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. 2001 Apr;77(906):240–243. doi: 10.1136/pmj.77.906.240

Smoking and diabetes in Chinese men

G Ko 1, J Chan 1, L Tsang 1, J Critchley 1, C Cockram 1
PMCID: PMC1742000  PMID: 11264486

Abstract

Smoking is a major cardiovascular risk factor and cause of death. Diabetes mellitus is also associated with an increased mortality and morbidity. Evidence concerning whether smoking increases the incidence of diabetes remains conflicting. Glycaemic status and smoking habits were analysed in 3718 Chinese subjects in order to assess the possible association between smoking and risk of diabetes in the Chinese population. The World Health Organisation 1998 criteria were used for the diagnosis of glucose intolerance. Smoking was defined as current cigarette smoking or ex-smoking without regard to daily consumption. The smoking habits of the studied subjects were correlated with glycaemic status. There were 3003 (80.8%) women and 715 (19.2%) men. The mean age (SD) was 38.4 (12.8) years (median 35.0, range 12-88 years). Of the 3718 subjects, 786 (21.1%) had diabetes, 708 (19.1%) had impaired glucose tolerance, and 2224 (59.8%) had normal results. Of the 3003 women, only 87 (2.9%) were smokers. The female smokers were younger, heavier, and had higher alcohol consumption than non-smokers. The prevalence of diabetes was similar between female smokers and non-smokers after adjustment for age, body mass index, family history of diabetes, and alcohol. Of the 715 men, 175 (24.5%) were smokers. The male smokers were younger, had lower blood pressure, and higher alcohol consumption. After adjustment for age, body mass index, family history of diabetes and alcohol, the male smokers had lower blood pressure, higher one hour plasma glucose, and more diabetes. Using logistic regression analysis (stepwise forward) with age, body mass index, alcohol, smoking, and family history of diabetes as independent variables to predict the risk of having diabetes, age and body mass index are independently associated with diabetes in both men and women. In addition, smoking is independently associated with the risk of diabetes in men, the odds ratio (95% confidence interval, CI) being 1.705 (1.106 to 2.630). Family history of diabetes is independently associated with the risk of diabetes in women, and the odds ratio (95% CI) is 1.643 (1.314, to 2.053). In conclusion, it was found that smoking is independently associated with diabetes after adjustment for age, body mass index, alcohol, and family history of diabetes in Hong Kong Chinese men, the odds ratio being 1.7. The prevalence of smoking in Hong Kong Chinese women is low and its association with diabetes is inconclusive.


Keywords: smoking; diabetes mellitus; Chinese men

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Selected References

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  1. Alberti K. G., Zimmet P. Z. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med. 1998 Jul;15(7):539–553. doi: 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S. [DOI] [PubMed] [Google Scholar]
  2. Benowitz N. L., Sharp D. S. Inverse relation between serum cotinine concentration and blood pressure in cigarette smokers. Circulation. 1989 Nov;80(5):1309–1312. doi: 10.1161/01.cir.80.5.1309. [DOI] [PubMed] [Google Scholar]
  3. Bornemisza P., Suciu I. Effect of cigarette smoking on the blood glucose level in normals and diabetics. Med Interne. 1980 Oct-Dec;18(4):353–356. [PubMed] [Google Scholar]
  4. Charlton A., While D. Blood pressure and smoking: observations on a national cohort. Arch Dis Child. 1995 Oct;73(4):294–297. doi: 10.1136/adc.73.4.294. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Chen Z. M., Xu Z., Collins R., Li W. X., Peto R. Early health effects of the emerging tobacco epidemic in China. A 16-year prospective study. JAMA. 1997 Nov 12;278(18):1500–1504. doi: 10.1001/jama.278.18.1500. [DOI] [PubMed] [Google Scholar]
  6. De Cesaris R., Ranieri G., Filitti V., Bonfantino M. V., Andriani A. Cardiovascular effects of cigarette smoking. Cardiology. 1992;81(4-5):233–237. doi: 10.1159/000175809. [DOI] [PubMed] [Google Scholar]
  7. Feskens E. J., Kromhout D. Cardiovascular risk factors and the 25-year incidence of diabetes mellitus in middle-aged men. The Zutphen Study. Am J Epidemiol. 1989 Dec;130(6):1101–1108. doi: 10.1093/oxfordjournals.aje.a115437. [DOI] [PubMed] [Google Scholar]
  8. Fujioka S., Matsuzawa Y., Tokunaga K., Tarui S. Contribution of intra-abdominal fat accumulation to the impairment of glucose and lipid metabolism in human obesity. Metabolism. 1987 Jan;36(1):54–59. doi: 10.1016/0026-0495(87)90063-1. [DOI] [PubMed] [Google Scholar]
  9. Grunberg N. E., Popp K. A., Bowen D. J., Nespor S. M., Winders S. E., Eury S. E. Effects of chronic nicotine administration on insulin, glucose, epinephrine, and norepinephrine. Life Sci. 1988;42(2):161–170. doi: 10.1016/0024-3205(88)90679-0. [DOI] [PubMed] [Google Scholar]
  10. Janzon L., Berntorp K., Hanson M., Lindell S. E., Trell E. Glucose tolerance and smoking: a population study of oral and intravenous glucose tolerance tests in middle-aged men. Diabetologia. 1983 Aug;25(2):86–88. doi: 10.1007/BF00250893. [DOI] [PubMed] [Google Scholar]
  11. Jarrett R. J., McCartney P., Keen H. The Bedford survey: ten year mortality rates in newly diagnosed diabetics, borderline diabetics and normoglycaemic controls and risk indices for coronary heart disease in borderline diabetics. Diabetologia. 1982 Feb;22(2):79–84. doi: 10.1007/BF00254833. [DOI] [PubMed] [Google Scholar]
  12. Kawakami N., Takatsuka N., Shimizu H., Ishibashi H. Effects of smoking on the incidence of non-insulin-dependent diabetes mellitus. Replication and extension in a Japanese cohort of male employees. Am J Epidemiol. 1997 Jan 15;145(2):103–109. doi: 10.1093/oxfordjournals.aje.a009080. [DOI] [PubMed] [Google Scholar]
  13. Ko G. T., Chan J. C., Woo J., Lau E., Yeung V. T., Chow C. C., Wai H. P., Li J. K., So W. Y., Cockram C. S. Simple anthropometric indexes and cardiovascular risk factors in Chinese. Int J Obes Relat Metab Disord. 1997 Nov;21(11):995–1001. doi: 10.1038/sj.ijo.0800508. [DOI] [PubMed] [Google Scholar]
  14. Ko G. T., Yeung V. T., Chan J. C., Chow C. C., Li J. K., So W. Y., Tsang L. W., Cockram C. S. Plasma fibrinogen concentration in a Chinese population. Atherosclerosis. 1997 Jun;131(2):211–217. doi: 10.1016/s0021-9150(97)06109-1. [DOI] [PubMed] [Google Scholar]
  15. Lam T. H., He Y., Li L. S., Li L. S., He S. F., Liang B. Q. Mortality attributable to cigarette smoking in China. JAMA. 1997 Nov 12;278(18):1505–1508. [PubMed] [Google Scholar]
  16. Law M. R., Morris J. K., Wald N. J. Environmental tobacco smoke exposure and ischaemic heart disease: an evaluation of the evidence. BMJ. 1997 Oct 18;315(7114):973–980. doi: 10.1136/bmj.315.7114.973. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Medalie J. H., Papier C. M., Goldbourt U., Herman J. B. Major factors in the development of diabetes mellitus in 10,000 men. Arch Intern Med. 1975 Jun;135(6):811–817. [PubMed] [Google Scholar]
  18. Mikkelsen K. L., Wiinberg N., Høegholm A., Christensen H. R., Bang L. E., Nielsen P. E., Svendsen T. L., Kampmann J. P., Madsen N. H., Bentzon M. W. Smoking related to 24-h ambulatory blood pressure and heart rate: a study in 352 normotensive Danish subjects. Am J Hypertens. 1997 May;10(5 Pt 1):483–491. doi: 10.1016/s0895-7061(96)00487-6. [DOI] [PubMed] [Google Scholar]
  19. Mühlhauser I. Cigarette smoking and diabetes: an update. Diabet Med. 1994 May;11(4):336–343. doi: 10.1111/j.1464-5491.1994.tb00283.x. [DOI] [PubMed] [Google Scholar]
  20. Rimm E. B., Chan J., Stampfer M. J., Colditz G. A., Willett W. C. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ. 1995 Mar 4;310(6979):555–559. doi: 10.1136/bmj.310.6979.555. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Rimm E. B., Manson J. E., Stampfer M. J., Colditz G. A., Willett W. C., Rosner B., Hennekens C. H., Speizer F. E. Cigarette smoking and the risk of diabetes in women. Am J Public Health. 1993 Feb;83(2):211–214. doi: 10.2105/ajph.83.2.211. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Simon J. A., Seeley D. G., Lipschutz R. C., Vittinghoff E., Browner W. S. The relation of smoking to waist-to-hip ratio and diabetes mellitus among elderly women. Prev Med. 1997 Sep-Oct;26(5 Pt 1):639–644. doi: 10.1006/pmed.1997.0230. [DOI] [PubMed] [Google Scholar]
  23. Stamler J., Vaccaro O., Neaton J. D., Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993 Feb;16(2):434–444. doi: 10.2337/diacare.16.2.434. [DOI] [PubMed] [Google Scholar]
  24. Steenkamp E., Jooste P. L., Christopher K. J. The prevalence of smoking and its relationship to other coronary risk factors in a rural white community. S Afr Med J. 1988 Apr 2;73(7):402–405. [PubMed] [Google Scholar]
  25. Willett W. C., Green A., Stampfer M. J., Speizer F. E., Colditz G. A., Rosner B., Monson R. R., Stason W., Hennekens C. H. Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes. N Engl J Med. 1987 Nov 19;317(21):1303–1309. doi: 10.1056/NEJM198711193172102. [DOI] [PubMed] [Google Scholar]
  26. Wilson P. W., Anderson K. M., Kannel W. B. Epidemiology of diabetes mellitus in the elderly. The Framingham Study. Am J Med. 1986 May 16;80(5A):3–9. doi: 10.1016/0002-9343(86)90532-2. [DOI] [PubMed] [Google Scholar]
  27. Yudkin J. S. How can we best prolong life? Benefits of coronary risk factor reduction in non-diabetic and diabetic subjects. BMJ. 1993 May 15;306(6888):1313–1318. doi: 10.1136/bmj.306.6888.1313. [DOI] [PMC free article] [PubMed] [Google Scholar]

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