: 10.1111/jch.14557. Epub 2022 Aug 9.
Smoking is an important modifiable factor in the risk of type 2 diabetes. Type 2 diabetes and hypertension overlap in the population. The present study investigated effects of smoking on glucose metabolism under different blood pressure (BP) levels in occupational population. A smoking survey among occupational groups was conducted in 2018. The general linear model was used to analyze the differences of glucose metabolism indexes and BP indexes influenced by different smoking intensity (never 0, mild <10, moderate <20, heavy ≥20 pack-years). Odds ratios of developing diabetes and β-cell deficiency were analyzed by using logistic regression model. BP was further taken into account in the relationship between smoking and glucose metabolism. As a result, 1730 male workers aged 21 to 60 years were included in the analysis finally. Compared to never smokers, heavy smokers had significantly increased fasting plasma glucose. Moderate and above smokers had significantly increased glycosylated hemoglobin, decreased fasting plasma insulin and β-cell function, after adjustment for covariates. Further, smoking intensity was found to have a dose-dependent relationship with impaired β-cell function and diabetes. In conclusion, smoking has a positive dose-dependent relationship with β-cell deficiency and diabetes. Male smoking workers, especially the moderate or higher smoking, with high-normal and high BP levels are at high risk of abnormal glucose metabolism.
吸烟是 2 型糖尿病风险的一个重要可改变因素。2 型糖尿病和高血压在人群中存在重叠。本研究在职业人群中，调查了不同血压（BP）水平下吸烟对葡萄糖代谢的影响。2018 年对职业人群进行了吸烟调查。采用一般线性模型分析不同吸烟强度（从不 0、轻度<10、中度<20、重度≥20 包年）对葡萄糖代谢指标和 BP 指标的影响差异。采用 logistic 回归模型分析发生糖尿病和β细胞功能缺陷的比值比。进一步考虑了 BP 在吸烟与葡萄糖代谢之间的关系。结果，最终纳入了 1730 名年龄在 21 至 60 岁的男性工人。与从不吸烟者相比，重度吸烟者的空腹血糖明显升高。调整了协变量后，中重度及以上吸烟者的糖化血红蛋白明显升高，空腹胰岛素和β细胞功能降低。此外，吸烟强度与β细胞功能障碍和糖尿病呈剂量依赖性关系。总之，吸烟与β细胞功能障碍和糖尿病呈正相关剂量关系。男性吸烟工人，尤其是中重度吸烟者，血压处于正常高值和较高水平，其葡萄糖代谢异常的风险较高。
