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The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population

 Hyungseon Yeom  ;  Jung Hyun Lee  ;  Hyeon Chang Kim  ;  Il Suh 
 Journal of Preventive Medicine and Public Health, Vol.49(2) : 108-117, 2016 
Journal Title
 Journal of Preventive Medicine and Public Health 
Issue Date
Aged ; Albumins/analysis ; Asian Continental Ancestry Group ; Blood Pressure ; Body Mass Index ; Creatinine/urine ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/diagnosis* ; Diabetic Nephropathies/epidemiology ; Diabetic Nephropathies/etiology* ; Female ; Glomerular Filtration Rate ; Glycated Hemoglobin A/analysis ; Humans ; Logistic Models ; Male ; Middle Aged ; Nutrition Surveys ; Odds Ratio ; Prevalence ; Republic of Korea ; Smoking/adverse effects*
Diabetes mellitus ; Diabetic nephropathies ; Diagnosis ; Smoking
Objectives: Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy. Methods: We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A “former smoker” was a patient who smoked only before receiving his diagnosis of diabetes. A “continuing smoker” was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m2). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked. Results: Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29). Conclusions: Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.
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1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Suh, Il(서일) ORCID logo https://orcid.org/0000-0002-9689-7849
Yeom, Hyung Seon(염형선)
Lee, Jung Hyun(이정현)
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