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Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: the KORA S4/F4 cohort study

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Abstract

Active smoking is a risk factor for type 2 diabetes (T2DM), but it is unclear whether exposure to environmental tobacco smoke (ETS) is also associated with T2DM. The effect of passive and active smoking on the 7-year T2DM incidence was investigated in a population-based cohort in Southern Germany (KORA S4/F4; 1,223 subjects aged 55–74 years at baseline in 1999–2001, 887 subjects at follow-up). Incident diabetes was identified by oral glucose tolerance tests or by validated physician diagnoses. Among never smokers, subjects exposed to ETS had an increased diabetes risk in the total sample (odds ratio (OR) = 2.5; 95% confidence interval (CI): 1.1, 5.6) and in a subgroup of subjects having prediabetes at baseline (OR = 4.4; 95% CI: 1.5, 13.4) after adjusting for age, sex, parental diabetes, socioeconomic status, and lifestyle factors. Active smoking also had a statistically significant effect on diabetes incidence in the total sample (OR = 2.8; 95% CI: 1.3, 6.1) and in prediabetic subjects (OR = 7.8; 95% CI: 2.4, 25.7). Additional adjustment for components of the metabolic syndrome including waist circumference did not attenuate any of these associations. This study provides evidence that both passive and active smoking is associated with T2DM.

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Abbreviations

BMI:

Body mass index

CI:

Confidence interval

ETS:

Environmental tobacco smoke

HOMA-IR:

Homeostatis model assessment of insulin resistance

HR:

Hazard ratio

IFG:

Impaired fasting glucose

IGT:

Impaired glucose tolerance

OGTT:

Oral glucose tolerance test

OR:

Odds ratio

RR:

Relative risk

SES:

Socioeconomic status

T2DM:

Type 2 diabetes mellitus

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Authors and Affiliations

  1. Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf′m Hennekamp 65, 40225, Düsseldorf, Germany

    Bernd Kowall, Wolfgang Rathmann, Klaus Strassburger, Margit Heier & Guido Giani

  2. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany

    Margit Heier, Barbara Thorand, Annette Peters & Christine Meisinger

  3. Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany

    Rolf Holle

Authors
  1. Bernd Kowall
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  2. Wolfgang Rathmann
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  3. Klaus Strassburger
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  4. Margit Heier
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  5. Rolf Holle
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  9. Christine Meisinger
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Correspondence to Wolfgang Rathmann.

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Kowall, B., Rathmann, W., Strassburger, K. et al. Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: the KORA S4/F4 cohort study. Eur J Epidemiol 25, 393–402 (2010). https://doi.org/10.1007/s10654-010-9452-6

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  • DOI: https://doi.org/10.1007/s10654-010-9452-6

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