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Smoking is a major cardiovascular risk factor and cause of death. Diabetes mellitus is also associated with an increased mortality and morbidity. Evidence concerning whether smoking increases the incidence of diabetes remains conflicting. Glycaemic status and smoking habits were analysed in 3718 Chinese subjects in order to assess the possible association between smoking and risk of diabetes in the Chinese population. The World Health Organisation 1998 criteria were used for the diagnosis of glucose intolerance. Smoking was defined as current cigarette smoking or ex-smoking without regard to daily consumption. The smoking habits of the studied subjects were correlated with glycaemic status. There were 3003 (80.8%) women and 715 (19.2%) men. The mean age (SD) was 38.4 (12.8) years (median 35.0, range 12-88 years). Of the 3718 subjects, 786 (21.1%) had diabetes, 708 (19.1%) had impaired glucose tolerance, and 2224 (59.8%) had normal results. Of the 3003 women, only 87 (2.9%) were smokers. The female smokers wer e younger, heavier, and had higher alcohol consumption than non-smokers. The prevalence of diabetes was similar between female smokers and non-smokers after adjustment for age, body mass index, family history of diabetes, and alcohol. Of the 715 men, 175 (24.5%) were smokers. The male smokers were younger, had lower blood pressure, and higher alcohol consumption. After adjustment for age, body mass index, family history of diabetes and alcohol, the male smokers had lower blood pressure, higher one hour plasma glucose, and more diabetes. Using logistic regression analysis (stepwise forward) with age, body mass index, alcohol, smoking, and family history of diabetes as independent variables to predict the risk of having diabetes, age and body mass index are independently associated with diabetes in both men and women. In addition, smoking is independently associated with the risk of diabetes in men, the odds ratio (95% confidence interval, CI) being 1.705 (1.106 to 2.630). Family history of diabetes is independ ently associated with the risk of diabetes in women, and the odds ratio (95% CI) is 1.643 (1.314, to 2.053). In conclusion, it was found that smoking is independently associated with diabetes after adjustment for age, body mass index, alcohol, and family history of diabetes in Hong Kong Chinese men, the odds ratio being 1.7. The prevalence of smoking in Hong Kong Chinese women is low and its association with diabetes is inconclusive.
Keywords: smoking; diabetes mellitus; Chinese men
Smoking is a major cardiovascular risk factor and cause of death. [1-4] Environmental tobacco smoke exposure alone has also been reported to be associated with an increased risk of ischaemic heart disease.  Diabetes mellitus is also associated with an increased mortality and morbidity. [6 7] However, whether smoking increases the incidence of diabetes remains controversial. Several earlier prospective studies showed no relationship between smoking and risk of diabetes. [8 9] More recently, however, evidence has accrued suggesting a positive association between smoking and the risk of diabetes in both men and women. [10-12] These reports are confined to white people, with the exception of one study from Japan.  There is no information for the Chinese population.
In this study, we examine 3718 Hong Kong Chinese subjects who underwent 75 g oral glucose tolerance tests (OGTTs) for screening for diabetes, and analyse glycaemic status with smoking habits in order to assess the association between smoking and risk of diabetes.
Subjects and methods
The results of 75 g OGTTs …