Smoking Linked to Glucose Intolerance
Houston TK, Person SD, Pletcher MJ, et al. Active and passing smoking and development of glucose intolerance among young adults in a prospective cohort: CARDIA study. Br Med J. 2006; 332.
Recent studies have identified a positive association between smoking and incidence of diabetes. This study indicated that active and passive smoking appears to increase the risk of glucose intolerance in young adults. Among current smokers, the total pack-years smoked is directly related to the risk of incident diabetes. The findings are based on an analysis of data from the Coronary Artery Risk Development in Young Adults study, a prospective evaluation started in 1985 with 15 years of follow-up. Subjects were between 18 and 30 years of age at baseline. They included 1,386 current smokers, 621 previous smokers, 1,452 never smokers with passive smoke exposure, and 1,113 never smokers with no passive smoke exposure.
Glucose intolerance was defined as a serum level of at least 100 mg/dL or the use of antidiabetic agents, the report indicates. During the study period, 16.7% of subjects developed glucose intolerance. The incident rate of glucose intolerance was highest for current smokers-21.8%-followed by never smokers with passive smoke exposure at 17.2%. Previous smokers had a rate of 14.4%, while never smokers with no passive smoke exposure had the lowest rate at 11.5%. After adjusting for potential confounders, including biologic and behavioral factors, current and never smokers with passive smoke exposure were 65% and 35% more likely respectively to develop glucose intolerance than never smokers without passive smoke exposure. By contrast, previous smokers were not at elevated risk. The authors believe there may be a toxin in cigarette smoke that impairs insulin production in the pancreas.