Cigarette smoking and risk for impaired fasting glucose and type 2 diabetes in middle-aged Japanese men.

Abstract

The contribution of cigarette smoking to development of impaired fasting glucose and type 2 diabetes remains unclear. To investigate the association of cigarette smoking with development of impaired fasting glucose and type 2 diabetes. Prospective cohort study. Work site in Osaka, Japan. 1,266 Japanese male office workers 35 to 59 years of age who did not have impaired fasting glucose or type 2 diabetes and were not taking medication for hypertension at study entry. Fasting plasma glucose levels were measured at annual health examinations from May 1994 through May 1999. Impaired fasting glucose was defined as a fasting glucose level of at least 6.1 mmol/L (110 mg/dL) but less than 7.0 mmol/L (126 mg/dL). Type 2 diabetes was defined as a fasting glucose level of 7.0 mmol/L or more or current receipt of hypoglycemic medication. 87 and 54 men developed impaired fasting glucose and type 2 diabetes during 5,817 and 5,937 person-years follow-up, respectively. After controlling for potential predictors of diabetes, the relative risk for impaired fasting glucose compared with never-smokers was 1.62 (95% CI, 0.85 to 3.10) for ever-smokers, 1.14 (CI, 0.58 to 2.25) for persons who smoked 1 to 20 cigarettes/d, 1.33 (CI, 0.63 to 2.80) for those who smoked 21 to 30 cigarettes/d, and 2.56 (CI, 1.32 to 4.95) for those who smoked 31 or more cigarettes/d (P for trend for current smokers only = 0.013). The respective multivariate-adjusted relative risks for type 2 diabetes compared with never-smokers were 1.08 (CI, 0.34 to 3.42), 1.88 (CI, 0.71 to 5.00), 3.02 (CI, 1.15 to 7.94), and 4.09 (CI, 1.62 to 1,029) (P for trend for current smokers only < 0.001). The number of pack-years of exposure was also positively related to development of impaired fasting glucose and type 2 diabetes (P for trend = 0.039 and 0.002, respectively). The relative risk for impaired fasting glucose and type 2 diabetes in current smokers versus never-smokers was stronger among men with a body mass index less than 242 kg/m2 than among men with a body mass index of 24.2 kg/m2 or more, although the absolute risk was greater in more obese men. The number of cigarettes smoked daily and the number of pack-years of exposure seem to be associated with development of impaired fasting glucose and type 2 diabetes in middle-aged Japanese men.