1
|
González-Muñoza C, Gely C, Gordillo J, Bertoletti F, Giordano A, López-Faba A, García-Planella E. Duration of smoking cessation in patients with inflammatory bowel disease. GASTROENTEROLOGIA Y HEPATOLOGIA 2024; 47:591-597. [PMID: 37977427 DOI: 10.1016/j.gastrohep.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND OBJECTIVES Smoking can worsen inflammatory bowel disease (IBD), although evidence regarding the duration of cessation is scarce. The objectives of the study were to determine the duration of abstinence and identify the characteristics of relapse in IBD patients. PATIENTS AND METHODS Using the local database of a nationwide registry of patients with IBD, we identified patients who were active smokers at the time of IBD diagnosis and invited them to participate in the study. Patients were asked about their smoking habit and those who were ex-smokers constituted the study cohort. We obtained clinical and smoking-related data of ex-smokers from medical records and telephone interviews. We measured nicotine dependence using the Fagerström Test for Nicotine Dependence (FTND). RESULTS We enrolled 121 IBD patients who were ex-smokers: 89 patients with Crohn's disease (CD) and 33 patients with ulcerative colitis (UC). The median age at cessation was lower in patients with CD (38 years) than in patients with UC (46 years) (p=0.002). Follow-up time was shorter in CD patients than in UC patients (114 vs. 168 months, p=0.035). No difference was found in the FTND score. Relapse was more common in CD patients (46%) than in UC patients (24%) (p=0.029), although time to first relapse was similar in both groups of patients (12 and 15 months, respectively; p=0.056). Nicotine dependence was the only independent factor associated with relapse. CONCLUSIONS The risk of smoking relapse was high, especially in CD patients, although their dependence level was similar to that of UC patients.
Collapse
Affiliation(s)
| | - Cristina Gely
- Hospital Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | - Jordi Gordillo
- Hospital Santa Creu i Sant Pau, Barcelona, Catalonia, Spain
| | | | | | | | | |
Collapse
|
2
|
Oswald M, Ross KM, Sun N, Yin W, Garcia SJ, Bursac Z, Krukowski RA. Importance of self-weighing to avoid post-cessation weight gain: A secondary analysis of the fit and quit randomized trial. Obes Sci Pract 2023; 9:416-423. [PMID: 37546280 PMCID: PMC10399538 DOI: 10.1002/osp4.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/21/2023] [Accepted: 03/01/2023] [Indexed: 08/08/2023] Open
Abstract
Background Smoking cessation is associated with weight gain, and the risk of weight gain is a common deterrent to quitting smoking. Thus, the identification of strategies for reducing post-smoking cessation weight gain is critical. Objective Conduct secondary analysis of data from the Fit & Quit trial to determine if greater frequency of self-weighing is associated with less weight gain in the context of smoking cessation. Methods Participants (N = 305) were randomized to one of three 2-month weight interventions (i.e., Stability, Loss, Bibliotherapy), followed by a smoking cessation intervention. Stability and Loss conditions received different types of self-weighing feedback. All participants received e-scales at baseline, to capture daily self-weighing data over 12 months. General linear models were applied to test the main objective. Results Frequency of self-weighing was (mean ± SD) 2.67 ± 1.84 days/week. The Stability condition had significantly higher self-weighing frequency (3.18 ± 1.72 days/week) compared to the Loss (2.51 ± 1.99 days/week) and the Bibliotherapy conditions (2.22 ± 1.63 days/week). Adjusting for baseline weight and treatment condition, self-weighing 3-4 days/week was associated with weight stability (-0.77 kg, 95% CI: -2.2946, 0.7474, p = 0.3175), and self-weighing 5 or more days/week was associated with 2.26 kg weight loss (95% CI: -3.9249, -0.5953, p = 0.0080). Conclusions Self-weighing may serve as a useful tool for weight gain prevention after smoking cessation. Feedback received about self-weighing behaviors and weight trajectory (similar to the feedback Stability participants received) might enhance adherence.
Collapse
Affiliation(s)
- Mackenzi Oswald
- Univeristy of VirginiaSchool of MedicineCharlottesvilleVirginiaUSA
| | - Kathryn M. Ross
- Department of Clinical and Health PsychologyUniversity of FloridaGainesvilleFloridaUSA
| | - Ning Sun
- Department of BiostatisticsRobert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiFloridaUSA
| | - Wupeng Yin
- Department of BiostatisticsRobert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiFloridaUSA
| | - Stephanie J. Garcia
- Department of BiostatisticsRobert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiFloridaUSA
| | - Zoran Bursac
- Department of BiostatisticsRobert Stempel College of Public Health and Social WorkFlorida International UniversityMiamiFloridaUSA
| | | |
Collapse
|
3
|
Choi SH, Stommel M, Broman C, Raheb-Rauckis C. Age of Smoking Initiation in Relation to Multiple Health Risk Factors among US Adult Smokers: National Health Interview Survey (NHIS) Data (2006-2018). Behav Med 2023; 49:312-319. [PMID: 35465849 DOI: 10.1080/08964289.2022.2060930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 02/23/2022] [Accepted: 03/23/2022] [Indexed: 11/02/2022]
Abstract
The adverse effects of multiple health risk factors have been well-documented; however, still understudied are the effects of early smoking in the context of multiple health risk factors. This study aimed to examine the role of early smoking initiation in relation to several health risk factors, including heavy drinking, physical inactivity, and obesity in later life among ever smokers in the USA. The National Health Interview Survey (NHIS) data from 2006 through 2018 were analyzed. The primary dependent variables were presence of three other risk factors: heavy drinking, physical inactivity, and obesity. The independent variable was the age of smoking initiation. Logit regression models were constructed to evaluate the association between smoking initiation and multiple health risk factors. All analyses were done in 2022. Among US adult smokers, 18.2% started smoking before age 15 (early initiators), 55.9% at ages 15-18 (middle initiators), and 25.9% at age 20 or later (late initiators). Compared to late smoking initiators, the odds of engaging in additional health risk factors increased by 37.3% among early initiators (OR = 1.373, 95% CI = 1.316, 1.432) and 7.7% among middle initiators (OR = 1.077, 95% CI= 1.041, 1.116). Additionally, current smoking was associated with higher odds (OR = 1.369, 95% CI = 1.322, 1.417) of having additional health risk factors compared to former smoking, with one exception: current smokers had lower odds of obesity (OR = 0.566, 95% CI = 0.537, 0.597). Tobacco control programs to prevent adolescents from initiating smoking may have the potential to prevent other health risk factors in adulthood.
Collapse
Affiliation(s)
- Seung Hee Choi
- College of Nursing, Wayne State University, Detroit, MI, USA
| | - Manfred Stommel
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Clifford Broman
- Department of Sociology, Michigan State University, East Lansing, MI, USA
| | | |
Collapse
|
4
|
Yammine L, Verrico CD, Versace F, Webber HE, Suchting R, Weaver MF, Kosten TR, Alibhai H, Cinciripini PM, Lane SD, Schmitz JM. Exenatide as an adjunct to nicotine patch for smoking cessation and prevention of postcessation weight gain among treatment-seeking smokers with pre-diabetes and/or overweight: study protocol for a randomised, placebo-controlled clinical trial. BMJ Open 2023; 13:e072707. [PMID: 37316311 DOI: 10.1136/bmjopen-2023-072707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/16/2023] Open
Abstract
INTRODUCTION Obesity and smoking are the two leading causes of preventable death in the USA. Unfortunately, most smokers gain weight after quitting. Postcessation weight gain (PCWG) is frequently cited as one of the primary barriers to a quit attempt and a common cause of relapse. Further, excessive PCWG may contribute to the onset or progression of metabolic conditions, such as hyperglycaemia and obesity. The efficacy of the current treatments for smoking cessation is modest, and these treatments have no clinically meaningful impact on mitigating PCWG. Here, we outline a novel approach using glucagon-like peptide 1 receptor agonists (GLP-1RA), which have demonstrated efficacy in reducing both food and nicotine intake. This report describes the design of a double-blind, placebo-controlled, randomised clinical trial that evaluates the effects of the GLP-1RA exenatide as an adjunct to nicotine patches on smoking abstinence and PCWG. METHODS AND ANALYSIS The study will be conducted at two university-affiliated research sites in Houston, Texas, the UTHealth Center for Neurobehavioral Research on Addiction and Baylor College of Medicine Michael E. DeBakey VA Medical Centre. The sample will consist of 216 treatment-seeking smokers with pre-diabetes (haemoglobin A1c of 5.7%-6.4%) and/or overweight (body mass index of 25 kg/m2 or above). Participants will be randomised (1:1) to receive subcutaneous injections of placebo or 2 mg exenatide, once weekly for 14 weeks. All participants will receive transdermal nicotine replacement therapy and brief smoking cessation counselling for 14 weeks. The primary outcomes are 4-week continuous abstinence and changes in body weight at the end of treatment. The secondary outcomes are (1) abstinence and changes in body weight at 12 weeks post end of treatment and (2) changes in neuroaffective responses to cigarette-related and food-related cues as measured by electroencephalogram. ETHICS AND DISSEMINATION The study has been approved by the UTHealth Committee for the Protection of Human Subjects (HSC-MS-21-0639) and Baylor College of Medicine Institutional Review Board (H-50543). All participants will sign informed consent. The study results will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER NCT05610800.
Collapse
Affiliation(s)
- Luba Yammine
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Christopher D Verrico
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
- Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | - Francesco Versace
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Heather E Webber
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Robert Suchting
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Michael F Weaver
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Thomas R Kosten
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas, USA
- Michael E DeBakey VA Medical Center, Houston, Texas, USA
| | | | | | - Scott D Lane
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Joy M Schmitz
- Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| |
Collapse
|
5
|
Pebley K, Bursac Z, Klesges RC, Ebbert JO, Womack CR, Graber J, Little MA, Derefinko KJ, Krukowski RA. A randomized controlled trial to reduce post-cessation weight gain. Int J Obes (Lond) 2023; 47:471-478. [PMID: 36841886 PMCID: PMC9958320 DOI: 10.1038/s41366-023-01286-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND/OBJECTIVES Weight gain is a barrier to smoking cessation. Previous interventions targeting weight gain while quitting smoking have largely been unsuccessful. The current study aimed to assess the efficacy of weight stability and weight loss interventions compared to a low-intensity, self-guided bibliotherapy weight management group. SUBJECTS/METHODS A randomized controlled trial with 12-month follow-up from 2018 to 2022 was conducted with participants (N = 305) who reported smoking at least five cigarettes per day for the last year and interest in quitting initially recruited from the Memphis, TN, USA area. Recruitment was expanded nationally with the onset of the COVID-19 pandemic. Subsequently, 276 completed 12-month follow-up. INTERVENTIONS/METHODS The Bibliotherapy group was provided a weight management book. Both the Stability and Loss groups met via telephone for eight weeks to learn strategies for maintaining/losing weight, respectively. All three groups then received the same six-week smoking cessation intervention, with six months of varenicline provided. RESULTS Individuals in the Loss group lost more weight (-2.01 kg, SE = 1.58) than individuals in the Bibliotherapy group (+1.08 kg, SE = 1.49, p = 0.0004), while the Stability group (-0.30 kg, SE = 1.56) was not significantly different from the Bibliotherapy group (p = 0.17). Those in the Stability group did not gain a significant amount of weight. Participants in the Loss group did not gain back all weight lost after smoking cessation and ended the study approximately 2.01 kg lower than baseline. The Bibliotherapy group did not gain the amount of weight expected after cessation. There were no significant differences between groups related to self-reported smoking cessation at each time point except at eight-month follow-up (p = 0.005). CONCLUSIONS AND RELEVANCE Results indicated the Stability and the Loss interventions were effective for preventing post-smoking cessation weight gain, with the Loss group having the benefit of sustained weight loss. These interventions may be helpful to implement to combat weight gain and potentially facilitate smoking cessation. TRIAL REGISTRATION The trial is registered on clinicaltrials.gov (NCT03156660).
Collapse
Affiliation(s)
- Kinsey Pebley
- The University of Memphis, Department of Psychology, 400 Innovation Drive, Memphis, TN, 38152, USA
| | - Zoran Bursac
- Florida International University, Department of Biostatistics, Miami, FL, 33199, USA
| | - Robert C Klesges
- University of Virginia, School of Medicine Department of Public Health Sciences, PO Box 800765, Charlottesville, VA, 22903, USA
| | - Jon O Ebbert
- Mayo Clinic, Department of Medicine, 200 1st Street SW, Rochester, MN, 55905, USA
| | - Catherine R Womack
- University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline St, Memphis, TN, 38105, USA
| | - Julia Graber
- University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline St, Memphis, TN, 38105, USA
| | - Melissa A Little
- University of Virginia, School of Medicine Department of Public Health Sciences, PO Box 800765, Charlottesville, VA, 22903, USA
| | - Karen J Derefinko
- University of Tennessee Health Science Center, Department of Preventive Medicine, 66 N Pauline St, Memphis, TN, 38105, USA
| | - Rebecca A Krukowski
- University of Virginia, School of Medicine Department of Public Health Sciences, PO Box 800765, Charlottesville, VA, 22903, USA.
| |
Collapse
|
6
|
Frallonardo FP, Lima DR, Carvalho CFC, Loreto AR, Guimarães-Pereira BBS, Ismael F, Torales J, Ventriglio A, de Andrade AG, da Silva Bizário JC, Castaldelli-Maia JM. Effect of BMI on Prolonged Abstinence after Smoking Cessation Treatment: A Retrospective Cohort Study. Curr Drug Res Rev 2021; 13:236-245. [PMID: 34011261 DOI: 10.2174/2589977513666210518160924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 02/03/2021] [Accepted: 02/27/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Despite the well-documented relationship between weight gain and poorer cessation outcomes among smokers, the role of the former (baseline) weight in smoking cessation is insufficiently investigated. We hypothesized that patients with higher baseline body mass index(BMI) have a worse prognosis in tobacco cessation. OBJECTIVES This retrospective clinical cohort study aimed to investigate the role of the baseline BMI on abstinence over 12 months after participation in smoking cessation treatment conducted in a middle-income country (n = 664). METHODS Data from a 6-week smoking cessation protocol performed in a Psychosocial Care Unit(CAPS) were used. The protocol included four medical consultations and six Cognitive-Behavioral Therapy(CBT) group sessions. Initially, 1,213 participants were evaluated for the study, but only the participants whose telephone contact was successful were included in the outcome analyses. The attrition rate was 45.3%. Continuous and categorical (normal, overweight, and obesity) BMI values were computed. Survival regression models were used to test the associations between BMI and the 12-month abstinence outcome. Self-report 4-week abstinence at the end of treatment was also investigated using logistic regression models. RESULTS Baseline BMI had no significant effect on both short (4-week-point abstinence) and long (12-month prolonged abstinence) treatment outcomes. CONCLUSION The possible influence of the baseline BMI on smoking cessation outcomes, especially considering prolonged abstinence, was not corroborated by our results. Regardless of our results, the detrimental health outcomes due to the combination of obesity/overweight and smoking justify that these subgroups of individuals be continuously targeted for adequate smoking prevention and treatment.
Collapse
Affiliation(s)
| | - Danielle Ruiz Lima
- Department of Psychiatry, Medical School, University of São Paulo, Butanta, SP, Brazil
| | | | | | | | - Flavia Ismael
- Municipal University of São Caetano do Sul (USCS), São Caetano do Sul, SP, Brazil
| | - Julio Torales
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, Asunción. Paraguay
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia. Italy
| | | | | | | |
Collapse
|
7
|
Wharton S, Astrup A, Endahl L, Lean MEJ, Satylganova A, Skovgaard D, Wadden TA, Wilding JPH. Estimating and reporting treatment effects in clinical trials for weight management: using estimands to interpret effects of intercurrent events and missing data. Int J Obes (Lond) 2021; 45:923-933. [PMID: 33462358 PMCID: PMC8081661 DOI: 10.1038/s41366-020-00733-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/03/2020] [Accepted: 12/15/2020] [Indexed: 12/26/2022]
Abstract
In the approval process for new weight management therapies, regulators typically require estimates of effect size. Usually, as with other drug evaluations, the placebo-adjusted treatment effect (i.e., the difference between weight losses with pharmacotherapy and placebo, when given as an adjunct to lifestyle intervention) is provided from data in randomized clinical trials (RCTs). At first glance, this may seem appropriate and straightforward. However, weight loss is not a simple direct drug effect, but is also mediated by other factors such as changes in diet and physical activity. Interpreting observed differences between treatment arms in weight management RCTs can be challenging; intercurrent events that occur after treatment initiation may affect the interpretation of results at the end of treatment. Utilizing estimands helps to address these uncertainties and improve transparency in clinical trial reporting by better matching the treatment-effect estimates to the scientific and/or clinical questions of interest. Estimands aim to provide an indication of trial outcomes that might be expected in the same patients under different conditions. This article reviews how intercurrent events during weight management trials can influence placebo-adjusted treatment effects, depending on how they are accounted for and how missing data are handled. The most appropriate method for statistical analysis is also discussed, including assessment of the last observation carried forward approach, and more recent methods, such as multiple imputation and mixed models for repeated measures. The use of each of these approaches, and that of estimands, is discussed in the context of the SCALE phase 3a and 3b RCTs evaluating the effect of liraglutide 3.0 mg for the treatment of obesity.
Collapse
Affiliation(s)
- Sean Wharton
- Weight Management and Diabetes, The Wharton Medical Clinic, Hamilton, ON, Canada. .,Department of Health and Kinesiology, York University, Toronto, ON, Canada.
| | - Arne Astrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Michael E J Lean
- School of Medicine, Dentistry and Nursing, University of Glasgow, Royal Infirmary, Glasgow, UK
| | | | | | - Thomas A Wadden
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John P H Wilding
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK
| |
Collapse
|
8
|
Fiório CE, Cesar CLG, Alves MCGP, Goldbaum M. Prevalência de hipertensão arterial em adultos no município de São Paulo e fatores associados. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2020; 23:e200052. [DOI: 10.1590/1980-549720200052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 04/09/2019] [Indexed: 11/21/2022] Open
Abstract
RESUMO: Objetivo: Analisar o comportamento da prevalência de hipertensão arterial no município de São Paulo e seus fatores associados. Métodos: O presente trabalho utilizou os dados do Inquérito de Saúde no Município de São Paulo (ISA Capital), estudo transversal de base populacional executado no município de São Paulo. Foram utilizados dados de 1.667 e de 3.184 indivíduos em 2003 e 2015, respectivamente, com idade de 20 anos e mais. Fizeram-se análises descritivas das prevalências de hipertensão arterial com respectivos intervalos de 95% de confiança. Análises simples e múltiplas foram realizadas para analisar possíveis associações com as variáveis socioeconômicas, demográficas e de estilo de vida por meio de regressão de Poisson. Resultados: A prevalência de hipertensão arterial passou de 17,2% em 2003 para 23,2% em 2015. Os fatores associados à hipertensão foram: sexo feminino; idade (60 anos e mais); situação conjugal (casados, separados e viúvos); ter religião; baixa escolaridade; ter nascido no estado de São Paulo (exceto capital); estado nutricional (baixo peso, sobrepeso e obesidade); e ex-fumantes. Conclusão: A prevalência de hipertensão autorreferida aumentou significativamente no período estudado em São Paulo. Considerando o impacto dessa doença na sociedade, conhecendo sua atual prevalência e identificando seus principais fatores associados, evidencia-se a necessidade de intensificar atividades que contribuam para a prevenção desse agravo, atenuando os danos aos indivíduos e gastos públicos.
Collapse
|
9
|
Dupont C, Faure C, Daoud F, Gautier B, Czernichow S, Lévy R. Metabolic syndrome and smoking are independent risk factors of male idiopathic infertility. Basic Clin Androl 2019; 29:9. [PMID: 31304019 PMCID: PMC6600889 DOI: 10.1186/s12610-019-0090-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/05/2019] [Indexed: 11/16/2022] Open
Abstract
Background Overweight and obesity are known to impact male fertility and are commonly associated with abdominal obesity and metabolic disorders. The association between abdominal obesity or metabolic syndrome with male reproduction has not been fully investigated. Moreover, many factors may interfere with the evaluation of the impact of metabolic syndrome on male fertility. Thus, tobacco is known to alter the spermatic parameters and phenomena linking smoking with metabolic syndrome are therefore complex. The main objective of this study has been to investigate the potential association of metabolic syndrome with male idiopathic infertility given smoking status. Materiel and methods The data of this study concerned infertile (n = 96) and fertile (n = 100) men under 45 years of age who have been recruited in the ALIFERT case-control study. Body mass index and waist circumference were measured. Serum triglycerides, cholesterol (total, high density lipoprotein, and low density lipoprotein cholesterol) and fasting blood glucose were assayed. Metabolic syndrome has been diagnosed in the presence of at least three of the following criteria: increased waist circumference, high triglycerides, fasting glucose or arterial blood pressure and low high density lipoprotein cholesterol. Results The present study reports that infertile men are in poorer health condition compared to fertile men and are more often smokers. The results of this study suggested metabolic syndrome and smoking to be independent risk factor for idiopathic infertility. Conclusions Metabolic syndrome and smoking should systematically be checked at the beginning of medical care in infertile males and personal and multifaceted coaching should be proposed to deal jointly with smoking and metabolic disorders. Trial registration NCT01093378 ALIFERT. Registered: March 25, 2010.
Collapse
Affiliation(s)
- Charlotte Dupont
- 1Sorbonne Université, Saint Antoine Research center, INSERM équipe Lipodystrophies génétiques et acquisesService de biologie de la reproduction-CECOS, AP-H, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France
| | - Céline Faure
- AP-HP, Hôpital Tenon, service de biologie de la reproduction CECOS, Paris, France
| | - Frederic Daoud
- AP-HP, Hôpital Tenon, service de biologie de la reproduction CECOS, Paris, France
| | - Benoit Gautier
- AP-HP, Hôpital Tenon, service de biologie de la reproduction CECOS, Paris, France
| | - Sébastien Czernichow
- 3Université Paris Descartes, Paris, France.,4APHP, Service de nutrition, Hôpital européen Georges-Pompidou, Paris, France
| | - Rachel Lévy
- 1Sorbonne Université, Saint Antoine Research center, INSERM équipe Lipodystrophies génétiques et acquisesService de biologie de la reproduction-CECOS, AP-H, Hôpital Tenon, 4 rue de la Chine, 75020 Paris, France
| | | |
Collapse
|
10
|
Jeremias-Martins E, Chatkin JM. Does everyone who quit smoking gain weight? A real-world prospective cohort study. ACTA ACUST UNITED AC 2019; 45:e20180010. [PMID: 30810645 PMCID: PMC6534411 DOI: 10.1590/1806-3713/e20180010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/18/2018] [Indexed: 12/23/2022]
Abstract
Objective: To evaluate weight changes after 12 months of biochemically confirmed smoking abstinence, comparing patients who lost weight or maintained their baseline weight with those who gained weight. Methods: This was a real-world prospective cohort study conducted at the Outpatient Smoking Cessation Clinic of São Lucas Hospital, in the city of Porto Alegre, Brazil, between 2010 and 2016. The patients evaluated received intensive smoking cessation counseling, focused especially on weight issues, together with pharmacotherapy, and were followed for 12 months. The baseline and final weights were measured. Continuous abstinence was confirmed by determining the concentration of exhaled carbon monoxide (eCO). Results: Of a total of 348 patients evaluated, 161 (46.2%) achieved continuous abstinence (eCO < 10 ppm) over the 12-month follow-up period. Of those 161 patients, 104 (64.6%) maintained their initial weight or had a weight change of no more than 5% in relation to their baseline weight, whereas the remaining 57 (35.4%) had a weight gain of more than 5%, 18 of those patients showing a > 10% increase over their baseline weight. The number needed to harm (i.e., the number of patients required in order to detect one patient with a weight increase) was calculated to be 3.6 (95% CI: 2.8-5.4). Conclusions: Weight gain is not necessarily associated with smoking cessation, and smokers who are motivated to quit should be informed of that fact. This information could also be useful for addressing smokers who are still undecided because of possibility of weight gain.
Collapse
Affiliation(s)
- Edna Jeremias-Martins
- . Ambulatório de Auxílio ao Abandono do Tabagismo, Hospital São Lucas, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil.,. Faculdades Integradas de Taquara - FACCAT - Taquara (RS) Brasil
| | - José Miguel Chatkin
- . Ambulatório de Auxílio ao Abandono do Tabagismo, Hospital São Lucas, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil.,. Departamento de Medicina Interna e Pneumologia, Faculdade de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul - PUCRS - Porto Alegre (RS) Brasil
| |
Collapse
|
11
|
Wills AG, Hopfer C. Phenotypic and genetic relationship between BMI and cigarette smoking in a sample of UK adults. Addict Behav 2019; 89:98-103. [PMID: 30286397 DOI: 10.1016/j.addbeh.2018.09.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/01/2018] [Accepted: 09/24/2018] [Indexed: 12/29/2022]
Abstract
In addition to the health hazards posed individually by cigarette smoking and obesity, the combination of these conditions poses a particular impairment to health. Genetic factors have been shown to influence both traits and, to understand the connection between these conditions, we examined both the observed and genetic relationship between adiposity (an electrical impedance measure of body mass index (BMI)) and cigarettes smoked per day (CPD) in a large sample of current, former, and never smokers in the United Kingdom. In former smokers, BMI was positively associated with cigarettes formerly smoked; further, the genetic factors related to a greater number of cigarettes smoked were also responsible for a higher BMI. In current smokers, there was a positive association between BMI and number of cigarettes smoked, though this relationship did not appear to be influenced by similar genetic factors. We found a positive genetic relationship between smoking in current/former smokers and BMI in never smokers (who would be unmarred by the effects of nicotine). In addition to CPD, in current smokers, we looked at two variables, time from waking to first cigarette and difficulty not smoking for a day, that may align better with cigarette and food 'craving.' However, these smoking measures provided mixed findings with respect to their relationship with BMI. Overall, the positive relationships between the genetic factors that influence CPD in smokers and the genetic factors that influence BMI in former and never smokers point to common biological influences behind smoking and obesity.
Collapse
Affiliation(s)
- Amanda G Wills
- Division of Substance Dependence, Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Mail Stop F570, Building 500, 13001 East 17th Place, Aurora, CO 80045, USA; Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO 80301, USA.
| | - Christian Hopfer
- Division of Substance Dependence, Department of Psychiatry, University of Colorado, Anschutz Medical Campus, Mail Stop F570, Building 500, 13001 East 17th Place, Aurora, CO 80045, USA; Institute for Behavioral Genetics, University of Colorado Boulder, 1480 30th Street, Boulder, CO 80301, USA
| |
Collapse
|
12
|
Wakiya T, Ishido K, Kudo D, Kimura N, Sato K, Mitsuhashi Y, Kagiya T, Uchida C, Umetsu S, Yoshida T, Wakasa Y, Toyoki Y, Hakamada K. Impact of Smoking Cessation in Donor Candidates for Living Donor Liver Transplantation. Transplant Proc 2018; 50:2593-2596. [PMID: 30401357 DOI: 10.1016/j.transproceed.2018.02.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 02/19/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND The relationship between smoking cessation and weight gain is well recognized. Examining the link between smoking cessation and weight gain in donor candidates for living donor liver transplantation (LDLT) is an important topic because of the influence of weight gain on the liver. This study assessed body weight (BW) changes after smoking cessation in donor candidates for LDLT. METHODS The 27 donor candidates were retrospectively analyzed. The smoking status was determined based on questionnaires administered at the initial presentation, and the candidates were divided into 2 groups: recent quitters and nonsmokers. The changes in BW were compared between the groups. RESULTS The recent quitters group included 10 (37.0%) candidates, and the nonsmokers group included 17 (63.0%). In the nonsmokers group, 1 candidate had gained weight since the initial presentation. In contrast, in the recent quitters group, 70.0% of candidates had gained weight since the initial presentation (P < .01). The change in BW from the initial presentation was greater in recent quitters than in nonsmokers (+1.6 kg [+2.4%] vs -0.5 kg [-0.9%]; P < .01). Two candidates in the recent quitters group gained ≥ 5 kg [8%] of weight. One of these 2 candidates was judged to be in a donor-inadequate status because of the appearance of fatty liver. CONCLUSIONS Weight gain due to smoking cessation was observed in donor candidates for LDLT. The amount of weight gain after smoking cessation is highly individualized, so everyone concerned with LDLT must be alert to its potential development.
Collapse
Affiliation(s)
- T Wakiya
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - K Ishido
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - D Kudo
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - N Kimura
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - K Sato
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Y Mitsuhashi
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - T Kagiya
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - C Uchida
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - S Umetsu
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - T Yoshida
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Y Wakasa
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Y Toyoki
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - K Hakamada
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| |
Collapse
|
13
|
Raptou E, Papastefanou G. An empirical investigation of the impact of smoking on body weight using an endogenous treatment effects model approach: the role of food consumption patterns. Nutr J 2018; 17:101. [PMID: 30396350 PMCID: PMC6217773 DOI: 10.1186/s12937-018-0408-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 10/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study explored the influence of cigarette smoking and food consumption patterns on BMI after adjusting for various socio-demographic characteristics. Since weight-based stereotypes may have an impact on smoking behaviour and both obesity and smoking have been associated with detrimental health effects, an interdependency between them is quite possible. METHODS Cross-sectional data were collected via a formal standardized questionnaire administered in personal interviews and two additional self-completion questionnaires from a random sample of 3471 German adults. The empirical framework considered potential endogeneity between smoking and body weight by employing an endogenous treatment effects model with an ordered outcome. The estimations derived from the endogenous treatment effects approach were also compared to the univariate ordered probit model results. RESULTS Our findings showed that ignoring potential endogeneity may affect both the statistical significance of the smoking estimate and the direction of the influence of smoking on BMI. Smoking was positively associated with BMI in both male (β = 1.236, p < 0.01) and female (β = 0.634, p < 0.10) participants. Smokers presented a 23.1% higher risk of obesity and a 24.3% lower likelihood of being within a healthy weight range. Male smokers also appeared to have a considerably augmented probability of being obese compared to their female counterparts (23.6% vs 15.1%). The relationship between smoking and BMI may be attributed to dietary practices, since smoking was correlated with poor dietary habits characterized by the frequent intake of more energy-dense foods (meat products and white-toasted bread) and less frequent consumption of healthy food items, such as whole-grain bread, vegetables and fruits. Concerning the impact of eating habits on body weight, frequent consumption of meat products and confectionery was found to have a direct association with BMI in both genders. Furthermore, white-toasted bread consumption was negatively linked with body weight in males (β = - 0.337, p < 0.01). CONCLUSIONS Our findings raised questions about the general belief that smoking is an effective weight control tool. Health interventions should be oriented toward a simultaneous decrease in smoking and obesity, since both behaviours seem to be interdependent. Nutrition programmes should also be designed according to the characteristics of different target groups in order to promote a healthy lifestyle.
Collapse
Affiliation(s)
- Elena Raptou
- Department of Agricultural Development, Laboratory of Management and Marketing, Democritus University of Thrace, Orestiada, Greece
| | | |
Collapse
|
14
|
Yaya S, Ekholuenetale M, Bishwajit G. Differentials in prevalence and correlates of metabolic risk factors of non-communicable diseases among women in sub-Saharan Africa: evidence from 33 countries. BMC Public Health 2018; 18:1168. [PMID: 30309337 PMCID: PMC6182823 DOI: 10.1186/s12889-018-6085-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 10/01/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Even with the widespread recognition of non- communicable diseases (NCDs) in sub-Saharan Africa region, yet, sufficient evidence-based surveillance systems to confirm the prevalence and correlates of these diseases is lacking. In an attempt to understand the problem of NCDs in resource-constrained settings, this study was conducted to establish the pattern of the risk factors of NCDs in sub-Sahara Africa region. METHODS The current Demographic and Health Survey (DHS) data sets from 33 countries in sub-Sahara Africa region were used in this study. The individual woman component of DHS 2008-2016 was used. The outcome variables include anemia, hypertension and body mass index (underweight, overweight and obesity). BMI was categorized into; underweight (BMI < 18.5 kg/m2), normal (BMI 18.5-24.9 kg/m2), overweight (BMI 25.0-29.9 kg/m2) and obesity (BMI ≥30 kg/m2). Hemoglobin level: anemic < 12.0 g/dL (< 120 g/L) for women. Hypertension was defined as systolic blood pressure (SBP) ≥140 mmHg and/or diastolic blood pressure (DBP) ≥90 mmHg. Binary and multinomial logistic regression models were used to investigate the correlates of the variables. RESULTS The percentage of hypertension was highest among women in Lesotho with about 17.3% and lowest among women in Burundi (1.0%). Anemia was prevalent among sub-Saharan Africa women; where more than half of the women from several countries were anemic with Gabon (60.6%) reporting the highest prevalence. The percentage of obesity in sub-Saharan Africa showed that Lesotho (19.9%), Gabon (18.9%) and Ghana (15.6%) were the prominent countries with obese women, while Madagascar (1.1%) had the minimum obese women. Body mass index was significantly associated with hypertension and anemia. The behavioural or modifiable factors of hypertension and body mass index were; smoking, fruits, vegetables and alcohol consumption. While the non-modifiable significant factors include; age, residence, religion, education, wealth index, marital status, employment and number of children ever born. However, anemia shared similar factors except that smoking and vegetable consumption were not statistically significant. In addition, involvement in exercise was associated with anemia and hypertension. CONCLUSION The problem of NCDs and associated factors remains high among women of reproductive age in sub-Sahara region. The findings of this study suggest that promotion of regular positive health care-seeking behaviour, screening and early treatment are essential to mitigate the burden of NCDs. Furthermore, preventive interventions of NCDs risk factors should be strengthened among key population through behavior change communication with support from government and stakeholders in health care.
Collapse
Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
| | - Michael Ekholuenetale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
| |
Collapse
|
15
|
Walker JF, Loprinzi PD. Association of BMI Changes Between Adolescence and Young Adulthood With Smoking Cessation. Am J Health Promot 2018; 33:358-362. [PMID: 30105914 DOI: 10.1177/0890117118772492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Weight gain frequently accompanies smoking cessation. This study examined if increasing body mass index (BMI) during the early years of smoking influences quitting by young adulthood. DESIGN Longitudinal, observational study using in-home interview data. SETTING National Longitudinal Study of Adolescent and Adult Health (Add Health) 1994 to 2008. SUBJECTS Nine hundred forty-nine adolescent smokers (12-19 years) followed into young adulthood (20-32 years) through 4 waves of in-home interviews. MEASURES Outcome variable: Young adult smoking status (yes or no) reported at in-home interviews. Factors: Gender and 4 longitudinal adolescent/young adult BMI trajectories-normal/normal, normal/overweight, normal/obese, and overweight/obese. Covariates: Race-ethnicity, education, household income, and recent quit attempt in adolescence. ANALYSIS Binary logistic regression analysis. RESULTS Overall, the rate at which young adults quit smoking was not significantly different based on gender. However, longitudinal changes in BMI trajectory and gender interact to influence young adult smoking status. Women having normal/overweight and normal/obese BMI trajectories were less likely to quit smoking than men. Odds that young adults having some college or post-high school education quit smoking were greater than those with high school education or less. CONCLUSION At a minimum, providing direct information regarding anticipated weight changes after quitting is indicated in smoking cessation intervention, in addition to strategies to mitigate postcessation weight gain. Faced with weight gain, younger smokers, particularly women, may be more resistant to quitting smoking.
Collapse
Affiliation(s)
- Jerome F Walker
- 1 Department of Respiratory Therapy, Bellarmine University, Louisville, KY, USA
| | - Paul D Loprinzi
- 2 Department of Health, Exercise Science, and Recreation Management, University of Mississippi, Oxford, MS, USA
| |
Collapse
|
16
|
Wakiya T, Ishido K, Kudo D, Kimura N, Sakuraba S, Tsutsumi S, Kagiya T, Uchida C, Hakamada K. Smoking cessation contributes to weight gain in patients with hepatobiliopancreatic malignancy. Clin Nutr ESPEN 2018; 23:54-60. [PMID: 29460814 DOI: 10.1016/j.clnesp.2017.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 10/14/2017] [Accepted: 12/13/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND & AIMS The relationship between smoking cessation and weight gain is well recognized. However, there is no data currently available on the effect of smoking cessation on weight gain in patients with malignancy. The aim of this study was to clarify the body weight (BW) change after smoking cessation in patients with malignancy. METHODS We retrospectively analyzed 159 subjects who underwent hepatobiliopancreatic surgery. The smoking status was determined using questionnaires administered at the initial presentation, and the candidates were divided into two groups: recent quitters and nonsmokers. The change in the BW was compared between these two groups. RESULTS There were 134 subjects with malignant disease (84.3%), with a median age of 68 (range: 26-84) years. In the nonsmoker group, 28 of 116 subjects (24.1%) gained weight between the initial presentation and admission. In the recent quitter group, 12 of 18 subjects (66.7%) gained weight in the same period (P < 0.01). Regarding the change in the BW from the initial presentation, recent quitters gained more weight than nonsmokers (+1.7 kg [+2.7%] vs. -1.0 kg [-2.0%], P < 0.01). Furthermore, the improvement from the initial presentation was seen in a higher percentage of recent quitters than nonsmokers with respect to Onodera's prognostic nutritional index (61.1% vs. 36.2%, P = 0.04) and the controlling nutritional status score (38.9% vs. 19.3%, P = 0.07). CONCLUSIONS Weight gain due to smoking cessation was observed even in patients with hepatobiliopancreatic malignancy.
Collapse
Affiliation(s)
- Taiichi Wakiya
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan.
| | - Keinosuke Ishido
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Daisuke Kudo
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Norihisa Kimura
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Shingo Sakuraba
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Shinji Tsutsumi
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Takuji Kagiya
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Chiaki Uchida
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| | - Kenichi Hakamada
- Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Japan
| |
Collapse
|
17
|
Conway BN, Han X, Munro HM, Gross AL, Shu XO, Hargreaves MK, Zheng W, Powers AC, Blot WJ. The obesity epidemic and rising diabetes incidence in a low-income racially diverse southern US cohort. PLoS One 2018; 13:e0190993. [PMID: 29324894 PMCID: PMC5764338 DOI: 10.1371/journal.pone.0190993] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 12/22/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Obesity is known to be a major risk factor for diabetes, but the magnitude of risk and variation between blacks and whites are less well documented in populations heavily affected by obesity. Herein we assess rates and risks of incident diabetes in a diverse southern population where obesity is common. METHODS A total of 24,000 black and 14,064 white adults aged 40-79 in the Southern Community Cohort Study with no self-reported diabetes at study enrollment during 2002-2009 was followed for up to 10 (median 4.5) years. Incidence rates, odds ratios (OR) and accompanying 95% confidence intervals (CI) for medication-treated incident diabetes were determined according to body mass index (BMI) and other characteristics, including tobacco and alcohol consumption, healthy eating and physical activity indices, and socioeconomic status (SES). RESULTS Risk of incident diabetes rose monotonically with increasing BMI, but the trends differed between blacks and whites (pinteraction < .0001). Adjusted ORs (CIs) for diabetes among those with BMI≥40 vs 20-25 kg/m2 were 11.9 (8.4-16.8) for whites and 4.0 (3.3-4.8) for blacks. Diabetes incidence was more than twice as high among blacks than whites of normal BMI, but the racial difference became attenuated as BMI rose, with estimated 5-year probabilities of developing diabetes approaching 20% for both blacks and whites with BMI≥40 kg/m2. Diabetes risk was also associated with low SES, significantly (pinteraction≤.02) more so for whites, current cigarette smoking, and lower healthy eating and physical activity indices, although high BMI remained the predominant risk factor among both blacks and whites. From baseline prevalence and 20-year projections of the incidence trends, we estimate that the large majority of surviving cohort participants with BMI≥40 kg/m2 will be diagnosed with diabetes. CONCLUSIONS Even using conservative criteria to ascertain diabetes incidence (i.e., requiring diabetes medication use and ignoring undiagnosed cases), rates of obesity-associated diabetes were exceptionally high in this low-income adult population. The findings indicate that effective strategies to halt the rising prevalence of obesity are needed to avoid substantial increases in diabetes in coming years.
Collapse
Affiliation(s)
- Baqiyyah N. Conway
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center, Tyler, Texas, United States of America
| | - Xijing Han
- International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Rockville, Maryland, United States of America
| | - Heather M. Munro
- International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Rockville, Maryland, United States of America
| | - Amy L. Gross
- International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Rockville, Maryland, United States of America
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Margaret K. Hargreaves
- Department of Internal Medicine, Meharry Medical College, Nashville, Tennessee, United States of America
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Alvin C. Powers
- Division of Diabetes, Endocrinology and Metabolism, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - William J. Blot
- International Epidemiology Field Station, Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Rockville, Maryland, United States of America
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| |
Collapse
|
18
|
Lee JY, Kim SM, Choi YS, Park YG, Kim EY, Yoon SJ, Kim JW, Yoon JH, Kim M, Jeon HR. The Relationship between Body Mass Index and Smoking Cessation Plans in Korean Adults. J Obes Metab Syndr 2017; 26:281-286. [PMID: 31089531 PMCID: PMC6489477 DOI: 10.7570/jomes.2017.26.4.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 07/11/2017] [Accepted: 09/21/2017] [Indexed: 11/26/2022] Open
Abstract
Background Concerns regarding weight gain after smoking cessation may interfere with quitting smoking. This study investigated the association between smoking cessation plans and body mass index (BMI, kg/m2) in Korean adult smokers. Methods Using data from the sixth Korea National Health and Nutrition Examination Survey (2013–2015), 3,000 current smokers aged 19 years or older were selected and divided into four weight groups. The cohorts included an underweight group (BMI, <18.5 kg/m2), normal weight group (BMI, ≥18.5 to <23 kg/m2), overweight group (BMI, ≥23 to <25 kg/m2), and obese group (BMI, ≥25 kg/m2). The relationship between BMI and smoking cessation plans in Korean adults was analyzed using multiple logistic regression analysis. Results Multiple logistic regression analysis showed sex (odds ratio [OR], 0.723; 95% confidence interval [CI], 0.556–0.939), high-risk drinking (OR, 0.796; 95% CI, 0.634–0.998), aerobic physical activity (OR, 1.326; 95% CI, 1.092–1.612), and hypertension (OR, 1.387; 95% CI, 1.034–1.860) were the significant factors related to smoking cessation plans. According to the BMI categories, the ORs of smoking cessation plans were numerically higher in the normal weight group than the other three groups. However, the difference was not statistically significant. Conclusion Normal weight subjects tended to have a greater number of smoking cessation plans than the other three weight groups, but the difference was not statistically significant. In the clinic, it is necessary to consider not only BMI but also other factors associated with a smoking cessation plans.
Collapse
Affiliation(s)
- Ji Young Lee
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Seon Mee Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yoon Seon Choi
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - E Yeon Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - So Jung Yoon
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jin Wook Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jung Hwan Yoon
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Man Kim
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Hye Ran Jeon
- Department of Family Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
19
|
Maddatu J, Anderson-Baucum E, Evans-Molina C. Smoking and the risk of type 2 diabetes. Transl Res 2017; 184:101-107. [PMID: 28336465 PMCID: PMC5429867 DOI: 10.1016/j.trsl.2017.02.004] [Citation(s) in RCA: 167] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/19/2017] [Accepted: 02/25/2017] [Indexed: 01/18/2023]
Abstract
Despite accumulating evidence demonstrating strong epidemiologic and mechanistic associations between cigarette smoking, hyperglycemia, and the development of type 2 diabetes, tobacco abuse has not been uniformly recognized as a modifiable risk factor in diabetes prevention or screening strategies. In this review, we highlight population-based studies that have linked cigarette smoking with an increased risk of type 2 diabetes and summarize clinical and preclinical studies offering insight into mechanisms through which cigarette smoking and nicotine exposure impact body composition, insulin sensitivity, and pancreatic β cell function. Key questions for future studies are identified and strategies for smoking cessation as a means to decrease diabetes risk are discussed.
Collapse
Affiliation(s)
- Judith Maddatu
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind
| | | | - Carmella Evans-Molina
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Ind; Department of Cellular and Integrative Physiology, Indiana University School of Medicine, Indianapolis, Ind; Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, Ind; Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Ind; Roudebush VA Medical Center, Indianapolis, Ind.
| |
Collapse
|
20
|
King CC, Piper ME, Gepner AD, Fiore MC, Baker TB, Stein JH. Longitudinal Impact of Smoking and Smoking Cessation on Inflammatory Markers of Cardiovascular Disease Risk. Arterioscler Thromb Vasc Biol 2016; 37:374-379. [PMID: 27932354 DOI: 10.1161/atvbaha.116.308728] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 11/22/2016] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To evaluate longitudinal changes in 6 inflammatory markers that predict cardiovascular disease events among smokers making a quit attempt and to characterize their cross-sectional associations between smoking and smoking heaviness. APPROACH AND RESULTS In a longitudinal cohort study of contemporary smokers (n=1652), we evaluated (1) independent associations of smoking heaviness markers (exhaled carbon monoxide, cigarettes/d, pack-years) with inflammatory markers (C-reactive protein, D-dimer, fibrinogen, urinary F2 isoprostane:creatinine [F2:Cr] ratio, white blood cell [WBC] count, myeloperoxidase) and (2) the effects of smoking cessation and continued smoking on these inflammatory markers after 1 year, among the 888 smokers who made an aided quit attempt as part of a randomized comparative effectiveness trial or standard care. There were strong, independent associations between smoking heaviness markers and the F2:Cr ratio, WBC, and myeloperoxidase (all Padj<0.001), but not high-sensitivity C-reactive protein, D-dimer, or fibrinogen. Participants were mean (SD) 49.6 years old (11.6), 54% women, 34% non-white, and smoked 16.8 cigarettes/d (8.5) for 27.3 pack-years (18.6). After 1 year, the 344 successful abstainers gained more weight (4.0 [6.0] versus 0.4 [5.7] pounds; P<0.001) and had larger increases in insulin resistance scores (P=0.02) than continuing smokers. Despite these increases, abstainers had significant decreases in F2:Cr ratio (P<0.001) and WBC counts (P<0.001). Changes in other markers were not related to quitting. CONCLUSIONS Smoking heaviness is associated with increased F2:Cr ratio, myeloperoxidase, and WBC counts. Cessation improves the F2:Cr ratio and WBC counts independent of weight change, suggesting reduced inflammation related to less oxidant stress.
Collapse
Affiliation(s)
- Cecile C King
- From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Megan E Piper
- From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Adam D Gepner
- From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Michael C Fiore
- From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison
| | - Timothy B Baker
- From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison
| | - James H Stein
- From the Department of Medicine (C.C.K., M.E.P., A.D.G., M.C.F., T.B.B., J.H.S.) and Center for Tobacco Research and Intervention (M.E.P., M.C.F., T.B.B.), University of Wisconsin School of Medicine and Public Health, Madison.
| |
Collapse
|