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Smoking and long-term risk of type 2 diabetes: the EPIC-InterAct study in European populations.
Diabetes Care 2014; 37(12):3164-71DC

Abstract

OBJECTIVE

The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors.

RESEARCH DESIGN AND METHODS

The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct is a prospective case-cohort study within eight European countries, including 12,403 cases of incident type 2 diabetes and a random subcohort of 16,835 individuals. After exclusion of individuals with missing data, the analyses included 10,327 cases and 13,863 subcohort individuals. Smoking status was used (never, former, current), with never smokers as the reference. Country-specific Prentice-weighted Cox regression models and random-effects meta-analysis were used to estimate hazard ratios (HRs) for type 2 diabetes.

RESULTS

In men, the HRs (95% CI) of type 2 diabetes were 1.40 (1.26, 1.55) for former smokers and 1.43 (1.27, 1.61) for current smokers, independent of age, education, center, physical activity, and alcohol, coffee, and meat consumption. In women, associations were weaker, with HRs (95% CI) of 1.18 (1.07, 1.30) and 1.13 (1.03, 1.25) for former and current smokers, respectively. There was some evidence of effect modification by BMI. The association tended to be slightly stronger in normal weight men compared with those with overall adiposity.

CONCLUSIONS

Former and current smoking was associated with a higher risk of incident type 2 diabetes compared with never smoking in men and women, independent of educational level, physical activity, alcohol consumption, and diet. Smoking may be regarded as a modifiable risk factor for type 2 diabetes, and smoking cessation should be encouraged for diabetes prevention.

Authors+Show Affiliations

No affiliation info availableNational Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands annemieke.spijkerman@rivm.nl.National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.Lund University, Malmö, Sweden.Navarre Public Health Institute (ISPN), Pamplona, Spain CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.Catalan Institute of Oncology, Barcelona, Spain.CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Public Health Division of Gipuzkoa, San Sebastian, Spain Instituto BIO-Donostia, Basque Government, Donostia, Spain.INSERM, CESP, U1018, Villejuif, France UMRS 1018, University Paris Sud 11, Villejuif, France.University Medical Center Utrecht, Utrecht, the Netherlands.German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.INSERM, CESP, U1018, Villejuif, France UMRS 1018, University Paris Sud 11, Villejuif, France.INSERM, CESP, U1018, Villejuif, France UMRS 1018, University Paris Sud 11, Villejuif, France.University of Wageningen, Wageningen, the Netherlands.Lund University, Malmö, Sweden Umeå University, Umeå, Sweden.Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.German Cancer Research Centre (DKFZ), Heidelberg, Germany.University of Oxford, Oxford, U.K.Department of Public Health, Aarhus University, Aarhus, Denmark Aalborg Hospital, Aalborg University, Aalborg, Denmark.Cancer Research and Prevention Institute (ISPO), Florence, Italy.Department of Clinical and Experimental Medicine, Federico II University, Naples, Italy.Public Health Directorate, Asturias, Spain.Umeå University, Umeå, Sweden.Department of Diet, Genes and Environment, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark.Center for Cancer Prevention, Torino, Italy Human Genetics Foundation (HuGeF), Torino, Italy.CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain Andalusian School of Public Health, Granada, Spain.German Institute of Human Nutrition, Potsdam-Rehbruecke, Nuthetal, Germany.International Agency for Research on Cancer, Lyon, France.German Cancer Research Centre (DKFZ), Heidelberg, Germany.Danish Cancer Society Research Center, Copenhagen, Denmark.Cancer Registry and Histopathology Unit, ASP 7, Ragusa, Italy AIRE-ONLUS - Ragusa, Ragusa, Italy.University Medical Center Utrecht, Utrecht, the Netherlands.MRC Epidemiology Unit, Cambridge, U.K.MRC Epidemiology Unit, Cambridge, U.K.MRC Epidemiology Unit, Cambridge, U.K.Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, U.K.MRC Epidemiology Unit, Cambridge, U.K.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25336749

Citation

InterAct Consortium, et al. "Smoking and Long-term Risk of Type 2 Diabetes: the EPIC-InterAct Study in European Populations." Diabetes Care, vol. 37, no. 12, 2014, pp. 3164-71.
InterAct Consortium, Spijkerman AM, van der A DL, et al. Smoking and long-term risk of type 2 diabetes: the EPIC-InterAct study in European populations. Diabetes Care. 2014;37(12):3164-71.
Spijkerman, A. M., van der A, D. L., Nilsson, P. M., Ardanaz, E., Gavrila, D., Agudo, A., ... Wareham, N. J. (2014). Smoking and long-term risk of type 2 diabetes: the EPIC-InterAct study in European populations. Diabetes Care, 37(12), pp. 3164-71. doi:10.2337/dc14-1020.
InterAct Consortium, et al. Smoking and Long-term Risk of Type 2 Diabetes: the EPIC-InterAct Study in European Populations. Diabetes Care. 2014;37(12):3164-71. PubMed PMID: 25336749.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Smoking and long-term risk of type 2 diabetes: the EPIC-InterAct study in European populations. AU - ,, AU - Spijkerman,Annemieke M W, AU - van der A,Daphne L, AU - Nilsson,Peter M, AU - Ardanaz,Eva, AU - Gavrila,Diana, AU - Agudo,Antonio, AU - Arriola,Larraitz, AU - Balkau,Beverley, AU - Beulens,Joline W, AU - Boeing,Heiner, AU - de Lauzon-Guillain,Blandine, AU - Fagherazzi,Guy, AU - Feskens,Edith J M, AU - Franks,Paul W, AU - Grioni,Sara, AU - Huerta,José María, AU - Kaaks,Rudolf, AU - Key,Timothy J, AU - Overvad,Kim, AU - Palli,Domenico, AU - Panico,Salvatore, AU - Redondo,M Luisa, AU - Rolandsson,Olov, AU - Roswall,Nina, AU - Sacerdote,Carlotta, AU - Sánchez,María-José, AU - Schulze,Matthias B, AU - Slimani,Nadia, AU - Teucher,Birgit, AU - Tjonneland,Anne, AU - Tumino,Rosario, AU - van der Schouw,Yvonne T, AU - Langenberg,Claudia, AU - Sharp,Stephen J, AU - Forouhi,Nita G, AU - Riboli,Elio, AU - Wareham,Nicholas J, Y1 - 2014/10/21/ PY - 2014/10/23/entrez PY - 2014/10/23/pubmed PY - 2015/6/17/medline SP - 3164 EP - 71 JF - Diabetes care JO - Diabetes Care VL - 37 IS - 12 N2 - OBJECTIVE: The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors. RESEARCH DESIGN AND METHODS: The European Prospective Investigation into Cancer and Nutrition (EPIC)-InterAct is a prospective case-cohort study within eight European countries, including 12,403 cases of incident type 2 diabetes and a random subcohort of 16,835 individuals. After exclusion of individuals with missing data, the analyses included 10,327 cases and 13,863 subcohort individuals. Smoking status was used (never, former, current), with never smokers as the reference. Country-specific Prentice-weighted Cox regression models and random-effects meta-analysis were used to estimate hazard ratios (HRs) for type 2 diabetes. RESULTS: In men, the HRs (95% CI) of type 2 diabetes were 1.40 (1.26, 1.55) for former smokers and 1.43 (1.27, 1.61) for current smokers, independent of age, education, center, physical activity, and alcohol, coffee, and meat consumption. In women, associations were weaker, with HRs (95% CI) of 1.18 (1.07, 1.30) and 1.13 (1.03, 1.25) for former and current smokers, respectively. There was some evidence of effect modification by BMI. The association tended to be slightly stronger in normal weight men compared with those with overall adiposity. CONCLUSIONS: Former and current smoking was associated with a higher risk of incident type 2 diabetes compared with never smoking in men and women, independent of educational level, physical activity, alcohol consumption, and diet. Smoking may be regarded as a modifiable risk factor for type 2 diabetes, and smoking cessation should be encouraged for diabetes prevention. SN - 1935-5548 UR - https://www.unboundmedicine.com/medline/citation/25336749/full_citation L2 - http://care.diabetesjournals.org/cgi/pmidlookup?view=long&pmid=25336749 DB - PRIME DP - Unbound Medicine ER -