High-Intensity Cigarette Smoking Is Associated With Incident Diabetes Mellitus In Black Adults: The Jackson Heart Study

被引:16
作者
White, Wendy B. [1 ]
Cain, Loretta R. [2 ]
Benjamin, Emelia J. [3 ]
DeFilippis, Andrew P. [4 ]
Blaha, Michael J. [5 ]
Wang, Wei [2 ]
Okhomina, Victoria [2 ]
Keith, Rachel J. [6 ]
Al Rifai, Mahmoud [7 ]
Kianoush, Sina [5 ]
Winniford, Michael D. [8 ]
Robertson, Rose M. [9 ]
Bhatnagar, Aruni [6 ]
Correa, Adolfo [8 ]
Hall, Michael E. [8 ]
机构
[1] Tougaloo Coll, Tougaloo, MS USA
[2] Univ Mississippi, Med Ctr, Dept Data Sci, Jackson, MS 39216 USA
[3] Boston Univ, Sch Med, Dept Med, Boston, MA 02118 USA
[4] Univ Louisville, Dept Med, Louisville, KY 40292 USA
[5] Johns Hopkins Sch Med, Ciccarone Ctr Prevent Heart Dis, Baltimore, MD USA
[6] Univ Louisville, Diabet & Obes Ctr, Louisville, KY 40292 USA
[7] Univ Kansas, Sch Med, Dept Med, Wichita, KS 67214 USA
[8] Univ Mississippi, Med Ctr, Dept Med, 2500 North State St, Jackson, MS 39216 USA
[9] Vanderbilt Univ, Med Ctr, Dept Med, Nashville, TN USA
来源
JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2018年 / 7卷 / 02期
基金
美国国家卫生研究院;
关键词
diabetes mellitus; race and ethnicity; smoking; C-REACTIVE-PROTEIN; INSULIN-RESISTANCE; AFRICAN-AMERICANS; CYTOKINES; STRESS; RISK;
D O I
10.1161/JAHA.117.007413
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background-Previous reports on whether smoking is associated with insulin resistance and diabetes mellitus have yielded inconsistent findings. We aimed to evaluate the relationship between cigarette smoking and incident diabetes mellitus in the Jackson Heart Study. Methods and Results-Jackson Heart Study participants enrolled at baseline without prevalent diabetes mellitus (n=2991) were classified by self-report as current smokers, past smokers (smoked >= 400 cigarettes/life and no longer smoking), or never smokers. We quantified smoking intensity by number of cigarettes smoked daily; we considered >= 20 cigarettes per day (1 pack) "high-intensity." We defined diabetes mellitus as fasting glucose >= 126 mg/dL, hemoglobin A1c >= 6.5% or International Federation of Clinical Chemistry units HbA1c 48 mmol/mol, or use of diabetes mellitus medication. We estimated the adjusted associations of smoking status, intensity, and dose (pack-years) with incident diabetes mellitus using Poisson regression models. At baseline there were 361 baseline current (1-10 cigarettes per day [n=242]; >= 20 [n=119]), 502 past, and 2128 never smokers. From Visit 1 to Visit 3 (mean 8.0 +/- 0.9 years), 479 participants developed incident diabetes mellitus. After adjustment for covariates, baseline current smokers who smoked less than a pack/d and past smokers had similar rates of incident diabetes mellitus compared with never smokers (incidence rate ratios 1.04, 95% confidence interval, 0.69-1.58 and 1.08, 95% confidence interval, 0.82-1.42, respectively). Baseline current high-intensity smokers had a 79% (95% confidence interval, 1.14-2.81) higher incidence of diabetes mellitus compared with never smokers. Smoking dose (per 10 pack-years) was also associated with a higher incidence of diabetes mellitus (incidence rate ratios 1.10, 95% confidence interval, 1.03-1.19) in adjusted models. Conclusions-High-intensity cigarette smoking and smoking pack-years are associated with an increased risk of developing diabetes mellitus in blacks.
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页数:7
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