被动吸烟对2型糖尿病女性患者血糖控制的影响

Effect of passive smoking on glycemic control in female patients with type 2 diabetes mellitus

目的探讨被动吸烟对2型糖尿病女性患者血糖控制的影响。方法以在我院新诊断的90例女性被动吸烟的2型糖尿病(T2DM)患者作为被动吸烟组,以性别、年龄、体质量指数(BMI)、运动控制及糖尿病并发症伴发情况等为配比条件选取新诊断的90例不被动吸烟的2型糖尿病患者作为非被动吸烟组,测定两组的空腹血糖(FBG)、餐后2小时血糖(2hPBG)、糖化血红蛋白(HbA1c)及空腹胰岛素(FIns)水平,并进行1∶1的配对研究。结果被动吸烟组的FBG、2hPBG、HbA1c水平及反映胰岛素抵抗程度的胰岛素抵抗指数(HOMA-IR)均显著高于非被动吸烟组,(8.24±2.10)mmol/L vs(7.56±2.06)mmol/L,(13.92±2.65)mmol/L vs(13.06±2.60)mmol/L,(7.94±1.41)%vs(7.52±1.36)%和(3.49vs 3.14)(P<0.05)。被动吸烟组的HbA1c≥8.0%的比例亦明显大于非被动吸烟组27.8%vs 15.6%(P<0.05)。HbA1c与HOMA-IR呈显著正相关(r=0.217,P<0.01)。结论被动吸烟可显著干扰T2DM患者的血糖控制,其机制可能与其加重胰岛素抵抗有关,被动吸烟的T2DM患者发生糖尿病并发症的危险可能远远高于不被动吸烟的T2DM患者。

Objective To investigate the effect of passive smoking on glycemic control in non-smoking female patients with type 2 diabetes mellitus. Methods Ninety female patients exposed to second hand smoking and newly diagnosed type 2 diabetes mellitus, hospitalized in our department were defined as passive smoking exposure group. Meanwhile, ninety patients not exposed to second hand smoking with newly diagnosed type 2 diabetes mellitus were enrolled as passive smoking non-exposure group, according to the pair matching conditions. There were no significant difference in gender, age, BMI, diet, exercise control and diabetic complications between two groups. Fasting blood glucose（FBG）, 2 h postprandial blood sugar （2 hPBG）, hemoglobin A （HbAlc） and fasting insulin （Fins） were determined and compared. Results Compared with passive smoking non-exposure group, the FBG, 2 hPBO, HbA1c levels and HOMA-IR （which reflects the degree of insulin resistance）, increased significantly in passive smoking exposure group,（8.24±2.10） mmol/L vs （7.56±2.06） mmol/L, （13. 92±2.65） mmol/L vs （13.06±2.60） mmol/L, （7.94± 1.41 ）% vs （7.52 ± 1.36） % and （3.49 vs 3.14） median （ P 〉 0.05）, respectively）. The percentage of patients with HbA1 c no less than 8.0% in the passive smoking exposure group was also prominently higher than that in the passive smoking non-exposure group （27.8% vs 15.6%, P 〈0.05）. HbA1 c positively correlated with HOMA- IR （ r =0. 217, P 〈0.01）. Conclusion Passive smoking may have a significantly positive influence on the glycemic control in non-smoking female patients with type 2 diabetes mellitus. The underlying mechanism may be associated with the increased insulin resistance. The risk of DM complications increases sharply in the patients with type 2 diabetes mellitus and exposed to second hand smoking.