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. 2013 Mar;36(3):604-10.
doi: 10.2337/dc12-0913. Epub 2012 Nov 19.

Smoking is associated with reduced risk of autoimmune diabetes in adults contrasting with increased risk in overweight men with type 2 diabetes: a 22-year follow-up of the HUNT study

Bahareh Rasouli  1 , Valdemar Grill, Kristian Midthjell, Anders Ahlbom, Tomas Andersson, Sofia Carlsson
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Smoking is associated with reduced risk of autoimmune diabetes in adults contrasting with increased risk in overweight men with type 2 diabetes: a 22-year follow-up of the HUNT study

Bahareh Rasouli et al. Diabetes Care. 2013 Mar.

Abstract

Objective: To investigate the association between smoking habits and risk of autoimmune diabetes in adults and of type 2 diabetes.

Research design and methods: We used data from the three surveys of the Nord-Trøndelag Health Study, spanning 1984-2008 and including a cohort of 90,819 Norwegian men (48%) and women (52%) aged ≥20 years. Incident cases of diabetes were identified by questionnaire and classified as type 2 diabetes (n = 1,860) and autoimmune diabetes (n = 140) based on antibodies to glutamic decarboxylase (GADA) and age at onset of diabetes. Hazard ratios (HRs) adjusted for confounders were estimated by Cox proportional hazards regression models.

Results: The risk of autoimmune diabetes was reduced by 48% (HR 0.52 [95% CI 0.30-0.89]) in current smokers and 58% in heavy smokers (0.42 [0.18-0.98]). The reduced risk was positively associated with number of pack-years. Heavy smoking was associated with lower levels of GADA (P = 0.001) and higher levels of C-peptide (964 vs. 886 pmol/L; P = 0.03). In contrast, smoking was associated with an increased risk of type 2 diabetes, restricted to overweight men (1.33 [1.10-1.61]). Attributable proportion due to an interaction between overweight and heavy smoking was estimated to 0.40 (95% CI 0.23-0.57).

Conclusions: In this epidemiological study, smoking is associated with a reduced risk of autoimmune diabetes, possibly linked to an inhibitory effect on the autoimmune process. An increased risk of type 2 diabetes was restricted to overweight men.

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Figure 1
Figure 1
A chart presentation for the HUNT Study, 1984–2008.
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References

    1. Rehani K, Scott DA, Renaud D, et al. Cotinine-induced convergence of the cholinergic and PI3 kinase-dependent anti-inflammatory pathways in innate immune cells. Biochim Biophys Acta 2008;1783:375–382 - PubMed
    1. Wittebole X, Hahm S, Coyle SM, Kumar A, Calvano SE, Lowry SF. Nicotine exposure alters in vivo human responses to endotoxin. Clin Exp Immunol 2007;147:28–34 - PMC - PubMed
    1. Mabley JG, Pacher P, Southan GJ, Salzman AL, Szabó C. Nicotine reduces the incidence of type I diabetes in mice. J Pharmacol Exp Ther 2002;300:876–881 - PubMed
    1. Carlsson S, Midthjell K, Grill V, Nord-Trøndelag study Smoking is associated with an increased risk of type 2 diabetes but a decreased risk of autoimmune diabetes in adults: an 11-year follow-up of incidence of diabetes in the Nord-Trøndelag study. Diabetologia 2004;47:1953–1956 - PubMed
    1. Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type 2 diabetes: a systematic review and meta-analysis. JAMA 2007;298:2654–2664 - PubMed

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