title: Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: the KORA S4/F4 cohort study.
abstract: Active smoking is a risk factor for type 2 diabetes (T2DM), but it is unclear whether exposure to environmental tobacco smoke (ETS) is also associated with T2DM. The effect of passive and active smoking on the 7-year T2DM incidence was investigated in a population-based cohort in Southern Germany (KORA S4/F4; 1,223 subjects aged 55-74 years at baseline in 1999-2001, 887 subjects at follow-up). Incident diabetes was identified by oral glucose tolerance tests or by validated physician diagnoses. Among never smokers, subjects exposed to ETS had an increased diabetes risk in the total sample (odds ratio (OR) = 2.5; 95% confidence interval (CI): 1.1, 5.6) and in a subgroup of subjects having prediabetes at baseline (OR = 4.4; 95% CI: 1.5, 13.4) after adjusting for age, sex, parental diabetes, socioeconomic status, and lifestyle factors. Active smoking also had a statistically significant effect on diabetes incidence in the total sample (OR = 2.8; 95% CI: 1.3, 6.1) and in prediabetic subjects (OR = 7.8; 95% CI: 2.4, 25.7). Additional adjustment for components of the metabolic syndrome including waist circumference did not attenuate any of these associations. This study provides evidence that both passive and active smoking is associated with T2DM.
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
authors.forename: Bernd
authors.initials: B
authors.lastname: Kowall
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Rathmann
authors.forename: Klaus
authors.initials: K
authors.lastname: Strassburger
authors.forename: Margit
authors.initials: M
authors.lastname: Heier
authors.forename: Rolf
authors.initials: R
authors.lastname: Holle
authors.forename: Barbara
authors.initials: B
authors.lastname: Thorand
authors.forename: Guido
authors.initials: G
authors.lastname: Giani
authors.forename: Annette
authors.initials: A
authors.lastname: Peters
authors.forename: Christine
authors.initials: C
authors.lastname: Meisinger
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011236:Prediabetic State / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055105:Waist Circumference
chemical_list: D014028:Tobacco Smoke Pollution