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. 2018 Apr 4;8(4):e017706.
doi: 10.1136/bmjopen-2017-017706.

Interaction of diabetes and smoking on stroke: a population-based cross-sectional survey in China

Heqing Lou  1 , Zongmei Dong  1   2 , Pan Zhang  2 , Xiaoping Shao  1 , Ting Li  2 , Chunyan Zhao  1 , Xunbao Zhang  1 , Peian Lou  1   2
Affiliations

Interaction of diabetes and smoking on stroke: a population-based cross-sectional survey in China

Heqing Lou et al. BMJ Open. .

Abstract

Objectives: Diabetes and smoking are known independent risk factors for stroke; however, their interaction concerning stroke is less clear. We aimed to explore such interaction and its influence on stroke in Chinese adults.

Design: Cross-sectional study.

Setting: Community-based investigation in Xuzhou, China.

Participants: A total of 39 887 Chinese adults who fulfilled the inclusion criteria were included.

Methods: Participants were selected using a multistage stratified cluster method, and completed self-reported questionnaires on stroke and smoking. Type 2 diabetes mellitus (DM2) was assessed by fasting blood glucose or use of antidiabetic medication. Interaction, relative excess risk owing to interaction (RERI), attributable proportion (AP) and synergy index (S) were evaluated using a logistic regression model.

Results: After adjustment for age, sex, marital status, educational level, occupation, physical activity, body mass index, hypertension, family history of stroke, alcohol use and blood lipids, the relationships between DM2 and stroke, and between smoking and stroke, were still significant: ORs were 2.75 (95% CI 2.03 to 3.73) and 1.70 (95% CI 1.38 to 2.10), respectively. In subjects with DM2 who smoked, the RERI, AP and S values (and 95% CIs) were 1.80 (1.24 to 3.83), 0.52 (0.37 to 0.73) and 1.50 (1.18 to 1.84), respectively.

Conclusions: The results suggest there are additive interactions between DM2 and smoking and that these affect stroke in Chinese adults.

Keywords: rpidemiology; stroke medicine.

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Conflict of interest statement

Competing interests: None declared.

References

    1. GBD 2016 Causes of Death Collaborators. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017. 390:1151–210. 10.1016/S0140-6736(17)32152-9 - DOI - PMC - PubMed
    1. Stroke Control Project Committee of National Health and Family Planning Commission of the People’s Republic of China. Report on the Chinese stroke prevention (2015). 1st edn Beijing: China Pecking Union Medical College Press, 2015.
    1. Yang G, Wang Y, Zeng Y, et al. . Rapid health transition in China, 1990-2010: findings from the global burden of disease study 2010. Lancet 2013;381:1987–2015. 10.1016/S0140-6736(13)61097-1 - DOI - PMC - PubMed
    1. Hata J, Kiyohara Y. Epidemiology of stroke and coronary artery disease in Asia. Circ J 2013;77:1923–32. 10.1253/circj.CJ-13-0786 - DOI - PubMed
    1. Mi T, Sun S, Du Y, et al. . Differences in the distribution of risk factors for stroke among the high-risk population in urban and rural areas of Eastern China. Brain Behav 2016;6:e00461 10.1002/brb3.461 - DOI - PMC - PubMed

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