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Smoking is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients.
Eur J Clin Invest. 2006 Jul; 36(7):459-65.EJ

Abstract

BACKGROUND

Smoking and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This study tested the hypothesis that smoking is associated with insulin resistance/hyperinsulinaemia and cardiovascular autonomic dysfunction in type 2 diabetic patients who are not treated with insulin.

MATERIALS AND METHODS

The study patients were 22 current smokers with type 2 diabetes mellitus (age: 57 +/- 5 years, mean +/- SD) and 30 age-matched never-smoked patients with type 2 diabetes mellitus (control group, 57 +/- 8 years). The quality of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin (F-IRI), homeostasis model assessment (HOMA) index and haemoglobin A1c (HbA1c). The severity of smoking status was expressed by the Brinkman index, which is calculated as number of cigarettes per day multiplied by years of smoking. Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart-rate variability, plasma norepinephrine concentration and cardiac (123)I-metaiodobenzylguanidine (MIBG) scintigraphic findings.

RESULTS

Baroreflex sensitivity was lower in the current smokers group than in the never-smoked group (P < 0.05). Early and delayed (123)I-MIBG myocardial uptake values were lower (P < 0.05, and P < 0.01, respectively) and the percentage washout-rate of (123)I-MIBG was higher (P < 0.0001) in the current smokers group than in the never-smoked group. Fasting immunoreactive insulin (F-IRI) concentration (P < 0.0001) and the homeostasis model assessment (HOMA) index (P < 0.0001) were higher in the current smokers group than the never-smoked group. Multiple logistic regression analysis revealed that smoking was independently predicted by F-IRI and the percentage washout-rate of (123)I-MIBG.

CONCLUSIONS

The results of the study suggested that smoking was associated with cardiovascular autonomic dysfunction and hyperinsulinaemia and that F-IRI and the percentage washout-rate of (123)I-MIBG were independent predictors of smoking in these Japanese patients with type 2 diabetes mellitus.

Authors+Show Affiliations

Department of Cardiovascular Science, Faculty of Medicine, Oita University, 1-1 Idaigaoka, Hasama, Oita 879-5593, Japan. anan-f@med.oita-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16796602

Citation

Anan, F, et al. "Smoking Is Associated With Insulin Resistance and Cardiovascular Autonomic Dysfunction in Type 2 Diabetic Patients." European Journal of Clinical Investigation, vol. 36, no. 7, 2006, pp. 459-65.
Anan F, Takahashi N, Shinohara T, et al. Smoking is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients. Eur J Clin Invest. 2006;36(7):459-65.
Anan, F., Takahashi, N., Shinohara, T., Nakagawa, M., Masaki, T., Katsuragi, I., Tanaka, K., Kakuma, T., Yonemochi, H., Eshima, N., Saikawa, T., & Yoshimatsu, H. (2006). Smoking is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients. European Journal of Clinical Investigation, 36(7), 459-65.
Anan F, et al. Smoking Is Associated With Insulin Resistance and Cardiovascular Autonomic Dysfunction in Type 2 Diabetic Patients. Eur J Clin Invest. 2006;36(7):459-65. PubMed PMID: 16796602.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients. AU - Anan,F, AU - Takahashi,N, AU - Shinohara,T, AU - Nakagawa,M, AU - Masaki,T, AU - Katsuragi,I, AU - Tanaka,K, AU - Kakuma,T, AU - Yonemochi,H, AU - Eshima,N, AU - Saikawa,T, AU - Yoshimatsu,H, PY - 2006/6/27/pubmed PY - 2006/11/2/medline PY - 2006/6/27/entrez SP - 459 EP - 65 JF - European journal of clinical investigation JO - Eur J Clin Invest VL - 36 IS - 7 N2 - BACKGROUND: Smoking and cardiovascular autonomic dysfunction are associated with high mortality in type 2 diabetic patients. This study tested the hypothesis that smoking is associated with insulin resistance/hyperinsulinaemia and cardiovascular autonomic dysfunction in type 2 diabetic patients who are not treated with insulin. MATERIALS AND METHODS: The study patients were 22 current smokers with type 2 diabetes mellitus (age: 57 +/- 5 years, mean +/- SD) and 30 age-matched never-smoked patients with type 2 diabetes mellitus (control group, 57 +/- 8 years). The quality of blood glucose was assessed by fasting plasma glucose (FPG), fasting immunoreactive insulin (F-IRI), homeostasis model assessment (HOMA) index and haemoglobin A1c (HbA1c). The severity of smoking status was expressed by the Brinkman index, which is calculated as number of cigarettes per day multiplied by years of smoking. Cardiovascular autonomic function was assessed by baroreflex sensitivity (BRS), heart-rate variability, plasma norepinephrine concentration and cardiac (123)I-metaiodobenzylguanidine (MIBG) scintigraphic findings. RESULTS: Baroreflex sensitivity was lower in the current smokers group than in the never-smoked group (P < 0.05). Early and delayed (123)I-MIBG myocardial uptake values were lower (P < 0.05, and P < 0.01, respectively) and the percentage washout-rate of (123)I-MIBG was higher (P < 0.0001) in the current smokers group than in the never-smoked group. Fasting immunoreactive insulin (F-IRI) concentration (P < 0.0001) and the homeostasis model assessment (HOMA) index (P < 0.0001) were higher in the current smokers group than the never-smoked group. Multiple logistic regression analysis revealed that smoking was independently predicted by F-IRI and the percentage washout-rate of (123)I-MIBG. CONCLUSIONS: The results of the study suggested that smoking was associated with cardiovascular autonomic dysfunction and hyperinsulinaemia and that F-IRI and the percentage washout-rate of (123)I-MIBG were independent predictors of smoking in these Japanese patients with type 2 diabetes mellitus. SN - 0014-2972 UR - https://www.unboundmedicine.com/medline/citation/16796602/Smoking_is_associated_with_insulin_resistance_and_cardiovascular_autonomic_dysfunction_in_type_2_diabetic_patients_ L2 - https://doi.org/10.1111/j.1365-2362.2006.01650.x DB - PRIME DP - Unbound Medicine ER -