J Prev Med Public Health.  2016 Mar;49(2):108-117. 10.3961/jpmph.15.062.

The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population

• Yeom H
• Lee JH
• Kim HC
• Suh I

• KMID: 2373654
• DOI: http://doi.org/10.3961/jpmph.15.062

Abstract

OBJECTIVES
Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy.
METHODS
We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A "former smoker" was a patient who smoked only before receiving his diagnosis of diabetes. A "continuing smoker" was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m2). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked.
RESULTS
Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29).
CONCLUSIONS
Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.

Keyword

Diabetes mellitus; Diabetic nephropathies; Smoking; Diagnosis

MeSH Terms

Aged
Albumins/analysis
Asian Continental Ancestry Group
Blood Pressure
Body Mass Index
Creatinine/urine
Diabetes Mellitus, Type 2/complications/*diagnosis
Diabetic Nephropathies/epidemiology/*etiology
Female
Glomerular Filtration Rate
Hemoglobin A, Glycosylated/analysis
Humans
Logistic Models
Male
Middle Aged
Nutrition Surveys
Odds Ratio
Prevalence
Republic of Korea
Smoking/*adverse effects
Albumins
Creatinine
Hemoglobin A, Glycosylated