Cigarette smoking is associated with low glomerular filtration rate in male patients with type 2 diabetes
Cigarette smoking is associated with low glomerular filtration rate in male patients with type 2 diabetes
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DOI：
10.2337/dc06-0940
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发表时间：
2006-11-01
期刊：
影响因子：
16.2
通讯作者：
Cignarelli, Mauro
中科院分区：
文献类型：
--
作者：
De Cosmo, Salvatore;Lamacchia, Olga;Cignarelli, Mauro
目的：吸烟与糖尿病肾功能不全之间的关系主要在I型糖尿病患者中被证实。本研究的目的是探讨吸烟和肾小球滤过率（GFR）在男性2型糖尿病患者中进行的大型横断面研究之间的关系。代谢综合征在调节这种关系的作用也investigated.RESEARCH设计和方法-一百五十八个当前吸烟者和158从未吸烟者与2型糖尿病连续招募。低GFR定义为GFR < 60 ml/min/1.73 m2。结果-目前吸烟者中受低GFR影响的患者比例显著较高（20.9 vs. 12.0%，P = 0.03）。当前吸烟者GFR降低的校正风险（比值比[OR]）为2.20（95% CI 1.14-4.26，P = 0.02），病程前三分位的患者明显更高（4.27 [1.26-14.40]，P = 0.02）。当将代谢综合征添加到探索吸烟与低GFR之间关系的统计模型中时，低GFR的风险显示出较小的变化，尽管它没有变得更显著（1.84 [0.98-3.45]，P = 0.06）。目前吸烟者显示出更高的氧自由基检测单位值（560.0 +/- 91.5 vs. 442.7 +/- 87.2，P < 0.0001）.结论：在大量男性2型糖尿病患者中，吸烟显著增加了低GFR的风险，并且至少部分由代谢综合征介导。
OBJECTIVE - The relationship between cigarette smoking and renal dysfunction in diabetes has predominantly been documented in patients with type I diabetes. The aim of the present study was to explore the relationship between cigarette smoking and glomerular filtration rate (GFR) in a large cross-sectional study carried out in male subjects with type 2 diabetes. The role of metabolic syndrome in modulating this relationship was also investigated.RESEARCH DESIGN AND METHODS - One hundred fifty-eight current smokers and 158 never smokers with type 2 diabetes were consecutively recruited. Low GFR was defined as GFR < 60 ml/min per 1.73 m(2).RESULTS - The proportion of patients affected by low GFR was significantly higher in current smokers (20.9 vs. 12.0%, P = 0.03). The adjusted risk (odds ratio [OR]) of low GFR in current smokers was 2.20 (95% Cl 1.14-4.26, P = 0.02) and markedly higher in patients from the first tertile of disease duration (4.27 [1.26-14.40], P = 0.02). When metabolic syndrome was added to the statistical model exploring the relationship between smoking and low GFR, the risk of low GFR showed a small change, although it did not become any more significant (1.84 [0.98-3.45], P = 0.06). Current smokers showed even higher free oxygen radical test unit values (560.0 +/- 91.5 vs. 442.7 +/- 87.2, P < 0.0001).CONCLUSIONS - In a large population of male patients with type 2 diabetes, the risk of low GFR is markedly enhanced by smoking and is at least partially mediated by metabolic syndrome.