OBJECTIVE— The relationship between cigarette smoking and renal dysfunction in diabetes has predominantly been documented in patients with type 1 diabetes. The aim of the present study was to explore the relationship between cigarette smoking and glomerular filtration rate (GFR) in a large cross-sectional study carried out in male subjects with type 2 diabetes. The role of metabolic syndrome in modulating this relationship was also investigated. RESEARCH DESIGN AND METHODS— One hundred fifty-eight current smokers and 158 never smokers with type 2 diabetes were consecutively recruited. Low GFR was defined as GFR < 60 ml/min per 1.73 m2. RESULTS— The proportion of patients affected by low GFR was significantly higher in current smokers (20.9 vs. 12.0%, P =0.03). The adjusted risk (odds ratio [OR]) of low GFR in current smokers was 2.20 (95% CI 1.14–4.26, P =0.02) and markedly higher in patients from the first tertile of disease duration (4.27 [1.26 –14.40], P =0.02). When metabolic syndrome was added to the statistical model exploring the relationship between smoking and low GFR, the risk of low GFR showed a small change, although it did not become any more significant (1.84 [0.98 –3.45], P=0.06). Current smokers showed even higher free oxygen radical test unit values (560.0 ±91.5 vs. 442.7 ±87.2, P < 0.0001). CONCLUSIONS— In a large population of male patients with type 2 diabetes, the risk of low GFR is markedly enhanced by smoking and is at least partially mediated by metabolic syndrome.

Cigarette smoking is associated with low glomerular filtration rate in male patients with type 2 diabetes

LAMACCHIA, OLGA;CIGNARELLI, MAURO
2006

Abstract

OBJECTIVE— The relationship between cigarette smoking and renal dysfunction in diabetes has predominantly been documented in patients with type 1 diabetes. The aim of the present study was to explore the relationship between cigarette smoking and glomerular filtration rate (GFR) in a large cross-sectional study carried out in male subjects with type 2 diabetes. The role of metabolic syndrome in modulating this relationship was also investigated. RESEARCH DESIGN AND METHODS— One hundred fifty-eight current smokers and 158 never smokers with type 2 diabetes were consecutively recruited. Low GFR was defined as GFR < 60 ml/min per 1.73 m2. RESULTS— The proportion of patients affected by low GFR was significantly higher in current smokers (20.9 vs. 12.0%, P =0.03). The adjusted risk (odds ratio [OR]) of low GFR in current smokers was 2.20 (95% CI 1.14–4.26, P =0.02) and markedly higher in patients from the first tertile of disease duration (4.27 [1.26 –14.40], P =0.02). When metabolic syndrome was added to the statistical model exploring the relationship between smoking and low GFR, the risk of low GFR showed a small change, although it did not become any more significant (1.84 [0.98 –3.45], P=0.06). Current smokers showed even higher free oxygen radical test unit values (560.0 ±91.5 vs. 442.7 ±87.2, P < 0.0001). CONCLUSIONS— In a large population of male patients with type 2 diabetes, the risk of low GFR is markedly enhanced by smoking and is at least partially mediated by metabolic syndrome.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11369/14963
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