Inflammatory parameters and insulin resistance and cigarette smoking intype 2 diabetes mellitus

Aim: Smoking remains a global problem and it is known as a cause of many diseases. Globally, tobacco use is the most important cause of preventable morbidity and mortality. The aim of this study is to evaluate the impact of smoking on insulin parameters and inflammatory markers, and the variation of these parameters according to the duration of smoking cessation in patients who quit smoking.Material and Methods: 612 patients aged 18-70 years (n = 612) who were undergoing treatment and follow-up for type 2 diabetes mellitus were included in this study. The patients were categorized into 3 groups (i.e., smokers, ex-smokers, and nonsmokers). Test results ofof hemoglobin A1c (HbA1c), cholesterol, triglyceride, high density lipoprotein (HDL) levels, low density lipoprotein, leukocyte count, C-reactive protein, fibrinogen, and ferritin levels were obtained. Body mass indexes (BMI) and blood pressure were also measured.Results: Smoking was significantly associated with the male gender, HbA1c, HDL level, BMI, waist circumference, the homeostatic model assessment-insulin resistance (HOMA-IR) core, and inflammatory markers. Current smokers who smoked ≥20 packs/year demonstrated poorer metabolic results compared to those who smoked 0-10 pack(s)/year. The metabolic parameters were worse in ex-smokers who quit smoking 10 years ago.Conclusion: We demonstrated that smoking increased insulin resistance, metabolic syndrome, and inflammation. Smoking was also observed to worsen glycemic control by further increasing insulin resistance in diabetic patients.

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Chow CK, Jolly S, Rao-Melacini P, Fox KA, Anand SS, Yusuf S. Association of diet, exercise, and smoking modification with risk of early cardiovascular events after acute coronary syndromes. Circulation 2010;121(6):750-8.
Śliwińska-Mossoń M1, Milnerowicz H. The impact of smoking on the development of diabetes and its complications. Diab Vasc Dis Res 2017;14(4):265-76
Zhu P, Pan XF, Sheng L, Chen H, Pan A. Cigarette smoking, diabetes, and diabetes complications: call for urgent action. Curr Diab Rep 2017;17(9):78.
Chang S.A. Smoking and type 2 diabetes mellitus. Diabetes Metab J 2012;36(6):399-403.
Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ 1998;316(7134):823-8.
Gaedt Thorlund M, Borg Madsen M, Green A, Sjølie AK, Grauslund J. Is smoking a risk factor for proliferative diabetic retinopathy in type 1 diabetes? Ophthalmologica 2013;230(1):50-4.
Feodoroff M, Harjutsalo V, Forsblom C, Thorn L, Wade´n J, Tolonen N, et al. Smoking and progression of diabetic nephropathy in patients with type 1 diabetes. Acta Diabetol 2016;53(4):525-33.
Liu J, Liang Q, Frost-Pineda K, Muhammad-Kah R, Rimmer L, Roethig H, et al. Relationship between biomarkers of cigarette smoke exposure and biomarkers of inflammation, oxidative stress, and platelet activation in adult cigarette smokers. Cancer Epidemiol Biomarkers Prev 2011;20(8):1760-9.
Fröhlich M, Sund M, Löwel H, Imhof A, Hoffmeister A, Koenig W. Independentassociation of various smoking characteristics with markers of systemic inflammation in men Results from a representative sample of the general population (MONICA Augsburg Survey 1994/95). Eur Heart J 2003;24(14):1365-72.
Cena H, Fonte ML, Turconi G. Relationship between smoking and metabolic syndrome.Nutr Rev 2011;69:745-53.
Anan F, Takahashi N, Shinohara T, Nakagawa M, Masaki T, Katsuragi I, et al. Smoking is associated with insulin resistance and cardiovascular autonomic dysfunction in type 2 diabetic patients.Eur J Clin Invest 2006;36:459-65.
Gunton JE, Davies L, Wilmshurst E, Fulcher G, McElduff A. Cigarette smoking affects glycemic control in diabetes. Diabetes Care 2002;25:796-7.
Will JC, Galuska DA, Ford ES, Mokdad A, Calle EE. Cigarette smoking and diabetes mellitus: evidence of a positive association from a large prospective cohort study. Int J Epidemiol 2001;30(3):540-6.
Wannamethee SG, Shaper G, Perry IJ. Smoking as a modifiable risk factor for type 2diabetes in middle-aged men. Diabetes Care 2001;24:1590-5.
Gerber PA, Locher R, Schmid B, Spinas GA, Lehmann R. Smoking is associated with impaired long-term glucose metabolism in patients with type 1 diabetes mellitus. Nutr Metab Cardiovasc Dis 2013;23(2):102-8.
Morimoto A, Tatsumi Y, Deura K, Mizuno S, Ohno Y, Watanabe S. Impact of cigarette smoking on impaired insulin secretion and insulin resistance in Japanese men: The Saku Study. J Diabetes Investig 2013;4(3):274-80.
Chiolero A, Faeh D, Paccaud F, Cornuz J. Consequences of smoking for body weight, bodyfat distribution, and insulin resistance. Am J Clin Nutr 2008;87(4):801-9.
Willi C, Bodenmann P, Ghali WA, Faris PD, Cornuz J. Active smoking and the risk of type2 diabetes: a systematic review and meta-analysis. JAMA 2007;298:2654-64.
Manson JE, Ajani UA, Liu S, Nathan DM, Hennekens CH. A prospective study of cigarette smoking and incidence of diabetes mellitus among US male physicians Am J Med 2000;109(7):538-42.
Pinsker JE , Shank T , Dassau E , Kerr D. .Comment on american diabetes association. approaches to glycemic treatment. sec. 7. ın standards of medical care in diabetes-2015. diabetes care 2015;38(suppl. 1):s41-s48..Diabetes Care 2015;38(10):e174.
Rabaeus M, Salen P, Lorgeril M. Is it smoking or related lifestyle variables that increasmetabolic syndrome risk? BMC Med 2013;11:196.
Chang SA. Smoking and type 2 diabetes mellitus. Diabetes Metab J 2012;36(6):399-403.
Radzeviciene L, Ostrauskas R. Smoking habits and the risk of type 2 diabetes: a case-control study. Diabetes Metab 2009;35(3):192-7.
WHO Report on the Global Tobacco Epidemic: Warning about the dangers of tobacco. http://whqlibdoc.who.int/hq/2011/ WHO_NMH_TFI_11.3_eng.pdf. accessed date 19.01.2012
Ford SK, Shilliday BB. Smoking and diabetes: helping patients quit. Clin Diabetes 2006;24(3):133-7.