Study On The Relationship Between Smoking And Dietary Patterns And Pathoglycemia

Diabetes is a group of metabolic diseases characterized by hyperglycemia.Impaired insulin secretion and impaired biological function of insulin or the combination of the both can lead to hyperglycemia.High blood sugar can canse chronic damage and dysfunction of various tissues,especially the eyes,kidneys,heart,blood vessels,and nerve.The occurrence of diabetes are closely related to genetic factors,social environmental factors and lifestyles.According to a survey of the national population in our country in2010,the prevalence of adults type 2 diabetes was 11.6% and there were about 113 million person have diabetes.The result of a survey of type 2 diabetes in parts of our country from 2007 to 2008 showed that the prevalence of prediabetes was 15.5% and only 40% patients with diabetes have diagnosised,there is a huge number of potential diabetes patients in our country.Smoking is an important risk factor of chronic noncommunicable diseases,such as cardiocerebrovascular disease,cancer,respiratory system disease and diabetes;and it affects the people's physical and mental health and the quality of life seriously.Therefore,it brings serious financial burden and mental pressure to individuals,families and society at the same time.As one of the largest producer and consumer of tobacco in the world,China has 300 million smokers;moreover,the public's lack of awareness of the dangers of tobacco;which cause the trend of prevalence of smoking in our country very severe.So the smoking has greatly affected the public health and social development in our country..The relationship between chronic diseases and dietary patterns has received extensive attention in the researchers in recent years,among them,the influence of dietary pattern on the prevalence of diabetes is much more.A number of studies form domestic and foreign shows that a healthy diet based on fruits and vegetables can reduce the prevalence of diabetes and improve the people health,and the diet of animal food and high-energy food may increase the risk of diabetes.However,there has not a unification of the dietary pattern in the world due to various effects,such as geographical location and customs.This study based on the detection of chronic diseases and their risk factors for adult in Jiangsu province,and recruited the male population as the research subjects to explore the relationship between smoking and diabetes,and established the dietary pattern of male population and study the influence of dietary patterns on abnormal blood glucose.We also took further explore on the relationship of dietary patterns and abnormal blood glucose under the different condition,,such as whether smoking and the amount of smoking,to reveal the influence of smoking and dietary pattern,which were the two kinds of important lifestyle,on the level of blood glucose.Part?Epidemiological study of the association between smoking and type 2 diabetes in male adults in Jiangsu Province Objective: To explore the association between cigarette smoking and type 2 diabetes.Methods: Based on the monitor of the adult chronic non-communicable diseases and risk factors inJiangsu Province,1884 male adults were recruited in this study.The methods of t-test,one-way ANOVA analysis,nonparametric test and chi-square test were usedrespectively to describe the statistical of quantitative data and qualitative data.The single factor and multiple factors logistic regression model were used to analysis the relationship between smoking and diabetes in the males before and after the adjustment of confounding factors.Results: There are 1090 current smokers(57.9%)in the total 1884 male adults including 924 daily smokers(49.0%)and 166 not daily smokers(8.8%).The prevealence of new diagnosed diabetes was 6.4%(121/1884),the prevalence of diabetes was 5.9%(71/1090)in current smoker..The not daily smokers has the lowest prevalence of diabetes(4.8%)while daily smokers was the highest one(6.8%),non-smokers with the second(6.3%%).HOME – IR index of daily smokers was lower than that of the not daily smokers,but higher than non-smokers(p=0.023).The results of HOME–? showed a trend of increase from non-smokers,not daily smokers and to daily smokers,and the difference between non-smokers and daily smokers was statistical significantly(p=0.049).The HOME–IR and HOME–? index in the subjects with the amount of cigarettes ? 20 perday was the lowest.The difference of HOME– IR between the subjects withthe amount of cigarettes 1~14 package per years and 15~29 package per years was statistical significantly(p<0.001)and the the sample of 15~29 package years(p=0.026)and over 30 package years(p<0.001)were lower than 0 package years with significant difference.HOME – ? index have significant difference in each group(p<0.001).The prevalences of diabetes in the different groups according to the amount of cigarettes smoke perday was significant differently(p<0.001).The prevalence of diabetes in the group of the number of cigarettes smoked perday ? 20 was higher than that in the group of 1~19 cigarettes(p<0.001)and non-smokers(p=0.016)The package years of cigarettes smoked in the subjects was also a risk factor for diabetes(p=0.019),however the results of the pairwise comparison showed that the difference was only significant between the sujects with 1~14 package years of cigarettes smoked and the subjects with over 30 package years(p=0.007,?2=7.325).After adjusting the confounding factors of age,marriage,occupation,urban and rural,drinking,hypertension or not,dyslipidemia or not,and BMI,the results of multiariable logistic regression analysis showed that the number of cigarettes smoked(p<0.001)and the package years of cigarette smoked(p=0.004)were both the risk factors for diabetes.The risk of diabetes among the group with the number of cigarettes smoked perday ? 20(OR=1.748,95%CI:1.150~2.658,p=0.009)and the group with the package years of cigarettes smoked ?30(OR=2.121,95%CI:1.309~3.438,p=0.003)was 1.748 and 2.121 times respectively compared with the group of non smokers.After the stratification analysis according to BMI,in the group of BMI< 24 kg/m2,the results of multiariable logistic regression analysis showed that the number of cigarettes smoked(p=0.001)and the packageyears of cigarettes smoked(p=0.006)were still the risk factors for diabetes.The risk of diabetes among the group with the number of cigarettes smoked perday ?20(OR=2.933.95%CI:1.349~6.377,p=0.007)and the group with the package years of cigarettes smoked ?30(OR=3.530.95%CI:1.532~8.134,p=0.003)was 2.933 and 3.530 times respectively compared with the group of non smokers.Conclusion: Smoking is significantly correlated with diabetes in male,the results of hierarchical analysis indicated that a large number of smoking is a risk factor for diabetes.The risk of smoking on diabetes was statistically significant in Male adults with BMI under 24 kg/m2.Part ? The relationship between dietary patterns and pathoglycemia in male adults in Jiangs u Province Objective: To explore the relationship between dietary patterns and pathoglycemia under the influ ence of smoking.Methods: Based on the monitor of adult chronic non-communicable diseases and risk factors in Jiangsu Province,1929 male adults were recruited in this study.The methods of t-test,chi-square test were used to describe the general demography.The dietary patterns were established used the principal component anlysis according to the dietary information of uniform questionnaire(food frequency and consumption)..Using logistic regression model to comparise the influence of different dietary patterns on blood glucose and study the relationship between dietary patterns and pathoglycemia under the influence of smoking.Results: Four dietary patterns were established by principal component analysis,which were animal diet,healthy diet,fried food diet and traditional diet.The healthy diet(35.8%)has the lowest prevalence of pathoglycemia while the fried food diet has the highest(43.8%).After adjusting confounding factors animal diet(OR = 1.387,95% CI: 1.096 ~ 1.755,p = 0.007),fried food diet(OR = 1.703,95% CI: 1.230 ~2.359,p = 0.001)and traditional diet(OR = 1.358,95% CI: 1.019 ~ 1.810,p = 0.037)will increase the risk of pathoglycemia compared with healthy diet.And animal diet(OR = 1.347,95% CI: 1.062 ~ 1.710,p =0.014),fried food diet(OR = 1.659,95% CI: 1.194 ~ 2.307,p = 0.003)are also the risk of FPG abnormalities compared with healthful diet.After dividing the the subjects to subgroup according to the cigarettes smoked,there was no significant difference between the dietary patterns and blood glucose abnormalities in non-smokers group;the relationship between dietary patterns and blood glucose abnormalities in smokers has statistical significance(p < 0.001),whether or not to adjust the confounding factors..The risk of blood glucose abnormalities among animal diet(OR = 1.865,95% CI: 1.364 ~ 2.551,p < 0.001)and fried food diet(OR = 0.001,95% CI: 1.212 ~ 2.819,p = 0.004)were 1.865 and 1.849 times respectively compared with healthy diet.After further stratified analysis according to the amount of cigarettes smoked,the relationship between dietary patterns and the blood glucose abnormalities and FPG abnormalities had statistical significance.Among them,the risk of blood glucose abnormalities in people with animal diet was the highest(OR = 2.587,95% CI: 1.643 ~ 4.071,p < 0.001),while traditional diet was the lowest(OR = 2.244,95% CI: 1.299 ~ 3.876,p = 0.004)in the group of the number of cigarettes smoked ? 20 perday.And these three kinds of dietary patterns will increase the risk of fasting glucose abnormalities,the highest one was fried food diet and it was 3.275 times(OR = 3.275,95% CI:1.815 ~ 5.909,p < 0.001)comared with healthy diet after adjustment the confounding factors.In the group of cigarettes smoked ? 30 pack-years,the influence of Fried food diet on blood glucose abnormalities wasnot significant differently while the animal diet and traditional diet are risk factors.The results of multiple factors analysis showed that the risk of blood glucose abnormalities in animal diet and traditional diet are3.718 times and 3.719 times compared to healthy diet.However,the association between the diets and FPG abnormalists were different cmoared with that in diets and blood glucose abnormalities after adjusting the confounding factors,the animal diet and traditional diet were always the risk factors while the fried food diet had no statistical significance after adjustment the confounding factors(p = 0.060).Conclusion: In the male residents in Jiangsu province,dietary patterns will affect the occurrence of blood glucose abnormalities with statistically significant.Further study found that the effects of dietary patterns on blood glucose abnormalities in smokers have significant difference,but there were no significant differences in non-smokers.The results of more in-depth analysis shows that animal meal,fried food diet and traditional diet in heavy smokers will increase the risk of blood glucose abnormalities.