Secondhand smoke, obesity, and risk of type II diabetes among California teachers
Secondhand smoke, obesity, and risk of type II diabetes among California teachers
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DOI：
10.1016/j.annepidem.2019.01.011
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发表时间：
2019-04-01
影响因子：
5.6
通讯作者：
Anton-Culver, Hoda
中科院分区：
文献类型：
--
作者：
Jiang, Luohua;Chang, Jenny;Anton-Culver, Hoda
目的：研究二手烟（SHS）是否与加州教师患II型糖尿病的风险增加有关。我们还旨在确定是否全面和中心性肥胖的介质或效果modifiers的这种association.Methods：使用数据从加州教师研究，在1995-2013年在加州公立学校进行，我们获得的信息SHS暴露在39,887终身不吸烟者。采用考克斯回归模型评估了17年随访后SHS与糖尿病发病率之间的关系。BMI和腰围对这种关联的中介和修正作用进行了tested.Results：在基线时，70.2%的非吸烟者报告暴露于SHS。较高的SHS暴露强度、持续时间和强度年数以剂量反应方式与较高的多变量调整后糖尿病发病风险相关（风险比= 1.28; 95%置信区间，最高四分位数与最低四分位数的暴露量为1.11-1.48;趋势P = 0.001）。参与者的腰围（测量2年后基线）可以解释大于50%的SHS和diabetes.Conclusions之间的关联：SHS暴露与II型糖尿病的风险增加之间的非吸烟者的加州教师肥胖是一个潜在的重要调解人，但不是一个影响修饰符，这种关联。(C)2019爱思唯尔公司All rights reserved.
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. (C) 2019 Elsevier Inc. All rights reserved.