期刊论文详细信息
Tobacco Induced Diseases
Current smoking status may be associated with overt albuminuria in female patients with type 1 diabetes mellitus: a cross-sectional study
Shun Ishibashi1  Shoichiro Nagasaka1  Michiaki Miyamoto1  Hiroaki Yagyu1  Kazuhiko Kotani2  Jun-ichi Osuga1  Kenta Okada1 
[1] Department of Internal Medicine, Division of Endocrinology and Metabolism, Jichi Medical University, Tochigi 320-0498, Japan;Department of Clinical Laboratory Medicine, Jichi Medical University, Tochigi 320-0498, Japan
关键词: Overt albuminuria;    Current smoking;    Type 1 diabetes mellitus;   
Others  :  867045
DOI  :  10.1186/1617-9625-10-12
 received in 2012-02-29, accepted in 2012-08-06,  发布年份 2012
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【 摘 要 】

Background

There are very few clinical reports that have compared the association between cigarette smoking and microangiopathy in Asian patients with type 1 diabetes mellitus (T1DM). The objective of this study was to assess the relationships between urinary protein concentrations and smoking and gender-based risk factors among patients with T1DM.

Methods

A cross-sectional study of 259 patients with T1DM (men/women = 90/169; mean age, 50.7 years) who visited our hospital for more than 1 year between October 2010 and April 2011 was conducted. Participants completed a questionnaire about their smoking habits. Patient characteristics included gender, age, body mass index, blood pressure, hemoglobin A1c, lipid parameters, and microangiopathy. Diabetic nephropathy (DN) was categorized as normoalbuminuria (NA), microalbuminuria (MA), or overt albuminuria (OA) on the basis of the following urinary albumin/creatinine ratio (ACR) levels: NA, ACR levels less than 30 mg/g creatinine (Cr); MA, ACR levels between 30 and 299 mg/g Cr; and OA, ACR levels over 300 mg/g Cr.

Results

The percentages of current nonsmokers and current smokers with T1DM were 73.0% (n = 189) and 27.0% (n = 70), respectively. In addition, the percentage of males was higher than that of females (52.2% versus 13.6%) in the current smoking population. The percentage of DN was 61.8% (n = 160) in patients with NA, 21.6% (n = 56) in patients with MA, and 16.6% (n = 43) in patients with OA. The percentage of males among OA patients was also higher than that of females (24.4% versus 12.4%). However, current smoking status was associated with OA in females with T1DM only [unadjusted odds ratio (OR), 4.13; 95% confidence interval (CI), 1.45–11.73, P < 0.01; multivariate-adjusted OR, 5.41; 95% CI, 1.69–17.30, P < 0.01].

Conclusions

Based on our results in this cross-sectional study of Asian patients with T1DM, smoking might be a risk factor for OA among female patients. Further research is needed of these gender-specific results.

【 授权许可】

   
2012 Okada et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J: Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care 2000, 23:1516-1526.
  • [2]EURODIAB ACE Study Group: Variation and trends in incidence of childhood diabetes in Europe. Lancet 2000, 355:873-876.
  • [3]Japan IDDM Epidemiology Study Group: Lack of regional variation in IDDM risk in Japan. Diabetes Care 1993, 16:796-800.
  • [4]Chase HP, Garg SK, Marshall G, Berg CL, Harris S, Jackson WE, Hamman RE: Cigarette smoking increases the risk of albuminuria among subjects with type 1 diabetes. JAMA 1991, 265:614-617.
  • [5]Sawicki PT, Didjurgeit U, Mühlhauser I, Bender R, Heinemann L, Berger M: Smoking is associated with progression of diabetic nephropathy. Diabetes Care 1994, 17:126-131.
  • [6]Raile K, Galler A, Hofer S, Herbst A, Dunstheimer D, Busch P, Holl RW: Diabetic nephropathy in 27,805 children, adolescents, and adults with type 1 diabetes: effect of diabetes duration, A1C, hypertension, dyslipidemia, diabetes onset, and sex. Diabetes Care 2007, 30:2523-2528.
  • [7]Scott LJ, Warram JH, Hanna LS, Laffel LM, Ryan L, Krolewski AS: A nonlinear effect of hyperglycemia and current cigarette smoking are major determinants of the onset of microalbuminuria in type 1 diabetes. Diabetes 2001, 50:2842-2849.
  • [8]Mosca L, Linfante AH, Benjamin EJ, Berra K, Hayes SN, Walsh BW, Fabunmi RP, Kwan J, Mills T, Simpson SL: National study of physician awareness and adherence to cardiovascular disease prevention guidelines. Circulation 2005, 111:499-510.
  • [9]Chaturvedi N, Stephenson JM, Fuller JH: The relationship between smoking and microvascular complications in the EURODIAB IDDM Complications Study. Diabetes Care 1995, 18:785-792.
  • [10]American Diabetes Association: Diagnosis and classification of diabetes mellitus. Diabetes Care 2010, 33:S62-S69.
  • [11]Seino Y, Nanjo K, Tajima N, Kadowaki T, Kashiwagi A, Araki E, Ito C, Inagaki N, Iwamoto Y, Kasuga M, Hanafusa T, Haneda M, Ueki K: Report of the committee on the classification and diagnostic criteria of diabetes mellitus. Diabetol Int 2010, 1:2-20.
  • [12]Hirano T, Sakaue T, Misaki A, Murayama S, Takahashi T, Okada K, Takeuchi H, Yoshino G, Adachi M: Very low-density lipoprotein-apoprotein CI is increased in diabetic nephropathy: comparison with apoprotein CIII. Kidney Int 2003, 63:2171-2177.
  • [13]Resnick HE, Foster GL, Bardsley J, Ratner RE: Achievement of American Diabetes Association clinical practice recommendations among U.S. adults with diabetes, 1999–2002: the National Health and Nutrition Examination Survey. Diabetes Care 2006, 29:531-537.
  • [14]Haire-Joshu D, Glasgow RE, Tibbs TL: American Diabetes Association: Smoking and diabetes. Diabetes Care 2004, 27:S74-S75.
  • [15]Nilsson PM, Gudbjörnsdottir S, Eliasson B, Cederholm J: Steering Committee of the Swedish National Diabetes Register: Smoking is associated with increased HbA1c values and microalbuminuria in patients with diabetes–data from the National Diabetes Register in Sweden. Diabetes Metab 2004, 30:261-268.
  • [16]Orth SR, Ritz E, Schrier RW: The renal risks of smoking. Kidney Int 1997, 51:1669-1677.
  • [17]Nilsson TK, Lithner F: Glycaemic control, smoking habits and diabetes duration affect the extrinsic fibrinolytic system in type I diabetic patients but microangiopathy does not. Acta Med Scand 1988, 224:123-129.
  • [18]Mühlhauser I: Smoking and diabetes. Diabet Med 1990, 7:10-15.
  • [19]Ekberg G, Grefberg N, Larsson LO, Vaara I: Cigarette smoking and glomerular filtration rate in insulin-treated diabetics without manifest nephropathy. J Intern Med 1990, 228:211-217.
  • [20]Cadnapaphornchai P, Boykin JL, Berl T, McDonald KM, Schrier RW: Mechanism of effect of nicotine on renal water excretion. Am J Physiol 1974, 227:1216-1220.
  • [21]Hultberg B, Isaksson A, Brattström L, Israelsson B: Elevated urinary excretion of beta-hexosaminidase in smokers. Eur J Clin Chem Clin Biochem 1992, 30:131-133.
  • [22]Baron JA, La Vecchia C, Levi F: The antiestrogenic effect of cigarette smoking in women. Am J Obstet Gynecol 1990, 162:502-514.
  • [23]MacMahon B, Trichopoulos D, Cole P, Brown J: Cigarette smoking and urinary estrogens. N Engl J Med 1982, 307:1062-1065.
  • [24]Meek MD, Finch GL: Diluted mainstream cigarette smoke condensates activate estrogen receptor and aryl hydrocarbon receptor-mediated gene transcription. Environ Res 1999, 80:9-17.
  • [25]Tankó LB, Christiansen C: An update on the antiestrogenic effect of smoking: a literature review with implications for researchers and practitioners. Menopause 2004, 11:104-109.
  • [26]Michnovicz JJ, Hershcopf RJ, Naganuma H, Bradlow HL, Fishman J: Increased 2-hydroxylation of estradiol as a possible mechanism for the anti-estrogenic effect of cigarette smoking. N Engl J Med 1986, 315:1305-1309.
  • [27]Navab M, Reddy S, Van Lenten BJ, Anantharamaiah GM, Fogelman AM: Role of dysfunctional HDL in atherosclerosis. J Lipid Res 2009, 50:S145-S149.
  • [28]Vaziri ND, Navab M, Fogelman AM: HDL metabolism and activity in chronic kidney disease. Nat Rev Nephrol 2010, 6:287-296.
  • [29]Yokoyama H, Okudaira M, Otani T, Takaike H, Miura J, Saeki A, Uchigata Y, Omori Y: Existence of early-onset NIDDM Japanese demonstrating severe diabetic complications. Diabetes Care 1997, 20:844-847.
  • [30]Parving HH: Diabetic nephropathy: prevention and treatment. Kidney Int 2001, 60:2041-2055.
  • [31]Rossing P, Hougaard P, Parving HH: Risk factors for development of incipient and overt diabetic nephropathy in type 1 diabetic patients: a 10-year prospective observational study. Diabetes Care 2002, 25:859-864.
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