RESEARCH - Smoking linked to glucose intolerance in young adults

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Smoking Linked to Glucose Intolerance in Young Adults

NEW YORK (Reuters Health) Apr 06 - Active and even passive smoking appears

to increase the risk of glucose intolerance in young adults, according to a

report in the April 7th online issue of the British Medical Journal.

Moreover, among current smokers, the total pack years smoked is directly

related to the risk of incident diabetes.

" If confirmed by further research, these findings provide further

documentation of the deleterious effects of tobacco smoking, and policy

makers may use them as additional justification to reduce exposure to

passive smoke, " lead author Dr. K. Houston, from the Birmingham

Veterans Affairs Medical Center in Alabama, and colleagues note.

The findings are based on an analysis of data from the Coronary Artery Risk

Development in Young Adults (CARDIA) study, a prospective evaluation started

in 1985 with 15 years of follow-up.

The subjects, who were between 18 and 30 years of age at baseline and were

drawn from four US cities, included 1386 current smokers, 621 previous

smokers, 1452 never smokers with passive smoke exposure, and 1113 never

smokers with no passive smoke exposure. Fifty-five percent of subjects were

women and 50% were African American.

Glucose intolerance was defined as a serum level of at least 100 mg/dL or

the use of antidiabetic agents, the report indicates.

During the study period, 16.7% of subjects developed glucose intolerance,

the authors note. The incident rate of glucose intolerance was highest for

current smokers -- 21.8% -- followed by never smokers with passive smoke

exposure at 17.2%. Previous smokers had a rate of 14.4%, while never smokers

with no passive smoke exposure had the lowest rate at 11.5%.

After adjusting for potential confounders, including biological and

behavioral factors, current and never smokers with passive smoke exposure

were 65% and 35% more likely, respectively, to develop glucose intolerance

than never smokers without passive smoke exposure. By contrast, previous

smokers were not at elevated risk.

In women and men, the researchers found that the link between smoking and

glucose intolerance was stronger in white subjects than in their black

counterparts.

Regarding the mechanisms involved in the association, the authors

hypothesize that there may be a toxin in cigarette smoke that impairs

insulin production in the pancreas.

BMJ 2006;332.

http://www.medscape.com/viewarticle/529368

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