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Zhu Y, Gao Y, Lu Y, Wang Y, Pan Z, Sheng H, Li J, Chen Y, Lou J, Chen F, Yang F. The association between secondhand smoke exposure and accelerated biological aging: A population-based study and Mendelian randomization analysis. Tob Induc Dis 2025; 23:TID-23-59. [PMID: 40342722 PMCID: PMC12060151 DOI: 10.18332/tid/203865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2024] [Revised: 04/07/2025] [Accepted: 04/10/2025] [Indexed: 05/11/2025] Open
Abstract
INTRODUCTION Aging is an irreversible biological process significantly influenced by oxidative stress, which smoking exacerbates. While the impact of direct smoking on aging is well-documented, the association between secondhand smoke (SHS) exposure and biological aging remains less explored. This study examines the connection between SHS exposure in populations and biological aging, highlighting diabetes as a potential mediator due to its established links to both SHS exposure and accelerated aging through mechanisms such as oxidative stress and chronic inflammation. It further employs genetic tools to establish a causal relationship between SHS exposure and biological aging. METHODS This study combines secondary dataset analyses and Mendelian randomization analyses. Data from the NHANES 1999-2010 cycles were used, with serum cotinine levels indicating SHS exposure and phenotypic age, derived from age and clinical biomarkers reflecting inflammation, metabolism, and hematologic function, as the measure of biological aging. Multifactorial linear regression assessed associations, with restricted cubic splines used to explore nonlinear trends. Subgroup and mediation analyses were conducted to explore population-specific effects and the mediating role of diabetes. Two-sample Mendelian randomization (MR) using GWAS summary statistics on workplace SHS exposure (N=90168) and phenotypic age acceleration (N=6148) assessed causality. RESULTS In the NHANES analysis, low SHS exposure was associated with a 0.37-year increase in biological aging (β=0.37; 95% CI: 0.04-0.70), while high exposure showed a 0.76-year increase (β=0.76; 95% CI: 0.23-1.29). A U-shaped association was found between log-transformed serum cotinine and biological aging (p<0.001), with a threshold at -1.53. Diabetes mediated 31.25% of this association. In the MR analysis, workplace SHS exposure was causally linked to a 3.05-year acceleration in aging (β=3.05; 95% CI: 0.24-5.85). CONCLUSIONS SHS exposure accelerates biological aging, partly via diabetes. Genetic evidence supports a causal effect, emphasizing the need to minimize SHS exposure.
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Affiliation(s)
- Yue Zhu
- The School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Yufan Gao
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yangguang Lu
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Yukai Wang
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Ziyu Pan
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Huixiang Sheng
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Jiajun Li
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Yinuo Chen
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
| | - Jialing Lou
- The First School of Medicine, School of Information and Engineering, Wenzhou Medical University, Wenzhou, China
| | - Feng Chen
- The Second School of Medicine, Wenzhou Medical University, Wenzhou, China
- Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fajing Yang
- Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Della Corte KA, Bosler T, McClure C, Buyken AE, LeCheminant JD, Schwingshackl L, Della Corte D. Dietary Sugar Intake and Incident Type 2 Diabetes Risk: A Systematic Review and Dose-Response Meta-Analysis of Prospective Cohort Studies. Adv Nutr 2025; 16:100413. [PMID: 40122386 DOI: 10.1016/j.advnut.2025.100413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2025] [Revised: 03/10/2025] [Accepted: 03/18/2025] [Indexed: 03/25/2025] Open
Abstract
The dose-response relationship between dietary sugar and type 2 diabetes (T2D) risk is uncertain. MEDLINE, Embase, CINAHL, Web of Science and Cochrane databases were searched through July 9, 2024 for prospective cohort studies reporting relative measures of incident T2D risk by categories of dietary sugar (total, free, added, fructose, sucrose) or 2 beverage sources (non-diet sugar-sweetened beverages [SSBs], fruit juice) in healthy adults. Linear and restricted cubic spline dose-response models were fitted for each exposure, and study-specific slopes and confidence intervals (CIs) were calculated. Heterogeneity was evaluated using Q-statistics. Risk of bias was evaluated using the Risk of Bias in Non-randomized Studies of Exposures (ROBINS-E) tool. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was applied to assess the certainty of evidence. Of 10,384 studies, 29 cohorts were included: SSB: 18 (n = 541,288); fruit juice: 14 (n = 490,413); sucrose: 7 (n = 223,238); total sugar: 4 (n = 109,858); fructose: 5 (n = 158,136); and added sugar: 2 (n = 31,004). Studies were conducted in Europe (13), United States (11), Asia (6), Australia (4), and Latin America (3). Each additional serving of SSB and fruit juice was associated with a higher risk of T2D (risk ratio [RR]: 1.25; 95% CI: 1.17, 1.35 and RR: 1.05; 95% CI: >1.00, 1.11, respectively; moderate certainty). In contrast, 20 g/d intakes of total sugar and sucrose were inversely associated with T2D (RR: 0.96; 95% CI: 0.94, 0.98; low certainty; and RR: 0.95; 95% CI: 0.91, <1.00; moderate certainty, respectively). No associations were found for added sugar (RR: 0.99; 95% CI: 0.96, 1.01; low certainty) or fructose (RR: 0.98; 95% CI: 0.83, 1.15; very low certainty). These findings suggest that dietary sugar consumed as a beverage (SSB and fruit juice) is associated with incident T2D risk. The results do not support the common assumption that dietary sugar (i.e., total sugar and sucrose), irrespective of type and amount, is consistently associated with increased T2D risk. This study was registered in PROSPERO as CRD42023401800.
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Affiliation(s)
- Karen A Della Corte
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, United States.
| | - Tyler Bosler
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, United States
| | - Cole McClure
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, United States
| | - Anette E Buyken
- Institute of Nutrition, Consumption and Health, Faculty of Natural Sciences, Paderborn University, Paderborn, Germany
| | - James D LeCheminant
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT, United States
| | - Lukas Schwingshackl
- Institute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dennis Della Corte
- Department of Physics and Astronomy, Data Science, College of Computational, Mathematical and Physical Sciences, Brigham Young University, Provo, UT, United States
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Flor LS, Anderson JA, Ahmad N, Aravkin A, Carr S, Dai X, Gil GF, Hay SI, Malloy MJ, McLaughlin SA, Mullany EC, Murray CJL, O'Connell EM, Okereke C, Sorensen RJD, Whisnant J, Zheng P, Gakidou E. Health effects associated with exposure to secondhand smoke: a Burden of Proof study. Nat Med 2024; 30:149-167. [PMID: 38195750 PMCID: PMC10803272 DOI: 10.1038/s41591-023-02743-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024]
Abstract
Despite a gradual decline in smoking rates over time, exposure to secondhand smoke (SHS) continues to cause harm to nonsmokers, who are disproportionately children and women living in low- and middle-income countries. We comprehensively reviewed the literature published by July 2022 concerning the adverse impacts of SHS exposure on nine health outcomes. Following, we quantified each exposure-response association accounting for various sources of uncertainty and evaluated the strength of the evidence supporting our analyses using the Burden of Proof Risk Function methodology. We found all nine health outcomes to be associated with SHS exposure. We conservatively estimated that SHS increases the risk of ischemic heart disease, stroke, type 2 diabetes and lung cancer by at least around 8%, 5%, 1% and 1%, respectively, with the evidence supporting these harmful associations rated as weak (two stars). The evidence supporting the harmful associations between SHS and otitis media, asthma, lower respiratory infections, breast cancer and chronic obstructive pulmonary disease was weaker (one star). Despite the weak underlying evidence for these associations, our results reinforce the harmful effects of SHS on health and the need to prioritize advancing efforts to reduce active and passive smoking through a combination of public health policies and education initiatives.
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Affiliation(s)
- Luisa S Flor
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA.
| | - Jason A Anderson
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Noah Ahmad
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Aleksandr Aravkin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Sinclair Carr
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Xiaochen Dai
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Gabriela F Gil
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - Simon I Hay
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Matthew J Malloy
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Susan A McLaughlin
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Erin C Mullany
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Christopher J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Erin M O'Connell
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Chukwuma Okereke
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Reed J D Sorensen
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Joanna Whisnant
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Peng Zheng
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Emmanuela Gakidou
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
- Department of Health Metrics Sciences, School of Medicine, University of Washington, Seattle, WA, USA
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Qin GQ, Chen L, Zheng J, Wu XM, Li Y, Yang K, Liu TF, Fang ZZ, Zhang Q. Effect of passive smoking exposure on risk of type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Front Endocrinol (Lausanne) 2023; 14:1195354. [PMID: 37600719 PMCID: PMC10432686 DOI: 10.3389/fendo.2023.1195354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/12/2023] [Indexed: 08/22/2023] Open
Abstract
Objective The effect of passive smoking exposure on the risk of type 2 diabetes has not been systematically studied. A meta-analysis was conducted to assess the association between passive smoking exposure and the risk of diabetes. Methods We searched three major databases up to 31 October 2022 to identify relevant prospective cohort studies on the association between passive smoking and the risk of type 2 diabetes. The pooled relative risk (RR) and 95% confidence interval (CI) for the association between passive smoking exposure and the risk of type 2 diabetes were analyzed using a fixed-effect model. Results Ten prospective cohort studies were included in this meta-analysis, with a total of 251,620 participants involved. The pooled RR showed a significantly positive association between nonsmokers exposed to passive smoking and type 2 diabetes as compared to non-smokers who were not exposed to passive smoking [RR = 1.27; 95% CI (1.19, 1.36); p < 0.001]. Sensitivity analysis indicated that the pooled RR was not substantially affected by any of the individual studies. Conclusion Exposure to passive smoking increases the risk of type 2 diabetes. This study may have a positive effect on the prevention of type 2 diabetes. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023372532.
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Affiliation(s)
- Guo-Qiang Qin
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Li Chen
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jun Zheng
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
| | - Xiao-Min Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yang Li
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kai Yang
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Tong-Feng Liu
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhong-Ze Fang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
- National Demonstration Center for Experimental Preventive Medicine Education, Tianjin Medical University, Tianjin, China
| | - Qiang Zhang
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin Key Laboratory of Elderly Health, Tianjin Geriatrics Institute, Tianjin, China
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Nanda M, Sharma R, Mubarik S, Aashima A, Zhang K. Type-2 Diabetes Mellitus (T2DM): Spatial-temporal Patterns of Incidence, Mortality and Attributable Risk Factors from 1990 to 2019 among 21 World Regions. Endocrine 2022; 77:444-454. [PMID: 35841511 DOI: 10.1007/s12020-022-03125-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/17/2022] [Indexed: 12/20/2022]
Abstract
PURPOSE Type-2 diabetes Mellitus (T2DM) is one of the leading causes of death and disability worldwide. This study examines temporal patterns of the global, regional, and national burden of T2DM in the last three decades. DATA AND METHODS The estimates of age, sex and location-wise incident cases, deaths, prevalent cases, and disability-adjusted-life-years (DALYs) and risk factors for 21 regions and 204 countries are retrieved from the Global Burden of Disease 2019 study from 1990 to 2019. Socio-demographic index (SDI) is used as the indicator of the development status of countries, and quadratic regression is employed to examine the relationship between country-level age-standardized rates and SDI. RESULTS Globally, incident cases of T2DM more than doubled from 8.4 million[95% uncertainty interval, 7.8-9.1 million] in 1990 to 21.7 million[20.0-23.5 million] in 2019, and deaths more than doubled from 606,407[573,069-637,508] to 1.5 million[1.4-1.6 million] between 1990 and 2019. Global T2DM prevalence increased from 148.4 million[135.5-162.6 million] in 1990 to 437.9 million[402.0-477.0 million] in 2019. In 2019, global age-standardized prevalence rate stood at 5282.8/100,000[4853.6-5752.1], varying from 2174.5/100,000[1924.3-2470.5] in Mongolia to 19876.8/100,000[18211.1-21795.3] in American Samoa. SDI exhibited inverted-U shaped relationship with country-level age-standardised rates. Globally, high body-mass-index (51.9%), ambient particulate matter pollution (13.6%), smoking (9.9%) and secondhand smoke (8.7%) were the major contributing risk factors towards T2DM DALYs in 2019. CONCLUSION With ubiquitously rising prevalent cases globally, particularly in low and middle-income countries and regions, T2DM requires immediate attention and targeted policy response worldwide centered on lifestyle interventions (e.g., physical activity, smoking, diet, and obesity), air pollution control and cost-effective timely treatment.
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Affiliation(s)
- Mehak Nanda
- University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India
| | - Rajesh Sharma
- University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India.
| | - Sumaira Mubarik
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Aashima Aashima
- University School of Management and Entrepreneurship, Delhi Technological University, Delhi, India
| | - Kai Zhang
- Empire Innovation Associate Professor, Department of Environmental Health Sciences, School of Public Health | University at Albany, State University of New York, Albany, USA
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Interaction of PTPRD (rs17584499) polymorphism with passive smoking in Chinese women with susceptibility to type 2 diabetes. Int J Diabetes Dev Ctries 2022. [DOI: 10.1007/s13410-022-01078-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Kataoka H, Kaji S, Moai M. Risk Assessment of Passive Smoking Based on Analysis of Hair Nicotine and Cotinine as Exposure Biomarkers by In-Tube Solid-Phase Microextraction Coupled On-Line to LC-MS/MS. Molecules 2021; 26:molecules26237356. [PMID: 34885941 PMCID: PMC8659248 DOI: 10.3390/molecules26237356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022] Open
Abstract
Passive smoking due to environmental tobacco smoke is a serious public health concern because it increases the risk of lung cancer and cardiovascular disease. However, the current status and effect of passive smoking in various lifestyles are not fully understood. In this study, we measured hair nicotine and cotinine levels as exposure biomarkers in non-smokers and assessed the risk from the actual situation of passive smoking in different lifestyle environments. Nicotine and cotinine contents in hair samples of 110 non-smoker subjects were measured by in-tube solid-phase microextraction with on-line coupling to liquid chromatography-tandem mass spectrometry, and self-reported lifestyle questionnaires were completed by the subjects. Nicotine and cotinine were detected at concentrations of 1.38 ng mg−1 and 12.8 pg mg−1 respectively in the hair of non-smokers, with levels significantly higher in subjects who reported being sensitive to tobacco smoke exposure. These levels were also affected by type of food intake and cooking method. Nicotine and cotinine in hair are useful biomarkers for assessing the effects of passive smoking on long-term exposure to environmental tobacco smoke, and our analytical methods can measure these exposure levels in people who are unaware of passive smoking. The results of this study suggest that the environment and places of tobacco smoke exposure and the lifestyle behaviors therein are important for the health effects of passive smoking.
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Neelakantan N, Park SH, Chen GC, van Dam RM. Sugar-sweetened beverage consumption, weight gain, and risk of type 2 diabetes and cardiovascular diseases in Asia: a systematic review. Nutr Rev 2021; 80:50-67. [PMID: 33855443 DOI: 10.1093/nutrit/nuab010] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 12/21/2020] [Accepted: 02/19/2021] [Indexed: 11/12/2022] Open
Abstract
CONTEXT The prevalence of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs) is increasing in Asia and several countries are adopting preventive policies to reduce consumption of sugar-sweetened beverages (SSBs). However, evidence on the relation between SSB consumption and cardiometabolic health in Asian populations has not been summarized. OBJECTIVE In this systematic review, the associations between consumption of SSBs and cardiometabolic outcomes, including obesity, T2DM, and CVD, are examined in Asian populations. DATA SOURCES The PubMed, Scopus, and Web of Science databases, and gray literature were searched up to October, 2020 to identify relevant articles. DATA EXTRACTION Two investigators independently extracted data from included studies. DATA ANALYSIS When sufficient studies were available, a random-effects meta-analysis was used to calculate the pooled estimates (expressed as risk ratio [RR] and 95% confidence interval [CI]). Heterogeneity was tested and quantified using the Cochrane Q test and I2 statistic, respectively. RESULTS Of the 17 studies included, 8 provided results about measures of adiposity (3 on weight change, 4 on body mass index (BMI), 2 on percent body fat, and 1 on abdominal obesity), 6 reported results about T2DM, and 3 reported on different CVD outcomes. High SSB consumption was significantly associated with greater weight gain and with a higher risk of selected CVD outcomes as compared with low consumption. In the meta-analysis, high SSB consumption was associated with greater T2DM risk before (RR, 1.51; 95%CI, 1.15-1.98 for highest vs lowest category; I2 = 76%) and after (RR, 1.38; 95%CI, 1.09-1.73; I2 = 56%) adjustment for BMI. CONCLUSIONS These findings suggest that high SSB consumption is directly associated with weight gain, risk of T2DM, and, possibly, selected CVD outcomes in Asian populations. Public health strategies to reduce SSB consumption in Asian countries are warranted. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42019129456.Keywords: adiposity. cardiovascular disease, Asia, sugar-sweetened beverages, type 2 diabetes.
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Affiliation(s)
- Nithya Neelakantan
- N. Neelakantan, S.H. Park, G.-C. Chen, and R.M van Dam are with the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. G.-C. Chen is with the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York, USA. R.M van Dam is with the Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Su Hyun Park
- N. Neelakantan, S.H. Park, G.-C. Chen, and R.M van Dam are with the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. G.-C. Chen is with the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York, USA. R.M van Dam is with the Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Guo-Chong Chen
- N. Neelakantan, S.H. Park, G.-C. Chen, and R.M van Dam are with the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. G.-C. Chen is with the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York, USA. R.M van Dam is with the Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Rob M van Dam
- N. Neelakantan, S.H. Park, G.-C. Chen, and R.M van Dam are with the Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore. G.-C. Chen is with the Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, New York, USA. R.M van Dam is with the Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Kim BJ, Kim JH, Kang JG, Kim BS, Kang JH. Association between secondhand smoke exposure and diabetes mellitus in 131 724 Korean never smokers using self-reported questionnaires and cotinine levels: Gender differences. J Diabetes 2021; 13:43-53. [PMID: 32613744 DOI: 10.1111/1753-0407.13082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 05/28/2020] [Accepted: 06/26/2020] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The aim of this study is to compare the gender-different associations between secondhand smoke (SHS) exposure and diabetes in self-reported never smokers verified by cotinine. METHODS Self-reported never smokers verified by cotinine levels (<50 ng/mL) enrolled in the Kangbuk Samsung Health Study between April 2011 and December 2016 were included for this study. SHS exposure was defined as current exposure to passive smoke indoors at home or workplace. The gender-specific association between SHS exposure and diabetes was assessed using multivariable regression analyses. RESULTS Of the total 131 724 individuals (mean age 35 years, SD 7.1 years), 66.8% were female, and the prevalence of SHS exposure in the entire population was 22.9%. The prevalence of diabetes in the group exposed to SHS was higher than that in the group unexposed to SHS only in females (1.8% vs 1.2%, P < .001 for females; 2.2% vs 2.2%, P = .956 for males). A significant gender interaction existed for the relationships between SHS exposure and diabetes (P for interaction <.001). The multivariate regression model showed that SHS exposure was significantly associated with diabetes only in females (odds ratio [95% CI], 1.40 [1.20, 1.65] for females; 1.00 [0.85, 1.19] for males). In particular, females with SHS exposure ≥1 hour/day, ≥3 times/week, and ≥10 years showed an increased risk of diabetes by more than 50% compared to those without SHS exposure. CONCLUSIONS SHS exposure was significantly associated with diabetes in female never smokers with dose-dependent relationship. However, further longitudinal studies are needed to elucidate the gender difference in the incidence of diabetes associated with SHS exposure.
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Affiliation(s)
- Byung Jin Kim
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ji Hye Kim
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jeong Gyu Kang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Bum Soo Kim
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jin Ho Kang
- Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Oba S, Goto A, Mizoue T, Inoue M, Sawada N, Noda M, Tsugane S. Passive smoking and type 2 diabetes among never-smoking women: The Japan Public Health Center-based Prospective Study. J Diabetes Investig 2020; 11:1352-1358. [PMID: 32232941 PMCID: PMC7477535 DOI: 10.1111/jdi.13259] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 02/02/2020] [Accepted: 03/22/2020] [Indexed: 01/15/2023] Open
Abstract
AIMS/INTRODUCTION The aim of the current study was to prospectively evaluate the association between passive smoking from a spouse and the risk of diabetes among never-smoking Japanese women. Passive smoking at a workplace (or public facilities) was assessed as a secondary measure. MATERIALS AND METHODS In the Japan Public Health Center-based Prospective Study (baseline 1990 or 1993), we followed 25,391 never-smoking women aged 40-69 years and without diabetes. Passive smoking was defined as having a husband who was a self-reported smoker, and the exposure at a workplace (or public facilities) was self-reported by women. The development of diabetes was identified in questionnaires administered at the 5-year and 10-year surveys. A pooled logistic regression model was used to assess the association between passive smoking and the development of diabetes with adjustment for age and possible confounders. RESULTS Compared with women whose husbands had never smoked, women whose husband smoked ≥40 cigarettes/day had significantly higher odds of developing diabetes in an age-adjusted model, but the association was attenuated in a multivariable model (odds ratio 1.34, 95% confidence interval 0.96-1.87). There was a dose-response trend between the number of cigarettes smoked by a husband and the odds of developing diabetes (P = 0.02). Women reporting daily passive smoking at a workplace (or public facilities) had higher odds of developing diabetes than women reporting no such exposure (odds ratio 1.23, 95% confidence interval 0.995-1.53). CONCLUSIONS Our results indicated a higher risk of diabetes among never-smoking Japanese women with higher exposure to passive smoking from a spouse.
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Affiliation(s)
- Shino Oba
- Graduate School of Health SciencesGunma UniversityGunmaJapan
- Center for Food Science and WellnessGunma UniversityGunmaJapan
| | - Atsushi Goto
- Epidemiology and Prevention GroupCenter for Public Health SciencesNational Cancer CenterTokyoJapan
| | - Tetsuya Mizoue
- Department of Epidemiology and PreventionNational Center for Global Health and MedicineTokyoJapan
| | - Manami Inoue
- Epidemiology and Prevention GroupCenter for Public Health SciencesNational Cancer CenterTokyoJapan
| | - Norie Sawada
- Epidemiology and Prevention GroupCenter for Public Health SciencesNational Cancer CenterTokyoJapan
| | - Mitsuhiko Noda
- Department of Diabetes, Metabolism and EndocrinologyIchikawa HospitalInternational University of Health and WelfareChibaJapan
| | - Shoichiro Tsugane
- Epidemiology and Prevention GroupCenter for Public Health SciencesNational Cancer CenterTokyoJapan
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Zhang M, Yang Y, Liu F, Jia J, Xu Q, Wang L, Wang Y, He Y, Zhang Y, Peng Z, Wang Q, Shen H, Xu Z, Zhang Y, Yan D, Zhang H, Ma X. The association of husbands' smoking with wives' dysglycemia status: A cross-sectional study among over 10 million Chinese women aged 20-49. J Diabetes 2020; 12:354-364. [PMID: 31747113 DOI: 10.1111/1753-0407.13009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 11/06/2019] [Accepted: 11/17/2019] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND We comprehensively evaluated the association between husbands' smoking amount and wives' dysglycemia status. METHODS We conducted a cross-sectional study which recruited 12 023 714 reproductive couples who participated in the National Free Pre-Pregnancy Checkups Project (NFPCP) between 2015 and 2016 in China. Multivariable logistic models were used to estimate odds ratio (OR) and 95% CI. Subgroup analysis and stratified analysis were further performed to investigate potential effect modification. RESULTS Compared to the neither-smoker group, the multivariable-adjusted ORs for diabetes mellitus (DM) among women was 1.09 (95% CI, 1.07-1.10), 1.04 (95% CI, 0.87-1.23), and 1.28 (95% CI, 1.17-1.41) in the husband-smoker, wife-smoker, and both-smokers groups, respectively. An increased risk of DM was also observed for women whose husbands smoke 1 to 10 (OR, 1.06; 95% CI, 1.04-1.07), 11 to 20 (OR, 1.13; 95% CI, 1.11-1.15), and over 20 cigarettes per day (OR, 1.25; 95% CI, 1.17-1.31). The prevalence of wives' DM showed significant linear trends with husbands' smoking amount (Pfor trend < .001). A similar growth tendency was also observed between husband smoking amount and impaired fasting glucose (IFG) prevalence with ORs of 1.04 (95% CI, 1.04-1.05), 1.05 (95% CI, 1.04-1.06), and 1.09 (95% CI, 1.06-1.11) for 1-10, 11-20, and over 20 cigarettes per day, respectively. The relationship between husbands' smoking amount and wives' IFG/DM prevalence appear to be modified by body mass index (BMI). CONCLUSIONS This study shows significant relationships between husbands' smoking and wives' risk of IFG/DM, and this result exists in both a categorical and dose-response manner. This association is modified by BMI. Family-oriented smoking interventions may both reduce husbands' active smoking and wives' risk of DM.
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Affiliation(s)
- Minjin Zhang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Fangchao Liu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Disease, China Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiajing Jia
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Qin Xu
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
| | - Long Wang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
| | - Qiaomei Wang
- Graduate School of Peking Union Medical College, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Zongyu Xu
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health and Family Planning Commission of the PRC, Beijing, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China
- National Human Genetic Resource Center, Beijing, China
- Graduate School of Peking Union Medical College, Beijing, China
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Lee PN, Coombs KJ. Systematic review with meta-analysis of the epidemiological evidence relating smoking to type 2 diabetes. World J Meta-Anal 2020; 8:119-152. [DOI: 10.13105/wjma.v8.i2.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/02/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023] Open
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Jiang L, Chang J, Ziogas A, Deapen D, Reynolds P, Bernstein L, Anton-Culver H. Secondhand smoke, obesity, and risk of type II diabetes among California teachers. Ann Epidemiol 2019; 32:35-42. [PMID: 30846276 PMCID: PMC7469797 DOI: 10.1016/j.annepidem.2019.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 01/04/2019] [Accepted: 01/15/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE To examine if secondhand smoke (SHS) is associated with elevated risk of type II diabetes among California teachers. We also aim to determine if overall and central obesity are mediators or effect modifiers of this association. METHODS Using data from the California Teachers Study, conducted in 1995-2013 in California public schools, we obtained information on SHS exposure among 39,887 lifetime nonsmokers. The association between SHS and incident diabetes after 17 years of follow-up was assessed using Cox regression models. The mediation and modification effects of BMI and waist circumference on this association were tested. RESULTS At baseline, 70.2% of the nonsmokers reported exposure to SHS. Higher intensity, duration, and intensity-years of exposure to SHS were associated with higher multivariate adjusted risk of incident diabetes in a dose-response manner (hazard ratio = 1.28; 95% confidence interval, 1.11-1.48 for highest quartile vs. lowest quartile of exposure; P = .001 for trend). Participant's waist circumference (measured 2 years after baseline) could explain greater than 50% of the association between SHS and diabetes. CONCLUSIONS SHS exposure is associated with increased risk of type II diabetes among nonsmokers of California teachers with obesity being a potentially important mediator but not an effect modifier for this association.
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Affiliation(s)
- Luohua Jiang
- Department of Epidemiology, School of Medicine, University of California Irvine, Irvine.
| | - Jenny Chang
- Department of Epidemiology, School of Medicine, University of California Irvine, Irvine
| | - Argyrios Ziogas
- Department of Epidemiology, School of Medicine, University of California Irvine, Irvine
| | - Dennis Deapen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | | | - Leslie Bernstein
- Division of Biomarkers of Early Detection and Prevention, Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA
| | - Hoda Anton-Culver
- Department of Epidemiology, School of Medicine, University of California Irvine, Irvine
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Jeon J, Jung KJ, Kimm H, Jee SH. Changes in secondhand smoke exposure levels and risk of type 2 diabetes in middle age: the Korean Genome and Epidemiology Study (KoGES). BMJ Open Diabetes Res Care 2019; 7:e000859. [PMID: 31875135 PMCID: PMC6904168 DOI: 10.1136/bmjdrc-2019-000859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/08/2019] [Accepted: 10/26/2019] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES Secondhand smoke (SHS) was known as one of the risk factors for type 2 diabetes. So far, some studies revealed the association of SHS exposure and type 2 diabetes, however, no studies to show the relationship of cumulative SHS exposure with type 2 diabetes exist. Therefore, the objectives of this study were to identify subgroups of participants who share similar trajectories in SHS exposure levels in middle age by using latent class growth modeling, and determine the independent association of these SHS exposure level trajectories with risk of incident type 2 diabetes. METHODS In Korean Genome and Epidemiology Study (2001-2014), 2079 participants aged 40 years and above who received biennially health check-up to follow-up and with available information of SHS exposure were selected. Four distinct trajectory groups (low-stable, moderate to low, moderate, and high to low) were identified for SHS exposure levels using trajectory modeling methods. Multivariable Cox proportional hazards model was used to examine the association of trajectories with risk of type 2 diabetes. RESULTS During 24 083.3 person-years of follow-up (mean follow-up duration, 11.6 years), 200 incident cases of type 2 diabetes and 640 incident cases of impaired fasting glucose (IFG) were identified. In multivariable Cox model, 'High to low' trajectory was significantly associated with risk of type 2 diabetes (OR 1.9; 95% CI 1.3 to 2.8) compared with 'Low-stable'. For IFG, all trajectories had significantly 30%-30% higher risk of type 2 diabetes compared with the 'Low-stable' trajectory. CONCLUSIONS Changes in SHS exposure levels have been shown to associate with subsequent type 2 diabetes risk. Reversing high exposure level of SHS in middle-aged adulthood may still lead to worse progressions of type 2 diabetes than remaining stable exposure level.
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Affiliation(s)
- Jooeun Jeon
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, South Korea
| | - Keum Ji Jung
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, South Korea
| | - Heejin Kimm
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, South Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Yonsei University Graduate School of Public Health, Seoul, South Korea
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Siti Hajar MH, Zulkefli S, Juwita S, Norhayati MN, Siti Suhaila MY, Rasool AHG, Harmy MY. Metabolic, inflammatory, and oxidative stress markers in women exposed to secondhand smoke. PeerJ 2018; 6:e5758. [PMID: 30356972 PMCID: PMC6196072 DOI: 10.7717/peerj.5758] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/14/2018] [Indexed: 12/20/2022] Open
Abstract
Background Secondhand smoke (SHS) exposure has adverse effects on the cardiovascular system. This study aimed to determine the effects of SHS on the cardiovascular disease biomarkers, namely the metabolic, inflammatory, and oxidative stress markers in healthy adult women. Methods This comparative cross-sectional study was conducted among healthy women. The cases included those women exposed to SHS, and the controls included those women not exposed to SHS. SHS exposure was defined as being exposed to SHS for at least 15 min for 2 days per week. Venous blood was taken to measure the metabolic markers (high molecular weight adiponectin, insulin level, insulin resistance, and nonesterified fatty acids), oxidative stress markers (oxidized low density lipoprotein cholesterol and 8-isoprostane), and inflammatory markers (high-sensitivity C-reactive protein and interleukin-6). A hair nicotine analysis was also performed. An analysis of covariance and a simple linear regression analysis were conducted. Results There were 101 women in the SHS exposure group and 91 women in the non-SHS exposure group. The mean (with standard deviation) of the hair nicotine levels was significantly higher in the SHS exposure group when compared to the non-SHS exposure group [0.22 (0.62) vs. 0.04 (0.11) ng/mg; P = 0.009]. No significant differences were observed in the high molecular weight adiponectin, insulin and insulin resistance, nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, interleukin-6, and high-sensitivity C-reactive protein between the two groups. The serum high molecular weight adiponectin was negatively associated with the insulin level and insulin resistance in the women exposed to SHS. However, no significant relationships were seen between the high molecular weight adiponectin and nonesterified fatty acids, 8-isoprostane, oxidized low density lipoprotein cholesterol, high-sensitivity C-reactive protein in the SHS group. Discussion There were no significant differences in the metabolic, oxidative stress, and inflammatory markers between the SHS exposure and non-SHS exposure healthy women. A low serum level of high molecular weight adiponectin was associated with an increased insulin level and resistance in the women exposed to SHS.
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Affiliation(s)
- Mohd Hanaffi Siti Hajar
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Sanip Zulkefli
- Central Research Laboratory, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Shaaban Juwita
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Noor Norhayati
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Mohd Yusoff Siti Suhaila
- Department of Family Medicine, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia
| | - Aida Hanum Ghulam Rasool
- Pharmacology Vascular Laboratory, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mohamed Yusoff Harmy
- Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, Malaysia
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Chang HC, Wang MC, Chen MH, Liao HC, Wang YH. The Impact of the Hazard Correlation between Risk Factors and Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102213. [PMID: 30309023 PMCID: PMC6210006 DOI: 10.3390/ijerph15102213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 10/03/2018] [Accepted: 10/05/2018] [Indexed: 12/23/2022]
Abstract
This study examined the occurrence of diabetes and sustainable risk factors in residents aged 30 and above of a community in Taoyuan County, Taiwan. The main purpose of this research was to explore the correlations between related variables and the occurrence of diabetes. The demographic variables, health exam variables, healthy behavior variables, and environmental variables had obvious impacts on the risk of diabetes. As age increased, the risk of developing the disease also increased; higher educational levels lowered risk, while unemployment raised it. Also, analysis of the health exam variables showed that abnormal BMIs, waist-hip ratios, and body fat percentages had significant impacts on individuals' risk of diabetes. Moreover, it was found that smoking affected the risk of having diabetes: smokers, particularly male smokers, had a relatively higher risk of developing the disease. Lastly, the results showed that exposure to second-hand smoke did not have a significant effect on the diabetes proportion in the male population. However, a significantly higher proportion of females who had been exposed to second-hand smoke had diabetes.
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Affiliation(s)
- Huan-Cheng Chang
- Division of Nephrology, Department of Medicine, Taiwan Landseed Hospital, No. 77, Guangtai Road, Pingzhen Dist., Taoyuan 324, Taiwan.
- Department of Health Care Management, Chang Gung University, No. 259, Wenhua 1st Road, Guishan Dist., Taoyuan 33302, Taiwan.
| | - Mei-Chin Wang
- Noble Health Management Center, Taiwan Landseed Hospital, No. 77, Guangtai Road, Pingzhen Dist., Taoyuan 324, Taiwan.
| | - Meng-Hao Chen
- Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
| | - Hung-Chang Liao
- Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
- Department of Health Services Administration, Chung Shan Medical University, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
| | - Ya-Huei Wang
- Department of Medical Management, Chung Shan Medical University Hospital, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
- Department of Applied Foreign Languages, Chung Shan Medical University, No. 110, Section 1, Jian-Koa N. Road, Taichung 402, Taiwan.
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Bowe B, Xie Y, Li T, Yan Y, Xian H, Al-Aly Z. The 2016 global and national burden of diabetes mellitus attributable to PM 2·5 air pollution. Lancet Planet Health 2018; 2:e301-e312. [PMID: 30074893 DOI: 10.1016/s2542-5196(18)30140-2] [Citation(s) in RCA: 209] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/22/2018] [Accepted: 06/05/2018] [Indexed: 05/22/2023]
Abstract
BACKGROUND PM2·5 air pollution is associated with increased risk of diabetes; however, a knowledge gap exists to further define and quantify the burden of diabetes attributable to PM2·5 air pollution. Therefore, we aimed to define the relationship between PM2·5 and diabetes. We also aimed to characterise an integrated exposure response function and to provide a quantitative estimate of the global and national burden of diabetes attributable to PM2·5. METHODS We did a longitudinal cohort study of the association of PM2·5 with diabetes. We built a cohort of US veterans with no previous history of diabetes from various databases. Participants were followed up for a median of 8·5 years, we and used survival models to examine the association between PM2·5 and the risk of diabetes. All models were adjusted for sociodemographic and health characteristics. We tested a positive outcome control (ie, risk of all-cause mortality), negative exposure control (ie, ambient air sodium concentrations), and a negative outcome control (ie, risk of lower limb fracture). Data for the models were reported as hazard ratios (HRs) and 95% CIs. Additionally, we reviewed studies of PM2·5 and the risk of diabetes, and used the estimates to build a non-linear integrated exposure response function to characterise the relationship across all concentrations of PM2·5 exposure. We included studies into the building of the integrated exposure response function if they scored at least a four on the Newcastle-Ottawa Quality Assessment Scale and were only included if the outcome was type 2 diabetes or all types of diabetes. Finally, we used the Global Burden of Disease study data and methodologies to estimate the attributable burden of disease (ABD) and disability-adjusted life-years (DALYs) of diabetes attributable to PM2·5 air pollution globally and in 194 countries and territories. FINDINGS We examined the relationship of PM2·5 and the risk of incident diabetes in a longitudinal cohort of 1 729 108 participants followed up for a median of 8·5 years (IQR 8·1-8·8). In adjusted models, a 10 μg/m3 increase in PM2·5 was associated with increased risk of diabetes (HR 1·15, 95% CI 1·08-1·22). PM2·5 was associated with increased risk of death as the positive outcome control (HR 1·08, 95% CI 1·03-1·13), but not with lower limb fracture as the negative outcome control (1·00, 0·91-1·09). An IQR increase (0·045 μg/m3) in ambient air sodium concentration as the negative exposure control exhibited no significant association with the risk of diabetes (HR 1·00, 95% CI 0·99-1·00). An integrated exposure response function showed that the risk of diabetes increased substantially above 2·4 μg/m3, and then exhibited a more moderate increase at concentrations above 10 μg/m3. Globally, ambient PM2·5 contributed to about 3·2 million (95% uncertainty interval [UI] 2·2-3·8) incident cases of diabetes, about 8·2 million (95% UI 5·8-11·0) DALYs caused by diabetes, and 206 105 (95% UI 153 408-259 119) deaths from diabetes attributable to PM2·5 exposure. The burden varied substantially among geographies and was more heavily skewed towards low-income and lower-to-middle-income countries. INTERPRETATION The global toll of diabetes attributable to PM2·5 air pollution is significant. Reduction in exposure will yield substantial health benefits. FUNDING US Department of Veterans Affairs.
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Affiliation(s)
- Benjamin Bowe
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Epidemiology and Biostatistics, Saint Louis University, Saint Louis, MO, USA
| | - Yan Xie
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA
| | - Tingting Li
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA
| | - Yan Yan
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - Hong Xian
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Epidemiology and Biostatistics, Saint Louis University, Saint Louis, MO, USA
| | - Ziyad Al-Aly
- Clinical Epidemiology Center, Research and Education Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Nephrology Section, Medicine Service, VA Saint Louis Health Care System, Saint Louis, Missouri, MO, USA; Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA; Institute for Public Health, Washington University in Saint Louis, Saint Louis, MO, USA.
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18
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Lu L, Mackay DF, Pell JP. Secondhand smoke exposure and risk of incident peripheral arterial disease and mortality: a Scotland-wide retrospective cohort study of 4045 non-smokers with cotinine measurement. BMC Public Health 2018; 18:348. [PMID: 29551089 PMCID: PMC5858137 DOI: 10.1186/s12889-018-5227-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 02/27/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Active smoking is an important risk factor for all-cause mortality and peripheral arterial disease (PAD). In contrast, published studies on the associations with secondhand smoke (SHS) are limited. The aim of this study was to examine the associations between SHS exposure and incident PAD, as well as mortality, among middle-aged non-smokers. METHODS We undertook a retrospective, cohort study using record linkage of the Scottish Health Surveys between 1998 and 2010 to hospital admissions and death certificates. Inclusion was restricted to participants aged > 45 years. Cox proportional hazard models were used to examine the association between SHS exposure and incident PAD (hospital admission or death) and all-cause mortality, with adjustment for potential confounders. RESULTS Of the 4045 confirmed non-smokers (self-reported non-smokers with salivary cotinine concentrations < 15 ng/mL), 1163 (28.8%) had either moderate or high exposure to SHS at baseline. In men, high exposure to SHS (cotinine ≥2.7 ng/mL) was associated with increased risk of all-cause mortality (fully adjusted hazard ratio [HR] 1.54, 95% CI 1.07-2.22, p = 0.020) with evidence of a dose-relationship (p for trend = 0.004). In men, high exposure to SHS was associated with increased risk of incident PAD over the first five years of follow-up (fully adjusted HR 4.29, 95% CI 1.14-16.10, p = 0.031) but the association became non-significant over longer term follow-up. CONCLUSIONS SHS exposure was independently associated with all-cause mortality and may be associated with PAD, but larger studies, or meta-analyses, are required to confirm the latter.
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Affiliation(s)
- Liya Lu
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
| | - Daniel F Mackay
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
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Abstract
Globally, the number of people with diabetes mellitus has quadrupled in the past three decades, and diabetes mellitus is the ninth major cause of death. About 1 in 11 adults worldwide now have diabetes mellitus, 90% of whom have type 2 diabetes mellitus (T2DM). Asia is a major area of the rapidly emerging T2DM global epidemic, with China and India the top two epicentres. Although genetic predisposition partly determines individual susceptibility to T2DM, an unhealthy diet and a sedentary lifestyle are important drivers of the current global epidemic; early developmental factors (such as intrauterine exposures) also have a role in susceptibility to T2DM later in life. Many cases of T2DM could be prevented with lifestyle changes, including maintaining a healthy body weight, consuming a healthy diet, staying physically active, not smoking and drinking alcohol in moderation. Most patients with T2DM have at least one complication, and cardiovascular complications are the leading cause of morbidity and mortality in these patients. This Review provides an updated view of the global epidemiology of T2DM, as well as dietary, lifestyle and other risk factors for T2DM and its complications.
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Affiliation(s)
- Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, 2005 Songhu Road, Shanghai, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 2005 Songhu Road, Shanghai, China
| | - Sylvia H Ley
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 2005 Songhu Road, Shanghai, China
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, Massachusetts 02115, USA
| | - Frank B Hu
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 2005 Songhu Road, Shanghai, China
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Boston, Massachusetts 02115, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, Massachusetts 02115, USA
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Akasaka H, Ohnishi H, Narita Y, Kameda M, Miki T, Takahashi H, Yamamoto W, Sohma H, Masumori N, Miura T. The Serum Level of KL-6 Is Associated with the Risk of Insulin Resistance and New-onset Diabetes Mellitus: The Tanno-Sobetsu Study. Intern Med 2017; 56:3009-3018. [PMID: 28943558 PMCID: PMC5725853 DOI: 10.2169/internalmedicine.8716-16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Inflammatory cytokines generated in visceral fat have been shown to contribute to the development of insulin resistance. The involvement of pulmonary inflammation in insulin resistance remains unclear, but smoking is known to be a risk factor for diabetes as well as chronic obstructive pulmonary disease. We herein examined the hypothesis that increased serum levels of lung interstitial injury biomarkers [surfactant protein (SP)-A, SP-D and Krebs von den Lungen (KL)-6] are associated with the risk of diabetes development. Methods For cross-sectional and longitudinal analyses, we enrolled 750 apparently healthy non-diabetic subjects who received annual examinations in 2011 or 2012 in the Tanno-Sobetsu cohort. Results A cross-sectional analysis showed that distinct clinical parameters were associated with SP-A, SP-D and KL-6. In a multiple regression analysis, independent explanatory variables were Brinkman index and brain natriuretic peptide (BNP) for SP-A, sex (women), BNP and body mass index (BMI) for SP-D, and age and BMI for KL-6. A longitudinal analysis of 415 subjects who received annual examinations in both 2011 and 2014 showed that 13 (3.1%) of the patients developed type 2 diabetes during the 3-year follow-up. A multiple logistic regression analysis showed the KL-6 levels, systolic blood pressure and homeostasis model assessment of insulin resistance (HOMA-IR) in 2011 to be independently associated with new-onset diabetes. In a multiple regression analysis for HOMA-IR in 2014, the KL-6 level and BMI in 2011 were selected as explanatory variables. Conclusion A modest elevation of the serum KL-6 level is therefore considered to be associated with the risk for insulin resistance development and new-onset diabetes mellitus in a general population.
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Affiliation(s)
- Hiroshi Akasaka
- Clinical Training Center, Sapporo Medical University Hospital, Japan
- Department of Cardiovascular, Renal and Metabolic Medicine, Japan
| | - Hirofumi Ohnishi
- Department of Public Health, Sapporo Medical University, School of Medicine, Japan
| | - Yoshifumi Narita
- Clinical Training Center, Sapporo Medical University Hospital, Japan
- Department of Respiratory Medicine and Allergology, Sapporo Medical University, School of Medicine, Japan
| | - Masami Kameda
- Clinical Training Center, Sapporo Medical University Hospital, Japan
- Department of Respiratory Medicine and Allergology, Sapporo Medical University, School of Medicine, Japan
| | - Takayuki Miki
- Department of Cardiovascular, Renal and Metabolic Medicine, Japan
| | - Hiroki Takahashi
- Department of Respiratory Medicine and Allergology, Sapporo Medical University, School of Medicine, Japan
| | - Wari Yamamoto
- Department of Community and General Medicine, Sapporo Medical University, School of Medicine, Japan
| | - Hitoshi Sohma
- Center for Medical Education, Sapporo Medical University, School of Medicine, Japan
| | - Naoya Masumori
- Clinical Training Center, Sapporo Medical University Hospital, Japan
- Department of Urology, Sapporo Medical University, School of Medicine, Japan
| | - Tetsuji Miura
- Clinical Training Center, Sapporo Medical University Hospital, Japan
- Department of Cardiovascular, Renal and Metabolic Medicine, Japan
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Akter S, Goto A, Mizoue T. Smoking and the risk of type 2 diabetes in Japan: A systematic review and meta-analysis. J Epidemiol 2017; 27:553-561. [PMID: 28716381 PMCID: PMC5623034 DOI: 10.1016/j.je.2016.12.017] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/12/2016] [Indexed: 12/20/2022] Open
Abstract
Cigarette smoking is the leading avoidable cause of disease burden. Observational studies have suggested an association between smoking and risk of type 2 diabetes mellitus (T2DM). We conducted a meta-analysis of prospective observational studies to investigate the association of smoking status, smoking intensity, and smoking cessation with the risk of T2DM in Japan, where the prevalence of smoking has been decreasing but remains high. We systematically searched MEDLINE and the Ichushi database to December 2015 and identified 22 eligible articles, representing 343,573 subjects and 16,383 patients with T2DM. We estimated pooled relative risks (RRs) using a random-effects model and conducted subgroup analyses by participant and study characteristics. Compared with nonsmoking, the pooled RR of T2DM was 1.38 (95% confidence interval [CI], 1.28–1.49) for current smoking (19 studies) and 1.19 (95% CI, 1.09–1.31) for former smoking (15 studies). These associations persisted in all subgroup and sensitivity analyses. We found a linear dose-response relationship between cigarette consumption and T2DM risk; the risk of T2DM increased by 16% for each increment of 10 cigarettes smoked per day. The risk of T2DM remained high among those who quit during the preceding 5 years but decreased steadily with increasing duration of cessation, reaching a risk level comparable to that of never smokers after 10 years of smoking cessation. We estimated that 18.8% of T2DM cases in men and 5.4% of T2DM cases in women were attributable to smoking. The present findings suggest that cigarette smoking is associated with an increased risk of T2DM, so tobacco control programs to reduce smoking could have a substantial effect to decrease the burden of T2DM in Japan.
This meta-analysis examined smoking and diabetes risk among Japanese. Current and former smokers showed a higher risk of diabetes than non-smokers. Diabetes risk linearly increased with higher consumption of cigarettes. Diabetes risk steadily decreased after smoking cessation.
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Affiliation(s)
- Shamima Akter
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Atsushi Goto
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
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Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017. [PMID: 28629199 PMCID: PMC5486341 DOI: 10.3390/ijerph14060655] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.
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Kermah D, Shaheen M, Pan D, Friedman TC. Association between secondhand smoke and obesity and glucose abnormalities: data from the National Health and Nutrition Examination Survey (NHANES 1999-2010). BMJ Open Diabetes Res Care 2017; 5:e000324. [PMID: 28405342 PMCID: PMC5372029 DOI: 10.1136/bmjdrc-2016-000324] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/22/2016] [Accepted: 01/05/2017] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE The objective of this study is to investigate the relationship between cotinine level-confirmed secondhand smoke (SHS) exposure and glycemic parameters and obesity. RESEARCH DESIGN AND METHODS We examined a cohort of 6472 adults from the National Health and Nutrition Examination Surveys, 1999-2010. Serum cotinine levels and self-reported data on smoking were used to determine smoking status. The outcome variables were body mass index (BMI) and glycemic status (HbA1c), Homeostasis Model Assessment of Insulin Resistance (HOMA-IR), and fasting plasma glucose (FPG). Descriptive, bivariate, and multivariate analyses were conducted. RESULTS Using cotinine level-confirmed smoking status, 1794 (27.4%) of the sample were current smokers, 1681 (25.0%) were former smokers, 1158 (17.8%) were secondhand smokers, and 1839 (29.8%) were non-smokers. In a generalized linear model after controlling for potential confounding variables, secondhand smokers had higher adjusted levels of HOMA-IR, FPG, and BMI compared with non-smokers (p<0.05). Adjustment for BMI demonstrated that some, but not all, of the detrimental effects of SHS on glycemic parameters are mediated by the increased body weight of secondhand smokers. CONCLUSIONS We conclude that SHS is associated with obesity and worsening glycemic parameters. More studies are needed to show a causal relationship between SHS and glycemic parameters and to understand the mechanisms involved in the association.
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Affiliation(s)
- Dulcie Kermah
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Magda Shaheen
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Deyu Pan
- Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
| | - Theodore C Friedman
- Division of Endocrinology, Metabolism, and Molecular Medicine, Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
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Imamura F, O'Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN, Forouhi NG. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. Br J Sports Med 2016; 50:496-504. [PMID: 27044603 PMCID: PMC4853528 DOI: 10.1136/bjsports-2016-h3576rep] [Citation(s) in RCA: 154] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2015] [Indexed: 11/20/2022]
Abstract
Objectives To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom. Design Systematic review and meta-analysis. Data sources and eligibility PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009–10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008–12 (n=1932 representing 44.7 million). Synthesis methods Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages. Results Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I2 for heterogeneity=89%) and 13% (6% to 21%, I2=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I2=70%) and 8% (2% to 15%, I2=64%); and for fruit juice, 5% (−1% to 11%, I2=58%) and 7% (1% to 14%, I2=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%). Conclusions Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.
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Affiliation(s)
- Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Laura O'Connor
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Zheng Ye
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Jaakko Mursu
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Yasuaki Hayashino
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Sakyo-ku, Kyoto, Japan
| | | | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
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25
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Sung YT, Hsiao CT, Chang IJ, Lin YC, Yueh CY. Smoking Cessation Carries a Short-Term Rising Risk for Newly Diagnosed Diabetes Mellitus Independently of Weight Gain: A 6-Year Retrospective Cohort Study. J Diabetes Res 2016; 2016:3961756. [PMID: 27478846 PMCID: PMC4960337 DOI: 10.1155/2016/3961756] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2016] [Revised: 05/17/2016] [Accepted: 06/09/2016] [Indexed: 12/22/2022] Open
Abstract
Background. The effects of smoking on human metabolism are complex. Although smoking increases risk for diabetes mellitus, smoking cessation was also reported to be associated with weight gain and incident diabetes mellitus. We therefore conducted this study to clarify the association between smoking status and newly diagnosed diabetes mellitus. Methods. An analysis was done using the data of a mass health examination performed annually in an industrial park from 2007 to 2013. The association between smoking status and newly diagnosed diabetes mellitus was analyzed with adjustment for weight gain and other potential confounders. Results. Compared with never-smokers, not only current smokers but also ex-smokers in their first two years of abstinence had higher odds ratios (ORs) for newly diagnosed diabetes mellitus (never-smokers 3.6%, OR as 1; current smokers 5.5%, OR = 1.499, 95% CI = 1.147-1.960, and p = 0.003; ex-smokers in their first year of abstinence 7.5%, OR = 1.829, 95% CI = 0.906-3.694, and p = 0.092; and ex-smokers in their second year of abstinence 9.0%, OR = 2.020, 95% CI = 1.031-3.955, and p = 0.040). Conclusion. Smoking cessation generally decreased risk for newly diagnosed diabetes mellitus. However, increased odds were seen within the first 2 years of abstinence independently of weight gain.
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Affiliation(s)
- Yi-Ting Sung
- Department of Family Medicine, Chang Gung Memorial Hospital, Putz, Chiayi 613, Taiwan
| | - Cheng-Ting Hsiao
- Department of Emergency Medicine, Chang Gung Memorial Hospital, Putz, Chiayi 613, Taiwan
| | - I-Jen Chang
- Department of Family Medicine, Chang Gung Memorial Hospital, Putz, Chiayi 613, Taiwan
| | - Yu-Chih Lin
- Department of Family Medicine, Chang Gung Memorial Hospital, Putz, Chiayi 613, Taiwan
| | - Chen-Yu Yueh
- Department of Family Medicine, Chang Gung Memorial Hospital, Putz, Chiayi 613, Taiwan
- Chang Gung University of Science and Technology, Putz, Chiayi 613, Taiwan
- *Chen-Yu Yueh:
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26
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Pan A, Wang Y, Talaei M, Hu FB, Wu T. Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015; 3:958-67. [PMID: 26388413 PMCID: PMC4656094 DOI: 10.1016/s2213-8587(15)00316-2] [Citation(s) in RCA: 367] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/01/2015] [Accepted: 08/10/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND Cigarette smoking remains the leading avoidable cause of disease burden worldwide, and observational studies have linked various smoking behaviours (active smoking, passive smoking, and smoking cessation) with risk of type 2 diabetes. We did a meta-analysis of prospective studies to investigate the associations between various smoking behaviours and diabetes risk. METHODS We systematically searched MEDLINE (up to May 3, 2015) and Embase (up to April 16, 2014) for reports of prospective studies, using search terms related to smoking, diabetes mellitus, and studies with a prospective design. We supplemented this strategy with manual searches of the reference lists of retrieved publications and relevant reviews. We included prospective studies that reported risk of type 2 diabetes by baseline smoking status. We calculated pooled relative risks (RRs) with 95% CIs using random-effects models, and did subgroup analyses by participant and study characteristics. FINDINGS We identified 88 eligible prospective studies with 5 898 795 participants and 295 446 incident cases of type 2 diabetes. The pooled RR of type 2 diabetes was 1·37 (95% CI 1·33-1·42) for comparing current smoking with non-smoking (84 studies with 5 853 952 participants), 1·14 (1·10-1·18) for comparing former smoking with never smoking (47 studies with 2 930 391 participants), and 1·22 (1·10-1·35) for comparing never smokers with and without exposure to passive smoke (seven studies with 156 439 participants). The associations persisted in all subgroups, and we identified a dose-response relation for current smoking and diabetes risk: compared with never smokers, the RRs were 1·21 (1·10-1·33) for light smokers, 1·34 (1·27-1·41) for moderate smokers, and 1·57 (1·47-1·66) for heavy smokers. Based on the assumption that the association between smoking and diabetes risk is causal, we estimated that 11·7% of cases of type 2 diabetes in men and 2·4% in women (ie, about 27·8 million cases in total worldwide) were attributable to active smoking. Compared with never smokers, the pooled RR from ten studies with 1 086 608 participants was 1·54 (95% CI 1·36-1·74) for new quitters (<5 years), 1·18 (1·07-1·29) for middle-term quitters (5-9 years), and 1·11 (1·02-1·20) for long-term quitters (≥10 years). INTERPRETATION Active and passive smoking are associated with significantly increased risks of type 2 diabetes. The risk of diabetes is increased in new quitters, but decreases substantially as the time since quitting increases. If the association between smoking and risk of type 2 diabetes is causal, public health efforts to reduce smoking could have a substantial effect on the worldwide burden of type 2 diabetes. FUNDING Chinese National Thousand Talents Program for Distinguished Young Scholars, US National Institutes of Health, the Chinese National 111 Project, and the Program for Changjiang Scholars and Innovative Research Team in University from the Chinese Ministry of Education.
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Affiliation(s)
- An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yeli Wang
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Mohammad Talaei
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Frank B Hu
- Departments of Nutrition and Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Tangchun Wu
- Department of Occupational and Environmental Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China; Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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27
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Imamura F, O'Connor L, Ye Z, Mursu J, Hayashino Y, Bhupathiraju SN, Forouhi NG. Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction. BMJ 2015; 351:h3576. [PMID: 26199070 PMCID: PMC4510779 DOI: 10.1136/bmj.h3576] [Citation(s) in RCA: 653] [Impact Index Per Article: 65.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom. DESIGN Systematic review and meta-analysis. DATA SOURCES AND ELIGIBILITY PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n = 4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n = 1932 representing 44.7 million). SYNTHESIS METHODS Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages. RESULTS Prespecified information was extracted from 17 cohorts (38,253 cases/10,126,754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I(2) for heterogeneity = 89%) and 13% (6% to 21%, I(2) = 79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I(2) = 70%) and 8% (2% to 15%, I(2) = 64%); and for fruit juice, 5% (-1% to 11%, I(2) = 58%) and 7% (1% to 14%, I(2) = 51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity = 0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79,000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%). CONCLUSIONS Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showed positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.
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Affiliation(s)
- Fumiaki Imamura
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Laura O'Connor
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Zheng Ye
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
| | - Jaakko Mursu
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Yasuaki Hayashino
- Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Sakyo-ku, Kyoto, Japan Department of Endocrinology, Tenri Hospital, Tenri City, Nara, Japan Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Sakyo-ku, Kyoto, Japan
| | | | - Nita G Forouhi
- Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge, CB2 0QQ, UK
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28
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[Comprehensive risk management chart for the prevention of cerebro- and cardiovascular diseases]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2015; 104:824-859. [PMID: 26536749 DOI: 10.2169/naika.104.824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
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Wei X, E M, Yu S. A meta-analysis of passive smoking and risk of developing Type 2 Diabetes Mellitus. Diabetes Res Clin Pract 2015; 107:9-14. [PMID: 25488377 DOI: 10.1016/j.diabres.2014.09.019] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/25/2014] [Accepted: 09/14/2014] [Indexed: 10/24/2022]
Abstract
AIMS To assess passive smoking as a risk factor for developing type 2 Diabetes Mellitus (T2DM). METHODS A search of PubMed, Web of Knowledge, Elsevier ScienceDirect and Springer (up to March, 2014) databases were performed using subject and random words. Two authors independently extracted the data. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. The odds ratio (ORs) for the association was determined using a fix-effects model. Subgroup and sensitivity analyses were performed and publication bias was assessed. RESULT 7 prospective studies were included in this meta-analysis which included a total of 162,001 subjects. The overall OR for developing T2DM for passive smoking was 1.33 (95% confidence interval (CI) 1.20-1.46), with no significant heterogeneity between studies. The result was stable in the subgroup and sensitivity analyses, however there was evidence of publication bias. After the "fill and trim" method, the recalculated OR was 1.27 (95%CI 1.16-1.40). CONCLUSIONS Passive smoking is a risk factor of T2DM even in those who were not themselves active smokers.
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Affiliation(s)
- Xiaomin Wei
- Institute of Occupational Health and Environmental, Health, Shandong University, 44 Wenhua Xi Road, Jinan, 250012 Shandong, PR China
| | - Meng E
- Institute of Occupational Health and Environmental, Health, Shandong University, 44 Wenhua Xi Road, Jinan, 250012 Shandong, PR China
| | - Sufang Yu
- Institute of Occupational Health and Environmental, Health, Shandong University, 44 Wenhua Xi Road, Jinan, 250012 Shandong, PR China.
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Sun K, Liu D, Wang C, Ren M, Yang C, Yan L. Passive smoke exposure and risk of diabetes: a meta-analysis of prospective studies. Endocrine 2014; 47:421-7. [PMID: 24532101 DOI: 10.1007/s12020-014-0194-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Accepted: 01/28/2014] [Indexed: 01/20/2023]
Abstract
Epidemiological evidence suggests that passive smoke exposure is related to the development of diabetes. However, data on this issue are controversial. We conducted a meta-analysis to provide a quantitative assessment of the association between passive smoking and the risk of diabetes. We searched the Medline and Embase databases up to October 2013 to identify prospective cohort studies related to passive smoke exposure and incident diabetes. Summary effect estimates with 95 % confidence intervals (CI) were derived using a fixed or random effects model, depending on the heterogeneity of the included studies. Six prospective studies that span three continents involving 154,406 participants (ages 18-74) with 7,116 new diabetes cases were included in the meta-analysis. On the basis of the Newcastle Ottawa Scale system, five studies were identified as relatively high-quality. In our primary analysis, compared to never smokers without passive smoke exposure, never smokers reporting passive smoke exposure was associated with increased risk of diabetes (pooled relative risk 1.21, 95 % CI 1.07-1.38). Such association persisted in the dose-response analysis. No indications of significant heterogeneity and publication bias were detected. Estimates of total effects were generally consistent in the sensitivity and subgroup analyses. Findings of the present meta-analysis suggest that passive smoke exposure is independently associated with the risk of diabetes. The conclusion may have a far-reaching significance for public health in countries of high smoking intensity and high incident diabetes.
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Affiliation(s)
- Kan Sun
- Department of Endocrinology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, People's Republic of China
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Faggiano F, Allara E. Passive smoke exposure and type-2 diabetes: is it time for action? Endocrine 2014; 47:348-50. [PMID: 25239204 DOI: 10.1007/s12020-014-0430-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/11/2014] [Indexed: 10/24/2022]
Affiliation(s)
- Fabrizio Faggiano
- Department of Translational Medicine, UPO - Università del Piemonte Orientale, Novara, Italy,
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Eze IC, Schaffner E, Zemp E, von Eckardstein A, Turk A, Bettschart R, Schindler C, Probst-Hensch N. Environmental tobacco smoke exposure and diabetes in adult never-smokers. Environ Health 2014; 13:74. [PMID: 25253088 PMCID: PMC4192739 DOI: 10.1186/1476-069x-13-74] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 09/13/2014] [Indexed: 05/25/2023]
Abstract
BACKGROUND Active smoking has been linked to type 2 diabetes mellitus (T2DM) but only few recent studies have shown environmental tobacco smoke (ETS) to be associated with DM in never-smokers. We assessed the association between long term ETS exposure and DM, and explored effect modifications of this association in our sample. METHODS We analysed 6392 participants of the Swiss study on air pollution and lung and heart diseases in adults (SAPALDIA). We used mixed logistic regression models to assess the cross-sectional association between ETS and DM. Selected variables were tested for effect modification and several sensitivity analyses were performed, mostly treating participants' study area as a random effect. RESULTS The prevalence of DM and ETS in the sample was 5.5% and 47% respectively. There were 2779 never-smokers with 4% diabetes prevalence. Exposure to ETS increased risk of DM in never-smokers by 50% [95% confidence interval (CI): 1.00, 2.26], and we observed a positive dose-response relationship between ETS exposure level and DM in never-smokers. Associations were strengthened (more than three-folds) by older age and chronic obstructive pulmonary disease, and were stronger in post-menopausal, obese, hypertriglyceridaemic and physically inactive participants. Estimates of association were robust across all sensitivity analyses (including inverse probability weighting for participation bias and fixed-effect analysis for study area). ETS had no substantial associations in current and ex-smokers in our study. CONCLUSIONS We found a positive association between ETS exposure and DM in never smokers. Additional longitudinal studies involving biomarkers are needed to further explore underlying mechanisms and susceptibilities.
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Affiliation(s)
- Ikenna C Eze
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
- />University of Basel, Basel, Switzerland
| | - Emmanuel Schaffner
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
- />University of Basel, Basel, Switzerland
| | - Elisabeth Zemp
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
- />University of Basel, Basel, Switzerland
| | | | - Alexander Turk
- />Zürcher Höhenklinik Wald, Wald-Faltigberg, Faltigberg-wald, Switzerland
| | | | - Christian Schindler
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
- />University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- />Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland
- />University of Basel, Basel, Switzerland
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Tian Y, Shen L, Wu J, Chen W, Yuan J, Yang H, Wang Y, Liang Y, Wu T. Parity and the risk of diabetes mellitus among Chinese women: a cross-sectional evidence from the Tongji-Dongfeng cohort study. PLoS One 2014; 9:e104810. [PMID: 25105792 PMCID: PMC4126778 DOI: 10.1371/journal.pone.0104810] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 07/14/2014] [Indexed: 12/21/2022] Open
Abstract
Objectives Little is known about the long-term health impact of pregnancy on women. The objective of this study was to examine the association between parity and the risk of diabetes among a population of Chinese women. Study design A total of 14,196 women (aged ≥45 years) from the Dongfeng-Tongji Cohort study who had experienced at least one live birth completed baseline questionnaires, medical examinations, and provided baseline blood samples. Participants were categorized into four groups according to parity (one, two, three, or four or more live births). Logistic regression models were used to investigate the association between parity and the risk of diabetes after controlling potential confounders. Results The prevalence of diabetes in the study population was 18.0% (2,552/14,196). Fasting plasma glucose levels increased with the increasing number of live births (P<0.001) and parity had a positive graded association with diabetes without adjustment for any covariates (P for trend <0.001). After adjusting for potential confounders, women who had had two, three, and four or more live births had 1.35 times (95% CI, 1.20–1.52), 1.59 times (95% CI, 1.39–1.82) and 1.44 times (95% CI, 1.21–1.71), respectively, higher risk of diabetes compared with women who had had one live birth. Conclusion Multiparity was associated with increasing risk of diabetes in this population of Chinese women. These findings suggested that multiparity may be a risk factor for the development of diabetes among Chinese women. Future studies are needed to examine the physiological changes during pregnancy for risk of diabetes in later life.
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Affiliation(s)
- Yaohua Tian
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Lijun Shen
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jing Wu
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Weihong Chen
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jing Yuan
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Handong Yang
- Dongfeng General Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Hubei, China
| | - Youjie Wang
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (YW); (YL)
| | - Yuan Liang
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- Department of Social Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
- * E-mail: (YW); (YL)
| | - Tangchun Wu
- MOE Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
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Lonergan BJ, Meaney S, Perry IJ, Comber H, Power B, Bradley C, Greiner BA. Smokers still underestimate the risks posed by secondhand smoke: a repeated cross-sectional study. Nicotine Tob Res 2014; 16:1121-8. [PMID: 24867880 DOI: 10.1093/ntr/ntu046] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Little is known about risk perception of secondhand smoke (SHS) and its changes over time. The aim of the study was to examine the role of smoking status and demographics on perceiving a range of health risks of SHS exposure and their trends over time among a representative sample of the Irish general population. METHODS This study included 2 repeated cross-sectional samples of Irish adults in 1999 (n = 1,240) and 2006 (n = 1,000), in addition to a representative sample of General Practitioners (2006: n = 248), sampled as a health care professional's view on SHS risk. Participants were asked to consider whether a nonsmoker, exposed to SHS, is at an increased risk of asthma, lung cancer, heart disease, bronchitis, diabetes, and ear infections in children. RESULTS There was a significant increase in the general population's risk perception of SHS for asthma, lung cancer, heart disease, and bronchitis from 1999 to 2006. Not even half of the general population in 1999 and in 2006 perceived a risk for the development of ear infections in children with SHS exposure (45% in 1999, 46% in 2006). With the exception of ear infections in children in 2006, the risk perception of all diseases differed significantly by smoking status; smokers' risk perception of SHS was significantly lower. Encouraging results suggest that the differences in risk perception between smokers and nonsmokers have decreased. CONCLUSION Risk perception of SHS exposure has improved as has the gap in perception between smokers and nonsmokers. This research points to a lack of awareness among the general population of the risk perception of SHS exposure to children.
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Affiliation(s)
- Bernie J Lonergan
- Department of Epidemiology and Public Health, University College Cork, Cork, Republic of Ireland;
| | - Sarah Meaney
- Department of Epidemiology and Public Health, University College Cork, Cork, Republic of Ireland
| | - Ivan J Perry
- Department of Epidemiology and Public Health, University College Cork, Cork, Republic of Ireland
| | - Harry Comber
- National Cancer Registry, Cork, Republic of Ireland
| | - Bernadette Power
- Department of Economics, University College Cork, Cork, Republic of Ireland
| | - Colin Bradley
- Department of General Practice, University College Cork, Cork, Republic of Ireland
| | - Birgit A Greiner
- Department of Epidemiology and Public Health, University College Cork, Cork, Republic of Ireland
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Zhu B, Wu X, Wang X, Zheng Q, Sun G. The Association Between Passive Smoking and Type 2 Diabetes. Asia Pac J Public Health 2014; 26:226-37. [PMID: 24824522 DOI: 10.1177/1010539514531041] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The number of people with diabetes has been exponentially increasing. A number of reports in the literature have suggested that exposure to passive smoke may play a key role in the development of diabetes; however, the association has not been jointly summarized yet. In this meta-analysis, 2 databases were searched to identify studies, and the references of these studies were scanned for further studies. Fourteen studies on the relationship between passive smoking and diabetes were included. After all the studies were pooled, the results showed that passive smoking was significantly associated with an increased risk of type 2 diabetes in a random model. The subgroup analysis results were consistent with overall results regardless of type of study design, age, gender, adjustment of dependent variables, area, or study quality. Sensitivity analysis indicated that the overall results were reliable. There was no publication bias observed in the selected studies.
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Affiliation(s)
- Bo Zhu
- China Medical University, Shenyang, China
- Liaoning Academy of Safety Science, Shenyang, China
| | - Xiaomei Wu
- The First Hospital of China Medical University, Shenyang, China
| | - Xin Wang
- Liaoning Academy of Safety Science, Shenyang, China
| | | | - Guifan Sun
- China Medical University, Shenyang, China
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Worksite Wellness for the Primary and Secondary Prevention of Cardiovascular Disease in Japan: The Current Delivery System and Future Directions. Prog Cardiovasc Dis 2014; 56:515-21. [DOI: 10.1016/j.pcad.2013.09.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Li L, Gao K, Zhao J, Feng T, Yin L, Wang J, Wang C, Li C, Wang Y, Wang Q, Zhai Y, You H, Ren Y, Wang B, Hu D. Glucagon gene polymorphism modifies the effects of smoking and physical activity on risk of type 2 diabetes mellitus in Han Chinese. Gene 2013; 534:352-5. [PMID: 24185078 DOI: 10.1016/j.gene.2013.09.121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 08/30/2013] [Accepted: 09/30/2013] [Indexed: 12/17/2022]
Abstract
Few genome-wide association studies have considered interactions between multiple genetic variants and environmental factors associated with disease. The interaction was examined between a glucagon gene (GCG) polymorphism and smoking, alcohol consumption and physical activity and the association with risk of type 2 diabetes mellitus (T2DM) in a case-control study of Chinese Han subjects. The rs12104705 polymorphism of GCG and interactions with environmental variables were analyzed for 9619 participants by binary multiple logistic regression. Smoking with the C-C haplotype of rs12104705 was associated with increased risk of T2DM (OR=1.174, 95% CI=1.013-1.361). Moderate and high physical activity with the C-C genotype was associated with decreased risk of T2DM as compared with low physical activity with the genotype (OR=0.251, 95% CI=0.206-0.306 and OR=0.190, 95% CI=0.164-0.220). However, the interaction of drinking and genotype was not associated with risk of T2DM. Genetic polymorphism in rs12104705 of GCG may interact with smoking and physical activity to modify the risk of T2DM.
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Affiliation(s)
- Linlin Li
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Kaiping Gao
- Shenzhen University School of Medicine, Shenzhen, 518060, People's Republic of China
| | - Jingzhi Zhao
- Military Hospital of Henan Province, Zhengzhou, 450003, People's Republic of China
| | - Tianping Feng
- Military Hospital of Henan Province, Zhengzhou, 450003, People's Republic of China
| | - Lei Yin
- Military Hospital of Henan Province, Zhengzhou, 450003, People's Republic of China
| | - Jinjin Wang
- Discipline of Public Health and Preventive Medicine, Center of Preventive Medicine Research and Assessment, Henan University of Traditional Chinese Medicine, Zhengzhou, 450008, People's Republic of China
| | - Chongjian Wang
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Chunyang Li
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Yan Wang
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Qian Wang
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Yujia Zhai
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Haifei You
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Yongcheng Ren
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Bingyuan Wang
- Department of Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, People's Republic of China
| | - Dongsheng Hu
- Shenzhen University School of Medicine, Shenzhen, 518060, People's Republic of China.
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Teramoto T, Sasaki J, Ishibashi S, Birou S, Daida H, Dohi S, Egusa G, Hiro T, Hirobe K, Iida M, Kihara S, Kinoshita M, Maruyama C, Ohta T, Okamura T, Yamashita S, Yokode M, Yokote K. Treatment A) lifestyle modification: executive summary of the Japan Atherosclerosis Society(JAS) guidelines for the diagnosis and prevention of atherosclerotic cardiovascular diseases in Japan--2012 version. J Atheroscler Thromb 2013; 20:835-49. [PMID: 24172256 DOI: 10.5551/jat.18820] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Lajous M, Tondeur L, Fagherazzi G, de Lauzon-Guillain B, Boutron-Ruaualt MC, Clavel-Chapelon F. Childhood and adult secondhand smoke and type 2 diabetes in women. Diabetes Care 2013; 36:2720-5. [PMID: 23757428 PMCID: PMC3747882 DOI: 10.2337/dc12-2173] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the relationship between childhood and adult secondhand smoke and type 2 diabetes. RESEARCH DESIGN AND METHODS We conducted a prospective cohort study among 37,343 French women from the E3N-EPIC (Etude Epidémiologique auprès des femmes de la Mutuelle Générale de l'Education Nationale-European Prospective Investigation into Cancer and Nutrition) who never smoked and who were free of type 2 diabetes, cancer, or cardiovascular disease at baseline in 1992. Self-reported childhood secondhand smoke exposure was defined as having at least one parent who smoked. Adult secondhand smoke was defined as the sum of self-reported hours recorded at baseline of exposure to tobacco smoke from a spouse who smoked (or domestic close contact) and from outside the home. RESULTS Between 1992 and 2007, 795 cases of incident type 2 diabetes were identified and validated through a drug reimbursement dataset and a specific questionnaire. Women with at least one parent who smoked appeared to have an 18% higher rate of type 2 diabetes than women with parents who did not smoke (age-adjusted hazard ratio 1.18 [95% CI 1.02-1.36]). Adult secondhand smoke exposure (no exposure versus ≥ 4 h/day) was associated with an increased rate of type 2 diabetes (1.36 [1.05-1.77], P = 0.002 for trend) after adjusting for parental history of diabetes, education, body silhouette at age 8, childhood secondhand smoke exposure, physical activity, body mass index, hypertension, hypercholesterolemia, menopausal status and hormone use, alcohol intake, and processed red meat and coffee consumption. CONCLUSIONS This prospective analysis suggests that secondhand smoke exposure in childhood and adulthood are associated with a higher rate of type 2 diabetes.
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Affiliation(s)
- Martin Lajous
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
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Wang Y, Ji J, Liu YJ, Deng X, He QQ. Passive smoking and risk of type 2 diabetes: a meta-analysis of prospective cohort studies. PLoS One 2013; 8:e69915. [PMID: 23922856 PMCID: PMC3724674 DOI: 10.1371/journal.pone.0069915] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 06/13/2013] [Indexed: 01/11/2023] Open
Abstract
Backgrounds/Objective The prevalence of diabetes is increasing rapidly all over the world. However, studies on passive smoking and type 2 diabetes have not been systematically assessed. Therefore, we conducted a meta-analysis to explore whether an association exists between passive smoking and risk of type 2 diabetes. Methods We searched PubMed, EMBASE, Cochrane library and Web of Science up to April 9th, 2013, to identify prospective cohort studies that assessed passive smoking and risk of type 2 diabetes. The fixed-effect model was used to calculate the overall relative risk (RR). Result 4 prospective cohort studies were included for analysis, with a total of 112,351 participants involved. The pooled RR was 1.28 (95% confidence interval (CI) 1.14 to 1.44) comparing those who were exposed to passive smoking with those who were not. Subgroup, sensitivity analysis and publication bias test suggested the overall result of this analysis was robust. Conclusions Passive smoking is associated with a significantly increased risk of type 2 diabetes. Further well-designed studies are warranted to confirm this association.
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Affiliation(s)
- Ying Wang
- School of Public Health, Wuhan University, Wuhan, P. R. China
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Jie Ji
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Yu-jian Liu
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Xuan Deng
- School of Public Health, Wuhan University, Wuhan, P. R. China
| | - Qi-qiang He
- School of Public Health, Wuhan University, Wuhan, P. R. China
- Global Health Institute, Wuhan University, Wuhan, P. R. China
- * E-mail:
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HARADA YUKA, OGA TORU, CHIN KAZUO, TAKEGAMI MISA, TAKAHASHI KENICHI, SUMI KENSUKE, NAKAMURA TAKAYA, NAKAYAMA-ASHIDA YUKIYO, MINAMI ITSUNARI, HORITA SACHIKO, OKA YASUNORI, WAKAMURA TOMOKO, FUKUHARA SHUNICHI, MISHIMA MICHIAKI, KADOTANI HIROSHI. Differences in relationships among sleep apnoea, glucose level, sleep duration and sleepiness between persons with and without type 2 diabetes. J Sleep Res 2012; 21:410-8. [DOI: 10.1111/j.1365-2869.2012.00997.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Okamura T, Nakamura K, Hayakawa T, Kanda H, Miura K, Okayama A, Ueshima H. [Effect of cardiovascular risk factors on individual and population medical expenditures: a 10-year cohort study of 4,535 National Health Insurance beneficiaries in Shiga]. Nihon Eiseigaku Zasshi 2012; 67:38-43. [PMID: 22449821 DOI: 10.1265/jjh.67.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A 10-year follow-up cohort study of 4,535 National Health Insurance beneficiaries aged 40 to 69 years in Shiga was performed as part of a research project conducted by the Health Promotion Research Committee of the Shiga National Health Insurance Organizations in 2002. The relationship between cardiovascular risk factors and medical expenditures during the 10-year study period has been examined in this cohort. For example, there was a positively graded correlation between blood pressure and individual total medical expenditures per month. The odds ratio for cumulative hospitalization and hazard ratio for all-cause mortality in severe hypertensives were also higher than those in normotensives. However, from the viewpoint of the entire population, the excess medical expenditures attributable to hypertension within the total medical expenditures were higher for mild-to-moderate hypertensives than for severe hypertensives. On the other hand, although individual medical expenditures per month were 1.7-fold higher for participants with 2 or 3 risk factors and obesity, which was broadly equivalent to metabolic syndrome, than for those without these factors, the excess medical expenditures determined by risk clustering within the total medical expenditures were higher in normal-weight people than in obese people because of the higher prevalence of normal weight. These findings suggest that high-risk individuals are a good target of a high-risk approach, such as intensive health guidance, from the viewpoint of medical expenditures. However, another approach for the majority with a low-to-moderate cardiovascular risk should be considered, because they account for a greater proportion of the excess medical expenditures. Another way to solve this problem may be a population approach with an effective method of providing information to citizens.
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Affiliation(s)
- Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan.
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Hayashino Y, Fukuhara S, Okamura T, Tanaka T, Ueshima H. High oolong tea consumption predicts future risk of diabetes among Japanese male workers: a prospective cohort study. Diabet Med 2011; 28:805-10. [PMID: 21244473 DOI: 10.1111/j.1464-5491.2011.03239.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Acute administration of oolong tea decreases blood glucose levels. We investigated the association between long-term oolong tea intake and subsequent risk of developing diabetes among men of working age. METHODS Data were analysed from a cohort of participants in the High-risk and Population Strategy for Occupational Health Promotion Study (HIPOP-OHP), conducted in Japan from 1999 to 2004. Oolong tea intake at baseline and subsequent risk of diabetes was evaluated using a Cox proportional hazards model. RESULTS Of 4975 male workers, a total of 201 cases of diabetes were reported over a median of 3.4 years of follow-up. Mean age and BMI of all participants at baseline were 38.3 years and 22.9 kg/m(2) , respectively. Compared with those not consuming oolong tea, multivariable adjusted hazard ratios for developing diabetes were 1.00 (95% CI 0.67-1.49) for those who drank one cup of oolong tea per day and 1.64 (95% CI 1.11-2.40) for those drinking two or more cups per day. Fasting blood glucose increment per year was 0.11 mmol/l (95% CI 0.09-0.12 mmol/l), 0.12 mmol/l (95% CI 0.09-0.15 mmol/l) and 0.15 mmol/l (95% CI 0.11-0.18 mmol/l), respectively, for oolong tea consumption of 0, 1 and ≥ 2 cups/day, with a significant linear trend (P < 0.0001). CONCLUSIONS Long-term consumption of oolong tea may be a predictive factor for new onset diabetes. Further studies are necessary to elucidate the role of oolong tea in the risk of developing diabetes.
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Affiliation(s)
- Y Hayashino
- Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine, Kyoto, Japan.
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Zhang L, Curhan GC, Hu FB, Rimm EB, Forman JP. Association between passive and active smoking and incident type 2 diabetes in women. Diabetes Care 2011; 34:892-7. [PMID: 21355099 PMCID: PMC3064047 DOI: 10.2337/dc10-2087] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Accumulating evidence has identified a positive association between active smoking and the risk of diabetes, but previous studies had limited information on passive smoking or changes in smoking behaviors over time. This analysis examined the association between exposure to passive smoke, active smoking, and the risk of incident type 2 diabetes among women. RESEARCH DESIGN AND METHODS This is a prospective cohort study of 100,526 women in the Nurses' Health Study who did not have prevalent diabetes in 1982, with follow-up for diabetes for 24 years. RESULTS We identified 5,392 incident cases of type 2 diabetes during 24 years of follow-up. Compared with nonsmokers with no exposure to passive smoke, there was an increased risk of diabetes among nonsmokers who were occasionally (relative risk [RR] 1.10 [95% CI 0.94-1.23]) or regularly (1.16 [1.00-1.35]) exposed to passive smoke. The risk of incident type 2 diabetes was increased by 28% (12-50) among all past smokers. The risk diminished as time since quitting increased but still was elevated even 20-29 years later (1.15 [1.00-1.32]). Current smokers had the highest risk of incident type 2 diabetes in a dose-dependent manner. Adjusted RRs increased from 1.39 (1.17-1.64) for 1-14 cigarettes per day to 1.98 (1.57-2.36) for ≥25 cigarettes per day compared with nonsmokers with no exposure to passive smoke. CONCLUSIONS Our study suggests that exposure to passive smoke and active smoking are positively and independently associated with the risk of type 2 diabetes.
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Affiliation(s)
- Luxia Zhang
- Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, USA.
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Ko KP, Min H, Ahn Y, Park SJ, Kim CS, Park JK, Kim SS. A prospective study investigating the association between environmental tobacco smoke exposure and the incidence of type 2 diabetes in never smokers. Ann Epidemiol 2011; 21:42-7. [PMID: 21130368 DOI: 10.1016/j.annepidem.2010.10.006] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2010] [Revised: 09/17/2010] [Accepted: 10/08/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE We studied a cohort of individuals to assess whether intensity of environmental tobacco smoke (ETS) exposure is associated with the incidence of type 2 diabetes. METHODS Study subjects were selected from an ongoing population-based cohort of Korea Genome and Epidemiology Study. Participants of the baseline study 10,038 persons within the age range of 40 to 69 years old. Among 4,442 never smokers without prevalent diabetes, 465 type 2 diabetes cases were identified through biennial active follow-ups for a 6-year period. Cox proportional hazard models were used to estimate the hazard ratio (HR) and 95% confidence intervals (CI) after adjustment for covariates. RESULTS The risk of type 2 diabetes was higher in subjects exposed to ETS compared with the nonexposure group (HR = 1.41, 95% CI: 1.1-1.70). Daily exposure to ETS at home increased the risk of type 2 diabetes when compared with the risk level of nonexposure (HR = 1.46, 95% CI: 1.16-1.83). Over 4 hours exposure to ETS at home and in the workplace was associated with increased the risk of type 2 diabetes (HR = 1.96, 95% CI: 1.21-3.19). CONCLUSIONS Our study suggests that ETS exposure is a significant risk factor for the development of type 2 diabetes with dose-response relationship.
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Affiliation(s)
- Kwang-Pil Ko
- Division of Epidemiology and Health Index, Center for Genome Science, Korea Centers for Disease Control and Prevention, Osong, Korea
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Fisher-Wellman K, Bell HK, Bloomer RJ. Oxidative stress and antioxidant defense mechanisms linked to exercise during cardiopulmonary and metabolic disorders. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2011; 2:43-51. [PMID: 20046644 PMCID: PMC2763230 DOI: 10.4161/oxim.2.1.7732] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 12/17/2008] [Accepted: 12/18/2008] [Indexed: 01/01/2023]
Abstract
Oxidative stress has been implicated in the pathophysiology of multiple human diseases, in addition to the aging process. Although various stimuli exist, acute exercise is known to induce a transient increase in reactive oxygen and nitrogen species (RONS), evident by several reports of increased oxidative damage following acute bouts of aerobic and anaerobic exercise. Although the results are somewhat mixed and appear disease dependent, individuals with chronic disease experience an exacerbation in oxidative stress following acute exercise when compared to healthy individuals. However, this increased oxidant stress may serve as a necessary “signal” for the upregulation in antioxidant defenses, thereby providing protection against subsequent exposure to prooxidant environments within susceptible individuals. Here we present studies related to both acute exercise-induced oxidative stress in those with disease, in addition to studies focused on adaptations resulting from increased RONS exposure associated with chronic exercise training in persons with disease.
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Affiliation(s)
- Kelsey Fisher-Wellman
- Cardiorespiratory/Metabolic Laboratory, The University of Memphis, Memphis, Tennessee 38152, USA
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Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: the KORA S4/F4 cohort study. Eur J Epidemiol 2010; 25:393-402. [PMID: 20369275 DOI: 10.1007/s10654-010-9452-6] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2009] [Accepted: 03/18/2010] [Indexed: 12/21/2022]
Abstract
Active smoking is a risk factor for type 2 diabetes (T2DM), but it is unclear whether exposure to environmental tobacco smoke (ETS) is also associated with T2DM. The effect of passive and active smoking on the 7-year T2DM incidence was investigated in a population-based cohort in Southern Germany (KORA S4/F4; 1,223 subjects aged 55-74 years at baseline in 1999-2001, 887 subjects at follow-up). Incident diabetes was identified by oral glucose tolerance tests or by validated physician diagnoses. Among never smokers, subjects exposed to ETS had an increased diabetes risk in the total sample (odds ratio (OR) = 2.5; 95% confidence interval (CI): 1.1, 5.6) and in a subgroup of subjects having prediabetes at baseline (OR = 4.4; 95% CI: 1.5, 13.4) after adjusting for age, sex, parental diabetes, socioeconomic status, and lifestyle factors. Active smoking also had a statistically significant effect on diabetes incidence in the total sample (OR = 2.8; 95% CI: 1.3, 6.1) and in prediabetic subjects (OR = 7.8; 95% CI: 2.4, 25.7). Additional adjustment for components of the metabolic syndrome including waist circumference did not attenuate any of these associations. This study provides evidence that both passive and active smoking is associated with T2DM.
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Hozawa A, Okamura T, Tanaka T, Miura K, Kikuchi Y, Kadowaki T, Yoshita K, Takebayashi T, Tamaki J, Minai J, Tada T, Chiba N, Okayama A, Ueshima H. Relation of Gamma-glutamyltransferase and alcohol drinking with incident diabetes: the HIPOP-OHP study. J Atheroscler Thromb 2010; 17:195-202. [PMID: 20150721 DOI: 10.5551/jat.3202] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Gamma-glutamyltransferase (GGT) is known to correlate well with alcohol consumption; however, the relation between GGT and diabetes and that between alcohol consumption and diabetes mellitus (DM) is inconsistent. Thus, several questions, such as whether light to moderate drinkers can be considered as low risk for diabetes incidence irrespective of their GGT level, is unresolved. In this study, we investigated the relation of GGT or alcohol drinking with DM incidence considering the body mass index (BMI) in healthy Japanese workers. METHODS We followed 3095 men who did not have DM at baseline for 4 years. Incident diabetes was defined as a fasting (non-fasting) plasma glucose level of >or=7.0 (11.1) mmol/L, or treatment of diabetes. Multiple adjusted hazard ratios (HR) were calculated using Cox proportional models. RESULTS Participants with higher GGT (GGT >or=27 IU/L) showed an increased risk of diabetes incidence even when their BMI level was low. Although a U-shaped relation between alcohol drinking and incident diabetes was observed, the risk to light to moderate drinkers (alcohol <23 g/day) was not low if they were either overweight (BMI >or=25 kg/m(2)) or had higher GGT (HR=2.60, p=0.08) or both overweight and higher GGT (HR=3.16, p=0.07) compared with never drinkers without higher GGT and overweight. CONCLUSIONS Higher GGT was associated with a higher incidence of DM irrespective of drinking status or obesity. Although a U-shaped relation between alcohol drinking and incident diabetes was observed, the risk to light to moderate drinkers was not low if they were either overweight or had higher GGT.
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Affiliation(s)
- Atsushi Hozawa
- Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
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Vardavas CI, Lionis C, Polychronopoulos E, Zeimbekis A, Bountziouka V, Stravopodis P, Metallinos G, Panagiotakos DB. The role of second-hand smoking on the prevalence of Type 2 diabetes mellitus in elderly men and women living in Mediterranean islands: the MEDIS study. Diabet Med 2010; 27:242-3. [PMID: 20546272 DOI: 10.1111/j.1464-5491.2009.02889.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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