吸烟和戒烟行为与男性2型糖尿病血糖控制关系的研究  

Association between smoking/smoking cessation and glycemic control in male patients with type 2 diabetes

作　　者：苏健 覃玉[2] 沈冲[3] 高艳[4] 潘恩春[5] 潘晓群 陶然 张永青 武鸣[1] 

机构地区：[1]东南大学公共卫生学院,南京210096 [2]江苏省疾病预防控制中心,南京210009 [3]南京医科大学公共卫生学院,211166 [4]苏州市疾病预防控制中心,215004 [5]淮安市疾病预防控制中心,223001

出　　处：《中华流行病学杂志》2017年第11期1454-1459,共6页Chinese Journal of Epidemiology

基　　金：江苏省医学领军人才和创新团队项目（K201105）;国家自然科学基金青年项目（81602919）;江苏省医学重点人才项目（RC2011192）;江苏省第四期“333工程”科研项目（BRA2013107）感谢常熟市、淮安市清河区和淮安区CDC相关人员和其他参加人员对调查工作的大力支持和帮助

摘　　要：目的 探讨男性2型糖尿病患者吸烟和戒烟行为与血糖控制的关系.方法 2013年12月至2014年1月,采用整群随机抽样方法,对江苏省常熟市、淮安市清河区和淮安区纳入国家基本公共卫生服务管理的7763名男性2型糖尿病患者进行问卷调查和体格测量,并检测FPG和糖化血红蛋白（HbA1c）.采用多元线性回归模型分析吸烟和戒烟行为与血糖控制的关系.结果 男性2型糖尿病患者现在吸烟率为45.5%.随着吸烟量的增加,FPG和HbA1c水平均呈现上升趋势（P〈0.001）.在药物治疗的糖尿病患者中,吸烟年限≥50年者和吸烟指数≥40包年者的HbA1c水平分别升高0.27%（95%CI：0.05%-0.49%）和0.38%（95%CI：0.23%-0.53%）,戒烟者随着戒烟年限的增加,其FPG和HbA1c水平呈下降趋势（P〈0.05）.在非药物治疗的糖尿病患者中,吸烟和戒烟年限与FPG及HbA1c水平均未发现剂量反应关系.结论 吸烟不利于糖尿病患者血糖的控制,尤其是药物治疗的患者.戒烟有利于血糖控制,应鼓励和帮助吸烟患者及早戒烟.Objective To explore the association of smoking and smoking cessation with glycemic control in male patients with type 2 diabetes. Methods From December 2013 to January 2014, a total of 7763 male patients with type 2 diabetes, who received national basic public health service in Changshu county of Suzhou city, Huai＇an and Qinghe districts of Huai＇an city, Jiangsu province, were recruited by cluster sampling. Questionnaire survey and anthropometric measurements were conducted, and fasting plasma glucose （FPG） and hemoglobin A1c （HbA1c） levels were measured. Multiple linear regression model was used to evaluate the association of smoking and smoking cessation with glycemic control. Results The prevalence of current smoking was 45.5%in male patients with type 2 diabetes. The levels of FPG and HbA1c increased with number of cigarettes smoked per day compared with non-smokers （P〈0.001）. Among patients with drug treatment, the average increase of HbA1c level in current smokers with smoking duration ≥30 years and smoking index ≥40 pack-years were 0.27% （95%CI： 0.05%-0.49%） and 0.38% （95%CI： 0.23%-0.53%）,respectively. FPG and HbA1c level decreased obviously with smoking cessation years among former smokers （P〈0.05）. Among the patients receiving no drug treatment, no dose-response relationships were observed between smoking duration, smoking cessation years and levels of FPG and HbA1c. Conclusion Cigarette smoking was negatively related with glycemic control in male type 2 diabetes patients, especially in patients with drug treatment. Smoking cessation may be beneficial for glycemic control. Smoking cessation should be encouraged for diabetes patients as early as possible.

关 键 词：吸烟 戒烟 糖尿病 2型 血糖控制 

分 类 号：R587.1[医药卫生—内分泌]