Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study
Active and passive smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study
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DOI：
10.1136/bmj.38779.584028.55
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发表时间：
2006-05-06
影响因子：
105.7
通讯作者：
Kiefe, CI
中科院分区：
文献类型：
--
作者：
Houston, TK;Person, SD;Kiefe, CI
目的评估主动吸烟者和被动吸烟者是否比非吸烟者更容易发生临床相关的葡萄糖耐受不良或糖尿病。设计年轻人冠状动脉风险发展（CARDIA）是一项前瞻性队列研究，始于1985-6年，随访15年。和奥克兰，加州，美国。参与者为基线时无葡萄糖耐受不良的18-30岁的黑人和白色男性和女性，包括1386名目前吸烟者，621名既往吸烟者，1452名从未吸烟者，报告暴露于二手烟（通过血清可替宁浓度1-15 ng/ml验证），以及1113名从未吸烟且未接触二手烟的人。主要结局指标至发生葡萄糖耐受不良的时间结果基线时的中位年龄为25岁，55%的参与者为女性，50%为非洲裔美国人。在随访期间，16.7%的参与者发生了葡萄糖耐受不良。吸烟暴露与葡萄糖耐受不良的发生之间存在分级关联。吸烟者15年葡萄糖耐受不良发生率最高（21.8%），其次是被动吸烟的从不吸烟者（17.2%），然后是既往吸烟者（14.4%）;无被动吸烟的从不吸烟者最低（11.5%）。当前吸烟者（风险比1.65，95%置信区间1.27至2.13）和从不吸烟的被动吸烟者（1.35，1.06至1.71）在调整多个基线社会人口统计学，生物学和行为因素后，仍然比没有被动吸烟暴露的从不吸烟者的风险更高，结论主动吸烟和被动吸烟在青年期糖耐量异常的发生中均起重要作用。
Objective To assess whether active and passive smokers are more likely than non-smokers to develop clinically relevant glucose intolerance or diabetes.Design Coronary artery risk development in Young adults (CARDIA) is a prospective cohort study begun in 1985-6 with 15 years of follow-up.Setting Participants recruited from Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California, USA.Participants Black and white men and women aged 18-30 years with no glucose intolerance at baseline, including 1386 current smokers, 621 previous smokers, 1452 never smokers with reported exposure to secondhand smoke (validated by serum cotinine concentrations 1-15 ng/ml), and 1113 never smokers with no exposure to secondhand smoke.Main outcome measure Time to development of glucose intolerance (glucose >= 100 mg/dl or taking antidiabetic drugs) during 15 years of follow-up.Results Median age at baseline was 25, 55% of participants were women, and 50% were African-American. During follow-up, 16.7% of participants developed glucose intolerance. A graded association existed between smoking exposure and the development of glucose intolerance. The 15 year incidence of glucose intolerance was highest among smokers (21.8%), followed by never smokers with passive smoke exposure (17.2%), and then previous smokers (14.4%); it was lowest for never smokers with no passive smoke exposure (11.5%). Current smokers (hazard ratio 1.65, 95% confidence interval 1.27 to 2.13) and never smokers with passive smoke exposure (1.35, 1.06 to 1.71) remained at higher risk than never smokers without passive smoke exposure after adjustment for multiple baseline sociodemographic, biological, and behavioural factors, but risk in previous smokers was similar to that in never smokers without passive smoke exposure.Conclusion These findings support a role of both active and passive smoking in the development of glucose intolerance in young adulthood.