Rönnemaa T, Rönnemaa E M, Puukka P, Pyörälä K, Laakso M
Department of Medicine, University of Turku, Finland.
Diabetes Care. 1996 Nov;19(11):1229-32. doi: 10.2337/diacare.19.11.1229.
Studies using the euglycemic clamp technique or the insulin suppression test in relatively small numbers of subjects have suggested that smoking may cause insulin resistance. Our aim was to study the association between smoking status and fasting plasma insulin in a large nondiabetic male population.
A total of 616 nondiabetic men aged 45-64 years were taken from a population register. Fasting plasma insulin and blood pressure were measured, and smoking history and medication were evaluated by interview.
Age- and BMI-adjusted insulin levels were significantly higher in smokers and ex-smokers than in nonsmokers (92.4, 86.4, and 78.6 pmol/l, respectively; P = 0.009). In every BMI-tertile, smokers and ex-smokers had higher plasma insulin than nonsmokers. After adjustment for factors potentially affecting insulin sensitivity (hypertension, systolic or diastolic blood pressure, use of beta-blockers and/or diuretics, use of vasodilating antihypertensive drugs, physical exercise, alcohol use, parental history of NIDDM, coronary heart disease, and previous myocardial infarction), insulin concentrations were still highest in smokers (91.2 pmol/l), intermediate in ex-smokers (86.8 pmol/l), and lowest in nonsmokers (78.9 pmol/l, P = 0.008 between groups).
Our results show that chronic smoking is associated with high age- and BMI-adjusted plasma insulin levels, independent of other factors known to influence insulin sensitivity. The effect of smoking may be partially reversible after quitting.
使用正常血糖钳夹技术或胰岛素抑制试验对相对少量受试者进行的研究表明，吸烟可能会导致胰岛素抵抗。我们的目的是在大量非糖尿病男性人群中研究吸烟状况与空腹血浆胰岛素之间的关联。
从人口登记册中选取了616名年龄在45 - 64岁之间的非糖尿病男性。测量空腹血浆胰岛素和血压，并通过访谈评估吸烟史和用药情况。
经年龄和体重指数调整后的胰岛素水平，吸烟者和既往吸烟者显著高于非吸烟者（分别为92.4、86.4和78.6 pmol/L；P = 0.009）。在每个体重指数三分位数组中，吸烟者和既往吸烟者的血浆胰岛素水平均高于非吸烟者。在对可能影响胰岛素敏感性的因素（高血压、收缩压或舒张压、使用β受体阻滞剂和/或利尿剂、使用血管舒张性抗高血压药物、体育锻炼、饮酒、非胰岛素依赖型糖尿病家族史、冠心病和既往心肌梗死）进行调整后，胰岛素浓度在吸烟者中仍然最高（91.2 pmol/L），既往吸烟者居中（86.8 pmol/L），非吸烟者最低（78.9 pmol/L，组间P = 0.008）。
我们的结果表明，长期吸烟与经年龄和体重指数调整后的高血浆胰岛素水平相关，且独立于其他已知影响胰岛素敏感性的因素。戒烟后吸烟的影响可能部分可逆。
