Interaction between Overweight, Obesity and Smoking on the Risk of Pre-Diabetes and Type 2 Diabetes in Guangdong, China

Zhuanping  Zeng; Jiao  Guo

doi:10.18502/ijph.v54i9.19857

Zhuanping Zeng Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China
Jiao Guo Guangdong Metabolic Diseases Research Center of Integrated Chinese and Western Medicine, Guangdong Pharmaceutical University, Guangzhou 510006, China

DOI: https://doi.org/10.18502/ijph.v54i9.19857

Keywords: Smoking; Overweight; Obesity; Type 2 diabetes mellitus; Pre-diabetes mellitus

Abstract

Background: Pre-diabetes mellitus (PDM) is considered a precursor stage of type 2 diabetes mellitus (T2DM) and serves as an early warning sign for the disease. However, most studies only analyze the risk factors of T2DM, ignore the exploration of PDM.

Methods: Here 28,208 patients with T2DM were selected from 5 cities in the Pearl River Delta, Guangdong Province, China in 2017. Then a 1:1 matched case-control study was conducted according to the matching conditions. Finally, 28208 patients with PDM and 28208 patients with normal glucose tolerance (NGT) were matched, and when multiple subjects were matched, the same subjects in the region were preferredOrdered multiple logistic regression was used to analyze the influencing factors of T2DM and PDM. When analyzing the relationship between overweight, obesity, smoking, and T2DM, factors such as age, education level, exercise were adjusted.

Results: Overweight, obesity (OR=1.427, 95%CI:1.388~1.468; OR=1.829,95%CI:1.753~1.908) and smoking (OR=1.161,95%CI:1.113~1.212) were risk factors for the onset of T2DM by ordered multiple logistic regression. There was an additive interaction between overweight obesity and smoking in the developing of T2DM. Moreover, there were 0.196(0.051~0.341) relative excess risk due to the additive interaction, 9.1% (2.0%-16.1%) of T2DM exposed to both risk factors was attributable to the additive interaction, and the risk of T2DM in overweight and obese smokers was 1.203(1.004-1.402) times as high as the sum of risks in the participants exposed to a single risk factor too.

Conclusion: Overweight obesity and smoking are the risk factors for the onset of T2DM.