Clinic for Endocrinology, Diabetes and Metabolic Disorders, Clinical Centre of Vojvodina, Medical Faculty, University of Novi Sad, Novi Sad, Serbia.
Second Propaedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Expert Rev Clin Pharmacol. 2024 Nov;17(11):1009-1012. doi: 10.1080/17512433.2024.2418398. Epub 2024 Oct 21.
Tobacco use represents the leading preventable risk factor for premature deaths worldwide. A meta-analysis of 74 epidemiological studies, including 3.2 million individuals with type 2 diabetes mellitus (T2DM) from 33 countries, reported a pooled prevalence of smoking of 20.8% among individuals with T2DM. Cigarette smoking further aggravates existing deleterious vascular effects of T2DM. Namely, chronic hyperglycemia and exposure to cigarette smoke cause additive injurious effect on the endothelium, leading to an acceleration of vascular complications seen in persons with T2DM and tobacco use disorders (TUD). In a recent study, Wang and colleagues found that semaglutide use was associated with a significantly lower risk for medical encounters for TUD, when compared to other antidiabetic drug classes; indeed, this effect was strongest compared with insulins and weakest compared with other glucagon-like peptide-1 receptor agonists. Semaglutide was associated with reduced smoking cessation medication prescriptions and counseling. Similar findings were observed irrespective of the presence of obesity. Therefore, semaglutide use might be useful in terms of smoking cessation among individuals with T2DM, thus offering an additional benefit for this constantly growing population. However, those interesting findings should be confirmed through dedicated, large-scale randomized controlled trials.
吸烟是全球导致过早死亡的首要可预防危险因素。一项荟萃分析纳入了来自 33 个国家的 74 项流行病学研究，共 320 万 2 型糖尿病（T2DM）患者，结果显示，T2DM 患者的吸烟率为 20.8%。吸烟进一步加重了 T2DM 已存在的有害血管效应。即，长期高血糖和接触香烟烟雾会对内皮细胞造成附加的损伤，从而加速 T2DM 患者和烟草使用障碍（TUD）患者的血管并发症的发生。最近一项研究中，Wang 及其同事发现，与其他降糖药物类别相比，司美格鲁肽的使用与 TUD 就诊风险显著降低相关；与胰岛素相比，这种相关性最强，而与其他胰高血糖素样肽-1 受体激动剂相比，这种相关性最弱。司美格鲁肽与减少戒烟药物处方和咨询相关。无论是否存在肥胖，均观察到了相似的发现。因此，对于 T2DM 患者，司美格鲁肽的使用可能有助于戒烟，从而为这一不断增长的人群带来额外获益。然而，这些有趣的发现需要通过专门的大型随机对照试验来证实。
