title: Risk of smoking and body mass index for incidence of diabetes mellitus in a rural Japanese population.
abstract: OBJECTIVE
  To assess the risk of smoking, body mass index (BMI), and both for incidence of diabetes in a rural Japanese population.
  
  
  METHODS
  This study was a 10.1-year cohort study of 2070 men and 3802 women aged 40-69 years without diabetes at baseline who underwent a health check-up at one central hospital in Nagano Prefecture. Participants were classified according to a combination of smoking status and BMI. Participants were followed from 1990 to 2006. The incidence of diabetes was determined from fasting and random levels of plasma glucose, HbA(1c) levels or being under medical treatment for diabetes.
  
  
  RESULTS
  Diabetes developed in 595 of the participants during 59,111 person-years of follow-up. In men, the multivariable-adjusted hazard ratios for incidence of diabetes compared with non-smokers of normal weight were as follows: 3.36 (2.02-5.60) in current smokers with normal weight and 1.70 (0.87-3.34) and 3.93 (2.22-6.96) in obese non-smokers and obese current smokers, respectively. In men the population-attributable fraction of diabetes onset due to current smoking, obesity and both were 22.0%, 2.5% and 11.2%, respectively.
  
  
  CONCLUSIONS
  Regardless of BMI, smoking is an important risk factor for diabetes in male populations with a high prevalence of smoking.
authors.affiliation: Department of Mathematical Health Science, Graduate School of Medicine, Osaka University, Osaka, Japan. aki62@belle.shiga-med.ac.jp
authors.forename: Akiko
authors.initials: A
authors.lastname: Morimoto
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ohno
authors.forename: Yukako
authors.initials: Y
authors.lastname: Tatsumi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Nishigaki
authors.forename: Fumio
authors.initials: F
authors.lastname: Maejima
authors.forename: Shoichi
authors.initials: S
authors.lastname: Mizuno
authors.forename: Shaw
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D005215:Fasting / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009765:Obesity / Q000150:complications / Q000453:epidemiology*; D010808:Physical Examination; D012424:Rural Population / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin