Tobacco Use, Insulin Resistance, and Risk of Type 2 Diabetes: Results from the Multi-Ethnic Study of Atherosclerosis

Tobacco use is associated with insulin resistance and incident diabetes. Given the racial/ethnic differences in smoking patterns and incident type 2 diabetes our objective was to evaluate the association between tobacco use and insulin resistance (IR) as well as incident type 2 diabetes mellitus in...

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Vydáno v:	PloS one Ročník 11; číslo 6; s. e0157592
Hlavní autoři:	Keith, Rachel J., Al Rifai, Mahmoud, Carruba, Christopher, De Jarnett, Natasha, McEvoy, John W., Bhatnagar, Aruni, Blaha, Michael J., Defilippis, Andrew P.
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	United States Public Library of Science 20.06.2016 Public Library of Science (PLoS)
Témata:	Addictions Addictive behaviors Arteriosclerosis Atherosclerosis Atherosclerosis - ethnology Bias Bioindicators Biology and Life Sciences Biomarkers Biomarkers - metabolism Body mass index Cardiology Cardiovascular disease Cigarettes Cotinine Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - epidemiology Disease prevention Ethnicity Ethnicity - statistics & numerical data Evaluation Fasting Female Gender Glucose Hazards Health aspects Health risk assessment Health risks Heart Humans Incidence Insulin Insulin Resistance Male Medicine Medicine and Health Sciences Metabolism Middle Aged Obesity Odds Ratio Physical Sciences Regression analysis Risk Factors Sensitivity and Specificity Sex Characteristics Smoking Statistical models Studies Systematic review Tobacco Tobacco habit Tobacco industry Tobacco Use - adverse effects Tobacco Use - epidemiology Trends United States > US Maryland Baltimore Maryland Kentucky
ISSN:	1932-6203, 1932-6203
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Shrnutí:	Tobacco use is associated with insulin resistance and incident diabetes. Given the racial/ethnic differences in smoking patterns and incident type 2 diabetes our objective was to evaluate the association between tobacco use and insulin resistance (IR) as well as incident type 2 diabetes mellitus in a contemporary multiethnic cohort. We studied 5,931 Multi- Ethnic Study of Atherosclerosis (MESA) participants who at baseline were free of type 2 diabetes (fasting glucose ≥7.0 mmol/l (126 mg/dl) and/or use of insulin or oral hypoglycemic medications) categorized by self-reported tobacco status and reclassified by urinary cotinine (available in 58% of participants) as never, current or former tobacco users. The association between tobacco use, IR (fasting plasma glucose, insulin, and the homeostatic model assessment of insulin resistance (HOMA-IR)) and incident diabetes over 10 years was evaluated using multivariable linear regression and Cox proportional hazards models, respectively. Mean age of the participants was 62 (±10) years, 46% were male, 41% Caucasian, 12% Chinese, 26% African American and 21% Hispanic/Latino. IR biomarkers did not significantly differ between current, former, and never cigarette users (P >0.10) but showed limited unadjusted differences for users of cigar, pipe and smokeless tobacco (All P <0.05). Fully adjusted models showed no association between dose or intensity of tobacco exposure and any index of IR. When stratified into participants that quit smoking vs. those who continued smoking during the 10-year study there was no difference in serum glucose levels or frequency of diabetes. In fully adjusted models, there was no significant difference in diabetes risk between former or current cigarette smokers compared to never smokers [HR (95% CI) 1.02 (0.77,1.37) and 0.81 (0.52,1.26) respectively]. In a contemporary multi-ethnic cohort, there was no independent association between tobacco use and IR or incident type 2 diabetes. The role smoking plays in causing diabetes may be more complicated than originally thought and warrants more in-depth large contemporary multi-ethnic studies.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors have declared that no competing interests exist. Conceived and designed the experiments: RJK MAR MJB APD. Performed the experiments: MAR MJB. Analyzed the data: MAR MJB. Wrote the paper: RJK MAR CC NDJ JWM AB MJB APD.
ISSN:	1932-6203 1932-6203
DOI:	10.1371/journal.pone.0157592