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Association of Education and Smoking Status on Risk of Diabetes Mellitus: A Population-Based Nationwide Cross-Sectional Study

Authors
 Jin-Hyeong Kim  ;  Juhwan Noh  ;  Jae-Woo Choi  ;  Eun-Cheol Park 
Citation
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, Vol.14(6) : E655, 2017 
Journal Title
 INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 
ISSN
 1661-7827 
Issue Date
2017
MeSH
Adult ; Aged ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/epidemiology* ; Diabetes Mellitus, Type 2/etiology ; Educational Status* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Republic of Korea/epidemiology ; Risk Factors ; Smoking/epidemiology* ; Tobacco Smoke Pollution/analysis* ; Young Adult
Keywords
diabetes ; education ; environmental tobacco smoke ; smoker
Abstract
Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007-2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.
Files in This Item:
T201701867.pdf Download
DOI
10.3390/ijerph14060655
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Noh, Juhwan(노주환) ORCID logo https://orcid.org/0000-0003-0657-0082
Park, Eun-Cheol(박은철) ORCID logo https://orcid.org/0000-0002-2306-5398
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160256
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