title: [Effects of active and passive smoking on chronic kidney disease in patients with type 2 diabetes mellitus].
abstract: OBJECTIVE
  This study aimed to assess the effects of active and passive smoking on chronic kidney disease (CKD) in patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  Seven hundred and five patients with T2DM were recruited in the study and were divided into three groups based on smoking status as active smokers, passive smokers and non-smokers. Twenty-four hour urinary albumin excretion (24hUAE) was measured, and estimate glomerular filtration rate (eGFR) was calculated with age and blood creatinine levels.
  
  
  RESULTS
  (1)The proportion of CKD in T2DM in the present study was 31.63% (223/705) with 28.6% (22/77) , 30.0% (15/50) and 29.6% (73/247) for non-smokers, passive smokers and active smokers in men, and 29.9% (40/134), 35.9% (66/184) and 7/13 for non-smokers, passive smokers and active smokers in women, respectively. In comparison with non-smokers, a higher risk of CKD was found in both passive and active smokers (OR = 1.07 and OR = 1.05 in men; OR = 1.31 and OR = 2.74 in women, respectively). (2) Compared with non-smokers, passive smokers had a significant higher risk for albuminuria in women (OR = 2.02, P = 0.016) . (3) After adjusting for gender, age, duration of T2DM, BMI, systolic blood pressure, glycosylated hemoglobin A1C and lipids, there was a significant decrease in eGFR between active and never smokers (P = 0.018) or passive smokers (P = 0.000) in women. No differences could be found in eGFR between each smoking statues in men.
  
  
  CONCLUSIONS
  Smoking exposure alone confers a high risk for CKD in patients with T2DM. Our results highlight an importance in implementation of a smoke-free environment for patients with T2DM.
authors.forename: Fei
authors.initials: F
authors.lastname: Jiang
authors.forename: Miao
authors.initials: M
authors.lastname: Chen
authors.forename: Cheng
authors.initials: C
authors.lastname: Hu
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai Clinical Center for Metabolic Disease, Shanghai Key Laboratory of Diabetes Mellitus, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China. Email:wpjia@sjtu.edu.cn.
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
mesh_terms: D000418:Albumins; D000419:Albuminuria; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008055:Lipids; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D000418:Albumins; D006442:Glycated Hemoglobin; D008055:Lipids; D014028:Tobacco Smoke Pollution