Cardiovascular Diabetology (Jan 2022)
Interaction between smoking and diabetes in relation to subsequent risk of cardiovascular events
- Yang Yang,
- Nianchun Peng,
- Gang Chen,
- Qin Wan,
- Li Yan,
- Guixia Wang,
- Yingfen Qin,
- Zuojie Luo,
- Xulei Tang,
- Yanan Huo,
- Ruying Hu,
- Zhen Ye,
- Guijun Qin,
- Zhengnan Gao,
- Qing Su,
- Yiming Mu,
- Jiajun Zhao,
- Lulu Chen,
- Tianshu Zeng,
- Xuefeng Yu,
- Qiang Li,
- Feixia Shen,
- Li Chen,
- Yinfei Zhang,
- Youmin Wang,
- Huacong Deng,
- Chao Liu,
- Shengli Wu,
- Tao Yang,
- Mian Li,
- Yu Xu,
- Min Xu,
- Zhiyun Zhao,
- Tiange Wang,
- Jieli Lu,
- Yufang Bi,
- Weiqing Wang,
- Guang Ning,
- Qiao Zhang,
- Lixin Shi
Affiliations
- Yang Yang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University
- Nianchun Peng
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University
- Gang Chen
- Fujian Provincial Hospital, Fujian Medical University
- Qin Wan
- The Affiliated Hospital of Luzhou Medical College
- Li Yan
- Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University
- Guixia Wang
- The First Hospital of Jilin University
- Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University
- Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University
- Xulei Tang
- The First Hospital of Lanzhou University
- Yanan Huo
- Jiangxi Provincial People’s Hospital Affiliated To Nanchang University
- Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention
- Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention
- Guijun Qin
- Division of Endocrinology, Department of Internal Medicine, The First Affiliated Hospital of Zhengzhou University
- Zhengnan Gao
- Dalian Municipal Central Hospital
- Qing Su
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine
- Yiming Mu
- Chinese People’s Liberation Army General Hospital
- Jiajun Zhao
- Shandong Provincial Hospital Affiliated To Shandong University
- Lulu Chen
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Tianshu Zeng
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Xuefeng Yu
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Qiang Li
- The Second Affiliated Hospital of Harbin Medical University
- Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University
- Li Chen
- Qilu Hospital of Shandong University
- Yinfei Zhang
- Central Hospital of Shanghai Jiading District
- Youmin Wang
- The First Affiliated Hospital of Anhui Medical University
- Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University
- Chao Liu
- Jiangsu Province Hospital On Integration of Chinese and Western Medicine
- Shengli Wu
- Karamay Municipal People’s Hospital
- Tao Yang
- The First Affiliated Hospital of Nanjing Medical University
- Mian Li
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Yu Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Min Xu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Zhiyun Zhao
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Tiange Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Jieli Lu
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Yufang Bi
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Weiqing Wang
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Guang Ning
- Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine
- Qiao Zhang
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University
- Lixin Shi
- Department of Endocrinology and Metabolism, Affiliated Hospital of Guizhou Medical University, Guizhou Medical University
- DOI
- https://doi.org/10.1186/s12933-022-01447-2
- Journal volume & issue
-
Vol. 21,
no. 1
pp. 1 – 12
Abstract
Abstract Background Whether smoking modifies the associations of diabetes and risk factor management with subsequent risk of cardiovascular disease (CVD), and whether the smoking related CVD risk differs among people with and without diabetes are unclear. This study aimed to examine the associations and interactions of smoking, diabetes, and risk factor management in relation to incident CVD. Methods This nationwide, population-based, prospective cohort study of 20 communities from various geographic regions recruited adults aged 40 years or older during 2011–2012. The follow-up survey was conducted between 2014 and 2016. This study included 126,181 participants who were free from CVD at baseline. Results Study participants included 19,397 current smokers (15.4%), 6,049 former smokers (4.8%), and 100,735 never smokers (79.8%). Mean (SD) age ranged from 55.8 (8.6) years to 60.7 (9.1) years. Compared with never smokers, heavy smokers exhibited a greater risk of CVD events among participants with diabetes (multivariable-adjusted hazard ratio [HR], 1.45; 95% CI, 1.17–1.78) than among participants without diabetes (HR, 1.20; 95% CI, 1.01–1.42; P for interaction = 0.006). Compared with participants without diabetes, participants with diabetes who were never smokers and had 5 or more controlled risk factors showed no significantly excess CVD risk (HR, 0.93; 95% CI, 0.71–1.22), but the cardiovascular benefits from risk factor management were counteracted among participants with diabetes who were current smokers (HR, 1.28; 95% CI, 0.77–2.14) or former smokers (HR, 1.22; 95% CI, 0.66–2.28). Conclusions Smoking and diabetes interacted with each other in relation to increased risk of CVD events, and the beneficial effect of risk factor management on CVD risk among participants with diabetes was attenuated by current or former smoking.
Keywords
