Water-pipe smoking and albuminuria: new dog with old tricks.
Water-pipe (WP) smoking is on rise worldwide for the past few years, particularly among younger individuals. Growing evidence indicates that WP smoking is as harmful as cigarette smoking. To date, most of the research has focused on acute health effects of WP smoking, and evidence remains limited when it comes to chronic health effects in relation to long-term WP smoking. Therefore, the aim of this study was to examine the association between WP smoking and albuminuria in apparently healthy individuals. This analysis was conducted on data of a population-based cross-sectional study--the Urban Rural Chronic Diseases Study (URCDS). The study sample was recruited from three sites in Pakistan. Trained nurses carried out individual interviews and obtained the information on demographics, lifestyle factors, and past and current medical history. Measurements of complete blood count, lipid profile, fasting glucose level, and 24-hour albuminuria were also made by using blood and urine samples. Albumin excretion was classified into three categories using standard cut-offs: normal excretion, high-normal excretion and microalbuminuria. Multiple logistic regression models were used to examine the relationship between WP smoking and albuminuria. The final analysis included data from 1,626 health individuals, of which 829 (51.0%) were males and 797 (49.0%) females. Of 1,626 individuals, 267 (16.4%) were current WP smokers and 1,359 (83.6%) were non-WP smokers. WP smoking was significantly associated with high-normal albuminuria (OR  =  2.33, 95% CI 1.68-3.22, p-value <0.001) and microalbuminuria (OR  =  1.75, 95% CI 1.18-2.58, p-value 0.005) after adjustment for age, sex, BMI, social class, hypertension, and diabetes mellitus. WP smoking was significantly associated with high-normal albuminuria and microalbuminuria when analysis was stratified on hypertension and diabetes mellitus categories. WP smoking has a strong association with albuminuria in apparently healthy individuals. More research is warranted to evaluate the temporality of this association between WP smoking and albuminuria.
University Medical and Dental College, Faisalabad, Pakistan.
Iqra
I
Ishtiaque
School of Public Health, Dow University of Health Sciences, Karachi, Pakistan ; Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, United Kingdom.
Kashif
K
Shafique
Institute of Health and Wellbeing, Public Health, University of Glasgow, Glasgow, United Kingdom ; Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, KPK, Pakistan.
Zia
Z
Ul-Haq
Department of Community Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Abdul Rauf
AR
Shaikh
Department of Surgery, Dow University of Health Sciences, Karachi, Pakistan.
Naveed Ali
NA
Khan
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
Abdul Rauf
AR
Memon
Department of Epidemiology, University of Rotterdam, Rotterdam, The Netherlands.
Saira Saeed
SS
Mirza
King Edward Medical University, Lahore, Pakistan.
Afra
A
Ishtiaque
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology*; D003920:Diabetes Mellitus / Q000209:etiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*