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Khodamoradi F, Nazemipour M, Mansournia N, Yazdani K, Khalili D, Mansournia MA. The Effects of Smoking on Metabolic Syndrome and Its Components Using Causal Methods in the Iranian Population. Int J Prev Med 2021; 12:118. [PMID: 34760129 PMCID: PMC8551769 DOI: 10.4103/ijpvm.ijpvm_45_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/27/2021] [Indexed: 11/04/2022] Open
Abstract
Background The aim of this study was to estimate the effect of smoking on metabolic syndrome (MS) and its components applying inverse probability-of-treatment weighting (IPTW) and propensity score (PS) matching. Methods Using data from Tehran Lipid and Glucose Study, 4857 participants aged over 20 years with information on smoking and confounders in the third phase (2005-2008) were included, and the MS was assessed in the fifth phase (2011-2014). IPTW and PS matching were used to adjust for confounders. Results Based on average treatment effect (ATE) estimates, smoking decreased the risk of hypertension (RR: 0.62; 95% CI: 0.43, 0.88), but increased the risk of low HDL cholesterol (1.20; 0.98, 1.48). Similarly, the average treatment effect in the treated (ATT) estimates using IPTW and PS matching suggested that smoking decreased the risk of hypertension (0.63; 0.52, 0.76, and 0.68; 0.54, 0.85), and increased the risk of low HDL cholesterol (1.24; 1.07, 1.43, and 1.28; 1.06, 1.54), respectively. Conclusions Smoking seems to increase the risk of low HDL cholesterol but decreases the risk of hypertension.
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Affiliation(s)
- Farzad Khodamoradi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nazemipour
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Mansournia
- Department of Endocrinology, AJA University of Medical Sciences, Tehran, Iran
| | - Kamran Yazdani
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Tehran, Iran.,Department of Biostatistics and Epidemiology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Walter KN, Wagner JA, Cengiz E, Tamborlane WV, Petry NM. Substance Use Disorders among Patients with Type 2 Diabetes: a Dangerous but Understudied Combination. Curr Diab Rep 2017; 17:2. [PMID: 28101793 DOI: 10.1007/s11892-017-0832-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
PURPOSE OF REVIEW This paper reviews research on substance use and disorders (SUDs) among adults with diabetes. It describes epidemiological data on SUDs in persons with type 2 diabetes, overviews effects of substance use on diabetes outcomes, and discusses treatments for SUDs in patients with diabetes. RECENT FINDINGS Rates of current smoking range from 10 to 26% and alcohol use disorders are 0-5%. Rates of illicit SUDs are 3-4%, but there are no population-based studies using nationally representative samples. Smoking increases the risk for long-term diabetes complications and premature death. Alcohol and illicit drug use can also impact long-term diabetes complications by impairing glucose homeostasis and adversely influencing self-management behaviors. There is mixed evidence about psychosocial smoking cessation interventions in adults with diabetes and little on alcohol and illicit SUD interventions. Limited data exist on pharmacotherapies for SUDs in this population, but a recent study suggests that varenicline is safe and effective for treating smoking in patients with diabetes. Substance use is an understudied problem in type 2 diabetes, and addressing substance use holds potential for improving outcomes. Additional large population-based epidemiological studies in those with type 2 diabetes are needed, particularly for alcohol and illicit SUDs. Longitudinal studies should be conducted to better understand the time course of diabetes onset and outcomes in relation to SUDs. Randomized controlled trials are needed to assess safety and efficacy of promising psychosocial and pharmacological interventions.
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Affiliation(s)
- Kimberly N Walter
- University of Connecticut School of Medicine (MC 3944), 263 Farmington Ave., Farmington, CT, 06030-3944, USA
| | - Julie A Wagner
- University of Connecticut School of Dental Medicine, 263 Farmington Ave., Farmington, CT, USA
| | - Eda Cengiz
- Yale University School of Medicine, PO Box 208064, New Haven, CT, USA
| | | | - Nancy M Petry
- University of Connecticut School of Medicine (MC 3944), 263 Farmington Ave., Farmington, CT, 06030-3944, USA.
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Lv J, Chen W, Sun D, Li S, Millwood IY, Smith M, Guo Y, Bian Z, Yu C, Zhou H, Tan Y, Chen J, Chen Z, Li L. Gender-specific association between tobacco smoking and central obesity among 0.5 million Chinese people: the China Kadoorie Biobank Study. PLoS One 2015; 10:e0124586. [PMID: 25897789 PMCID: PMC4405570 DOI: 10.1371/journal.pone.0124586] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 03/05/2015] [Indexed: 12/20/2022] Open
Abstract
Objectives Lifestyle factors are well-known important modifiable risk factors for obesity; the association between tobacco smoking and central obesity, however, is largely unknown in the Chinese population. This study examined the relationship between smoking and central obesity in 0.5 million Chinese adults, a population with a low prevalence of general obesity, but a high prevalence of central obesity. Subjects A total of 487,527 adults (200,564 males and 286,963 females), aged 30-79 years, were enrolled in the baseline survey of the China Kadoorie Biobank (CKB) Study conducted during 2004-2008. Waist circumference (WC) and WC/height ratio (WHtR) were used as measures of central obesity. Results The prevalence of regular smokers was significantly higher among males (60.6%) than among females (2.2%). The prevalence of central obesity increased with age and BMI levels, with a significant gender difference (females>males). Of note, almost all obese adults (99.4%) were centrally obese regardless of gender. In multivariable regression analyses, adjusting for age, education, physical activity, alcohol use and survey site, regular smoking was inversely associated with BMI in males (standardized regression coefficients, β= -0.093, p<0.001) and females (β= -0.025, p<0.001). Of interest, in the BMI stratification analyses in 18 groups, all βs of regular smoking for WHtR were positive in both genders; the βs showed a significantly greater increasing trend with increasing BMI in males than in females. In the analyses with model adjustment for BMI, the positive associations between regular smoking and WHtR were stronger in males (β= 0.021, p<0.001) than in females (β= 0.008, p<0.001) (p<0.001 for gender difference). WC showed considerably consistent results. Conclusions The data indicate that tobacco smoking is an important risk factor for central obesity, but the association is gender-specific and depends on the adjustment for general obesity.
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Affiliation(s)
- Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Wei Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
| | - Dianjianyi Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
| | - Shengxu Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
| | - Iona Y. Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Margaret Smith
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Beijing, China
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Huiyan Zhou
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yunlong Tan
- Chinese Academy of Medical Sciences, Beijing, China
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
- * E-mail: (LML); (ZMC)
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Chinese Academy of Medical Sciences, Beijing, China
- * E-mail: (LML); (ZMC)
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Light-to-moderate alcohol intake reduces lipid accumulation product and attenuates its relation to hypertension. J Hum Hypertens 2014; 29:359-65. [PMID: 25391757 DOI: 10.1038/jhh.2014.97] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Revised: 08/06/2014] [Accepted: 09/18/2014] [Indexed: 12/30/2022]
Abstract
Lipid accumulation product (LAP), an index calculated by using triglyceride level and waist circumference, has been shown to predict hypertension, diabetes and cardiovascular disease. Alcohol is known to influence blood pressure and blood lipids. The aim of this study was to clarify the relationships among alcohol intake, LAP and hypertension. The subjects, middle-aged Japanese men (n=21,572), were divided into non-, light (<22 g ethanol per day), moderate (⩾ 22 and<44 g ethanol per day) and heavy (⩾ 44 g ethanol per day) drinkers. The relationships between alcohol intake and LAP and between LAP and hypertension were investigated. There were U- and J-shaped relationships between alcohol intake and LAP in subjects with and without hypertension, respectively. The adjusted odds ratios with their 95% confidence intervals for hypertension in subjects with vs subjects without high LAP were 3.04 (2.69-3.43, P<0.01), 2.32 (1.92-2.81, P<0.01), 2.10 (1.89-2.33, P<0.01) and 2.11 (1.87-2.38, P<0.01) in non-, light, moderate and heavy drinkers, respectively. Thus, the positive association between LAP and hypertension is weaker in drinkers than in nondrinkers. The results suggest that light-to-moderate alcohol drinking reduces LAP level in patients with hypertension and attenuates the relation of LAP to hypertension.
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