Cigarette Smoking and Risk for Impaired Fasting Glucose and Type 2 Diabetes in Middle-Aged Japanese Men

1 August 2000 | Volume 133 Issue 3 | Pages 183-191

Background: The contribution of cigarette smoking to development of impaired fasting glucose and type 2 diabetes remains unclear.

Objective: To investigate the association of cigarette smoking with development of impaired fasting glucose and type 2 diabetes.

Design: Prospective cohort study.

Setting: Work site in Osaka, Japan.

Participants: 1266 Japanese male office workers 35 to 59 years of age who did not have impaired fasting glucose or type 2 diabetes and were not taking medication for hypertension at study entry.

Measurements: Fasting plasma glucose levels were measured at annual health examinations from May 1994 through May 1999. Impaired fasting glucose was defined as a fasting glucose level of at least 6.1 mmol/L (110 mg/dL) but less than 7.0 mmol/L (126 mg/dL). Type 2 diabetes was defined as a fasting glucose level of 7.0 mmol/L or more or current receipt of hypoglycemic medication.

Results: 87 and 54 men developed impaired fasting glucose and type 2 diabetes during 5817 and 5937 person-years follow-up, respectively. After controlling for potential predictors of diabetes, the relative risk for impaired fasting glucose compared with never-smokers was 1.62 (95% CI, 0.85 to 3.10) for ever-smokers, 1.14 (CI, 0.58 to 2.25) for persons who smoked 1 to 20 cigarettes/d, 1.33 (CI, 0.63 to 2.80) for those who smoked 21 to 30 cigarettes/d, and 2.56 (CI, 1.32 to 4.95) for those who smoked 31 or more cigarettes/d (P for trend for current smokers only = 0.013). The respective multivariate-adjusted relative risks for type 2 diabetes compared with never-smokers were 1.08 (CI, 0.34 to 3.42), 1.88 (CI, 0.71 to 5.00), 3.02 (CI, 1.15 to 7.94), and 4.09 (CI, 1.62 to 10.29) (P for trend for current smokers only < 0.001). The number of pack-years of exposure was also positively related to development of impaired fasting glucose and type 2 diabetes (P for trend = 0.039 and 0.002, respectively). The relative risk for impaired fasting glucose and type 2 diabetes in current smokers versus never-smokers was stronger among men with a body mass index less than 24.2 kg/m² than among men with a body mass index of 24.2 kg/m² or more, although the absolute risk was greater in more obese men.

Conclusion: The number of cigarettes smoked daily and the number of pack-years of exposure seem to be associated with development of impaired fasting glucose and type 2 diabetes in middle-aged Japanese men.

Author and Article Information

From Osaka University Graduate School of Medicine and Takenaka Corp., Osaka, Japan; and Japan Labor and Welfare Association, Tokyo, Japan.

Acknowledgments: The authors thank the employees and the Medical Office of the Osaka Main Office of Takenaka Corp. for their valuable cooperation for this study. They also thank Ryuichi Kaneko and his colleagues at the Japan Labor and Welfare Association for collecting and coding the data accurately and consistently in the course of 5 years.

Grant Support: In part by a Grant-in-Aid for the prevention of lifestyle-related diseases from the Arteriosclerosis Prevention Association, Tokyo, Japan.

Requests for Single Reprints: Noriyuki Nakanishi, MD, DrPH, Department of Social and Environmental Medicine, Course of Social Medicine, Osaka University Graduate School of Medicine F2, 2-2 Yamada-oka, Suita-shi, Osaka 565-0871, Japan.

Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.

Current Author Addresses: Drs. Nakanishi, Matsuo, and Tatara: Department of Social and Environmental Medicine, Course of Social Medicine, Osaka University Graduate School of Medicine F2, 2-2 Yamada-oka, Suita-shi, Osaka 565-0871, Japan.

Dr. Nakamura: Medical Office, Osaka Main Office, Takenaka Corp., 4-1-13 Honmachi, Chuo-ku, Osaka 541-0053, Japan.

Dr. Suzuki: Japan Labor and Welfare Association, 1-24-4 Ebisu, Shibuya-ku, Tokyo 150-0013, Japan.

Author Contributions: Conception and design: N. Nakanishi, K. Nakamura, Y. Matsuo, K. Suzuki, K. Tatara.

Analysis and interpretation of the data: N. Nakanishi, K. Nakamura, Y. Matsuo, K. Suzuki, K. Tatara.

Drafting of the article: N. Nakanishi, K. Tatara.

Critical revision of the article for important intellectual content: N. Nakanishi, K. Nakamura, Y. Matsuo, K. Suzuki, K. Tatara.

Final approval of the article: N. Nakanishi, K. Nakamura, Y. Matsuo, K. Suzuki, K. Tatara.

Provision of study materials or patients: K. Nakamura.

Statistical expertise: N. Nakanishi, Y. Matsuo, K. Suzuki, K. Tatara.

Obtaining of funding: K. Nakamura.

Administrative, technical, or logistic support: K. Nakamura, K. Suzuki.

Collection and assembly of data: K. Nakamura, K. Suzuki.