长期被动吸烟与血糖及血脂关系病例对照研究

Association of long-term passive smoking with blood glucose and lipids among non-smokers: a case-control study

目的了解长期被动吸烟与血糖及血脂的关系,为心血管疾病的有效预防控制提供参考依据。方法采用以医院为基础的病例对照研究方法对2012年5月—2014年5月在哈尔滨医科大学第一附属医院就诊的220名长期被动吸烟者和226名非被动吸烟者进行问卷调查、体格检查和实验室血糖及血脂检测。结果被动吸烟组中有血脂异常病史、高血压病史、糖尿病病史、脑卒中病史、冠心病病史、冠心病家族史和有降压药、降糖药、抗凝药、降脂药用药史的比例分别为31.36%、49.09%、20.45%、9.55%、61.82%、64.09%和44.09%、17.27%、20.91%、19.09%,均高于非被动吸烟组中的23.01%、39.38%、8.85%、3.54%、21.68%、41.15%和31.42%、7.52%、8.85%、8.85%（均P〈0.05）;在调整了年龄、性别、文化程度、婚姻状况、人均月收入、饮酒情况、睡眠时间、体育锻炼情况、有无病史（血脂异常、高血压、糖尿病、脑卒中、冠心病）、有无冠心病家族史、用药史（降压药、降糖药、抗凝药、降脂药）、体质指数（BMI）和是否中心性肥胖等混杂因素后,多因素logistic回归分析结果显示,长期被动吸烟与空腹血糖（FBG）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）和高密度脂蛋白胆固醇（HDL-C）关联强度的OR值分别为2.551（1.364~4.807）、1.382（0.915~2.104）、1.072（0.685~1.673）、1.288（0.847~1.946）和1.142（1.034~1.586）。结论长期被动吸烟可能与FBG及HDL-C的代谢异常有关联。

Objective To investigate the effect of long-term passive smoking on blood glucose and blood lipids among non-smokers. Methods A hospital-based case-control study was conducted among persons aged 40 years or older who sought outpatient service at the First Affiliated Hospital of Harbin Medical University between May 2012 through May 2014. The cases were 220 non-smokers with long-term passive smoking（ exposed to indoor tobacco smoke ≥0. 5hour per day continuously for 5 years） and the controls were 226 age- and gender-group matched non-smokers without passive smoking（ unexposed to indoor tobacco smoke or exposed to indoor tobacco smoke less than 15 minutes per time）. All the participants were surveyed with a self-designed questionnaire,health examination,and laboratory test. Results Compared to the controls,the cases reported significantly higher proportions of history of dyslipidemia（ 31. 36% vs. 23. 01%）,hypertension（ 49. 09% vs. 39. 38%）,diabetes（ 20. 45% vs. 8. 85%）,stroke（ 9. 55%vs. 3. 54%）,coronary heart disease（ 61. 82% vs. 21. 68%）,familial coronary heart disease（ 61. 82% vs. 41. 15%） and medication history of antihypertensive（ 44. 09% vs. 31. 42%）,hypoglycemic drugs（ 17. 27% vs. 7. 52%）,anticoagulant（ 20. 91% vs. 8. 85%）,lipid-lowering drugs（ 19. 09% vs. 8. 85%）（ P〈0. 05 for all）. After adjusting for age,gender,education,marital status,familial income per capita,alcohol drinking,sleeping,physical exercise,history of chronic diseases（ hypertension,dyslipidemia,diabetes,stroke,coronary heart disease）,familial history of coronary heart disease,medication history（ antihypertensive,hypoglycemic drugs,anticoagulant,lipid-lowering drugs）,and body mass index and central obesity,the results of multivariate logistic regression analyses showed that among the non-smokers long-term passive smoking was correlated with the abnormalities of fasting blood glucose（ FBG）（ odds ratio[OR] = 2. 551,95% confidence interval[95% CI]： 1. 364- 4. 807）,total cholesterol（ OR = 1. 382,95% CI： 0. 915- 2. 104）,triglyceride（ OR =1. 072,95% CI： 0. 685- 1. 673）,low-density lipoprotein cholesterol（ OR = 1. 288,95% CI： 0. 847- 1. 946）,and high-density lipoprotein cholesterol（ HDL-C）（ OR = 1. 142,95% CI： 1. 034- 1. 586）,respectively. Conclusion Abnormalities of FBG and HDL-C are associated with long-term passive smoking among non-smokers.