Environmental tobacco smoke exposure and diabetes in adult never-smokers

Environmental Health

Research

Ikenna C Eze¹  Nicole Probst-Hensch¹  Emmanuel Schaffner¹  Christian Schindler¹  Elisabeth Zemp¹  Arnold von Eckardstein²  Robert Bettschart³  Alexander Turk⁴ 

[1] Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002, Basel, Switzerland;University of Basel, Basel, Switzerland;Institute of Clinical Chemistry, University Hospital, Zurich, Switzerland;Lungenpraxis Hirslanden Klinik Aarau, Aarau, Switzerland;Zürcher Höhenklinik Wald, Wald-Faltigberg, Faltigberg-wald, Switzerland;

关键词: Passive smoke;    Type 2 diabetes;    Cross-sectional study;    Respiratory obstruction;    Never-smokers;   

DOI  :  10.1186/1476-069X-13-74

 received in 2014-06-24, accepted in 2014-09-13,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundActive smoking has been linked to type 2 diabetes mellitus (T2DM) but only few recent studies have shown environmental tobacco smoke (ETS) to be associated with DM in never-smokers. We assessed the association between long term ETS exposure and DM, and explored effect modifications of this association in our sample.MethodsWe analysed 6392 participants of the Swiss study on air pollution and lung and heart diseases in adults (SAPALDIA). We used mixed logistic regression models to assess the cross-sectional association between ETS and DM. Selected variables were tested for effect modification and several sensitivity analyses were performed, mostly treating participants’ study area as a random effect.ResultsThe prevalence of DM and ETS in the sample was 5.5% and 47% respectively. There were 2779 never-smokers with 4% diabetes prevalence. Exposure to ETS increased risk of DM in never-smokers by 50% [95% confidence interval (CI): 1.00, 2.26], and we observed a positive dose–response relationship between ETS exposure level and DM in never-smokers. Associations were strengthened (more than three-folds) by older age and chronic obstructive pulmonary disease, and were stronger in post-menopausal, obese, hypertriglyceridaemic and physically inactive participants. Estimates of association were robust across all sensitivity analyses (including inverse probability weighting for participation bias and fixed-effect analysis for study area). ETS had no substantial associations in current and ex-smokers in our study.ConclusionsWe found a positive association between ETS exposure and DM in never smokers. Additional longitudinal studies involving biomarkers are needed to further explore underlying mechanisms and susceptibilities.

【 授权许可】

Unknown   
© Eze et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.