Association between smoking and metabolic parameters in Korean men with type 2 diabetes

초록

Background: Smoking is a risk factor for cardiovascular disease and is associated with abdominal obesity. There is also data supporting its role in the development of diabetes by affecting insulin secretion and sensitivity. We aimed to study the current status of smoking in Korean type 2 diabetic men and its association with other lifestyle factors and metabolic parameters. Method: A total of 2,518 men with type 2 diabetes enrolled in the Korean National Diabetes Program from March, 2006 to Novermeber 2012 and had finished a survey on smoking at baseline was included in the study. Smoking was categorized to current smoker vs non-current smoker or never smoker, ex-smoker, <1pack/day smoker, ≥1pack/day smoker. Clinical and metabolic parameters were compared between the groups. Results: Among the participants, 36.2% were current smokers and 63.8% were non-current smokers. 22.9% were never smokers, 41.9% ex-smoker, 12.2% <1pack/day smoker, and 23.0% ≥1pack/day smokers. Current smokers were younger, had a shorter duration of diabetes, had a higher education and income level, and drank more alcohol. Current smokers also had less leisure time physical activity, intake of carbohydrate, fiber, calcium, iron, Vit B2, B6, C, E, and folate. Current smokers had a higher fasting and postprandial glucose, HbA1c, triglyceride and lower HDL-cholesterol and showed a higher 3 year prospective HbA1c and weight gain. Compared to never smokers the OR of having metabolic syndrome was 1.28 (1.02-1.61) for ex-smokers, 1.39 (1.01-1.90) for <1pack/day smokers, 1.66 (1.28-2.16) for ≥1pack/day smokers (Ptrend <0.001). Conclusion: Smoking in men was associated with less physical activity, less intake of micronutrients and worse glycemic control and metabolic syndrome. Since there is still a great number of current smokers and deleterious effects in metabolism, there is a great need to effectively guide men with type 2 diabetes to quit smoking.