Leicester Real World Evidence Unit, Diabetes Research Centre, University of Leicester, Leicester, UK.
Department of Population Health Sciences, University of Leicester, Leicester, UK; Department of Community Health, University of Ghana Medical School, Accra, Ghana.
Prim Care Diabetes. 2024 Aug;18(4):414-421. doi: 10.1016/j.pcd.2024.04.004. Epub 2024 May 11.
Smoking is a major risk factor for type 2 diabetes (T2D), but the evidence has mostly relied on self-reports. We aimed to compare the associations of smoking exposure as assessed by self-reports and urine cotinine with T2D.
Using the PREVEND prospective study, smoking status was assessed at baseline by self-reports and urine cotinine in 4708 participants (mean age, 53 years) without a history of diabetes. Participants were classified as never, former, light current and heavy current smokers according to self-reports and analogous cut-offs for urine cotinine. Hazard ratios (HRs) with 95% CIs were estimated for T2D.
During a median follow-up of 7.3 years, 259 participants developed T2D. Compared with self-reported never smokers, the multivariable adjusted HRs (95% CI) of T2D for former, light current, and heavy current smokers were 1.02 (0.75-1.4), 1.41 (0.89-2.22), and 1.30 (0.88-1.93), respectively. The corresponding adjusted HRs (95% CI) were 0.84 (0.43-1.67), 1.61 (1.12-2.31), and 1.58 (1.08-2.32), respectively, as assessed by urine cotinine. Urine cotinine-assessed but not self-reported smoking status improved T2D risk prediction beyond established risk factors.
Urine cotinine assessed smoking status may be a stronger risk indicator and predictor of T2D compared to self-reported smoking status.
吸烟是 2 型糖尿病（T2D）的一个主要危险因素，但这些证据主要依赖于自我报告。我们旨在比较通过自我报告和尿液可替宁评估的吸烟暴露与 T2D 的相关性。
使用 PREVEND 前瞻性研究，在没有糖尿病病史的 4708 名参与者（平均年龄 53 岁）中，基线时通过自我报告和尿液可替宁评估吸烟状况。根据自我报告和尿液可替宁的类似截断值，参与者被分为从不、曾经、轻度和重度吸烟者。使用风险比（HR）及其 95%置信区间（CI）来估计 T2D 的发病率。
在中位随访 7.3 年期间，259 名参与者发生了 T2D。与自我报告的从不吸烟者相比，曾经、轻度和重度吸烟者发生 T2D 的多变量调整 HR（95%CI）分别为 1.02（0.75-1.4）、1.41（0.89-2.22）和 1.30（0.88-1.93）。相应的调整 HR（95%CI）分别为 0.84（0.43-1.67）、1.61（1.12-2.31）和 1.58（1.08-2.32），这些值均通过尿液可替宁来评估。尿液可替宁评估的但不是自我报告的吸烟状况，可改善 T2D 风险预测，优于既定的风险因素。
与自我报告的吸烟状况相比，尿液可替宁评估的吸烟状况可能是 T2D 的更强风险指标和预测因子。
