Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis.
Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis.
复制标题
DOI：
10.1016/s2213-8587(15)00316-2
复制
发表时间：
2015-12
期刊：
影响因子：
--
通讯作者：
Wu T
中科院分区：
文献类型：
--
作者：
Pan A;Wang Y;Talaei M;Hu FB;Wu T
吸烟仍然是全球疾病负担的主要可避免原因，观察性研究已将各种吸烟行为(主动和被动吸烟以及戒烟)与2型糖尿病的风险联系起来。我们对评估各种吸烟行为与糖尿病风险关系的前瞻性研究进行了荟萃分析。我们系统地检索MEDLINE和EMBASE数据库(截至2015年5月3日)，手工检索检索到的出版物的参考文献和相关综述。我们纳入了前瞻性研究，这些研究报告了基线吸烟状态下患2型糖尿病的风险。使用随机效应模型合并相对风险(RR)和95%可信区间(CI)，并按参与者和研究特征进行亚组分析。这项搜索产生了88项前瞻性研究，近600万参与者和295446个事件案例。与从不吸烟相比，2型糖尿病合并RR(95%CI)：现在吸烟(84篇)为1.37(1.33-1.42)，既往吸烟(47篇)为1.14(1.10-1.18)，被动吸烟(7篇)为1.22(1.10-1.35)。这种关联在所有亚组中都存在，并且发现了当前吸烟和糖尿病风险的剂量-反应关系：与从不吸烟的人相比，轻度吸烟者、中度吸烟者和重度吸烟者的RRS(95%CI)分别为1.21(1.10-1.33)、1.34(1.27-1.41)和1.57(1.47-1.66)。我们估计，如果吸烟与糖尿病有因果关系，那么全世界有10.3%的男性和2.2%的女性2型糖尿病病例(约2500万人)可归因于吸烟。与从不吸烟的人相比，10项研究的合并RR(95%CI)在新戒烟者(5年)为1.54(1.36-1.74)，在长期戒烟者(≥为10年)为1.11(1.02-1.20)。主动吸烟和被动吸烟与患2型糖尿病的风险显著增加有关。新戒烟者患糖尿病的风险增加，但随着戒烟时间的增加，患糖尿病的风险大幅下降。
Cigarette smoking remains the leading avoidable cause of disease burden worldwide, and observational studies have linked various smoking behaviors (active and passive smoking and smoking cessation) with risk of type 2 diabetes. We did a meta-analysis of prospective studies assessing the relation of various smoking behaviors and diabetes risk. We systematically searched MEDLINE and EMBASE databases (up to 3 May 2015) with manual searches of the references of retrieved publications and relevant reviews. We included prospective studies that reported risk of type 2 diabetes by baseline smoking status. Relative risks (RRs) and 95% confidence intervals (CIs) were pooled using random-effects models, and subgroup analyses were performed by participant and study characteristics. The search yielded 88 prospective studies with nearly 6 million participants and 295446 incident cases. Compared with never smoking, the pooled RR (95% CI) of type 2 diabetes was 1·37 (1·33-1·42) for current smoking (84 studies), 1·14 (1·10-1·18) for former smoking (47 studies), and 1·22 (1·10-1·35) for passive smoking (7 studies). The associations persisted in all subgroups, and a dose-response relation was found for current smoking and diabetes risk: the RRs (95% CIs) were 1·21 (1·10-1·33), 1·34 (1·27-1·41) and 1·57 (1·47-1·66) for light, moderate, and heavy smokers, respectively, compared with never smokers. We estimated that 10·3% in men and 2·2% in women of type 2 diabetes cases (approximately 25 million) were attributable to cigarette smoking worldwide if smoking is causally related to diabetes. Compared to never smokers, the pooled RR (95% CI) from 10 studies was 1·54 (1·36-1·74) in new quitters (<5 years), and 1·11 (1·02-1·20) in long-term quitters (≥10 years). Active and passive smoking are associated with significantly increased risks of type 2 diabetes. The risk of diabetes is elevated in new quitters, but decreases substantially as the time since quitting increases.