Environmental tobacco smoke exposure and diabetes in adult never-smokersReport as inadecuate




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Environmental Health

, 13:74

First Online: 25 September 2014Received: 24 June 2014Accepted: 13 September 2014DOI: 10.1186-1476-069X-13-74

Cite this article as: Eze, I.C., Schaffner, E., Zemp, E. et al. Environ Health 2014 13: 74. doi:10.1186-1476-069X-13-74

Abstract

BackgroundActive smoking has been linked to type 2 diabetes mellitus T2DM but only few recent studies have shown environmental tobacco smoke ETS to be associated with DM in never-smokers. We assessed the association between long term ETS exposure and DM, and explored effect modifications of this association in our sample.

MethodsWe analysed 6392 participants of the Swiss study on air pollution and lung and heart diseases in adults SAPALDIA. We used mixed logistic regression models to assess the cross-sectional association between ETS and DM. Selected variables were tested for effect modification and several sensitivity analyses were performed, mostly treating participants’ study area as a random effect.

ResultsThe prevalence of DM and ETS in the sample was 5.5% and 47% respectively. There were 2779 never-smokers with 4% diabetes prevalence. Exposure to ETS increased risk of DM in never-smokers by 50% 95% confidence interval CI: 1.00, 2.26, and we observed a positive dose–response relationship between ETS exposure level and DM in never-smokers. Associations were strengthened more than three-folds by older age and chronic obstructive pulmonary disease, and were stronger in post-menopausal, obese, hypertriglyceridaemic and physically inactive participants. Estimates of association were robust across all sensitivity analyses including inverse probability weighting for participation bias and fixed-effect analysis for study area. ETS had no substantial associations in current and ex-smokers in our study.

ConclusionsWe found a positive association between ETS exposure and DM in never smokers. Additional longitudinal studies involving biomarkers are needed to further explore underlying mechanisms and susceptibilities.

KeywordsPassive smoke Type 2 diabetes Cross-sectional study Respiratory obstruction Never-smokers AbbreviationsBMIBody mass index

COCarbon monoxide

COPDChronic obstructive pulmonary disease

DMDiabetes mellitus

ETSEnvironmental tobacco smoke

FEV1Forced expiratory volume in one second

FVCForced vital capacity

HDLHigh density lipoprotein

hs-CRPHigh sensitivity C-reactive protein

PM10Particulate matter with diameter less than 10 micrograms

RBGRandom blood glucose

SAPALDIASwiss cohort study on air pollution and lung and heart diseases in adults

SESocio-economic

T1DMType 1 diabetes mellitus

T2DMType 2 diabetes mellitus.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-069X-13-74 contains supplementary material, which is available to authorized users.

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Author: Ikenna C Eze - Emmanuel Schaffner - Elisabeth Zemp - Arnold von Eckardstein - Alexander Turk - Robert Bettschart - Christia

Source: https://link.springer.com/







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