Cigarette Smoking Is Associated with Conversion from Normoglycemia to Impaired Fasting Glucose: The Western New York Health Study

Received 7 July 2008; accepted 27 January 2009. published online 06 April 2009.

Purpose

To determine whether cigarette smoking is associated with the conversion from normoglycemia to impaired fasting glucose (IFG).

Methods

During the years 2003 and 2004, 1,455 participants (mean age, 56.5 years; range, 35–79 years) from the Western New York Health Study who were free of type 2 diabetes and known cardiovascular disease at baseline (1996–2001) were reexamined (68% response rate). Incident IFG was defined as a subject whose baseline fasting plasma glucose was <100mg/dL (normoglycemic) and between 100 and 125mg/dL at follow-up. Prevalent IFG (n=528) was excluded. Baseline smoking status was categorized as never, former, or current.

Results

Of the 1,455 participants, 924 were normoglycemic at baseline: 101/924 converted to IFG over 6 years. Compared with those who remained normoglycemic, converters to IFG were at baseline older, had a larger body mass index, more likely to be hypertensive, currently smoke, and have a family history of type 2 diabetes mellitus (all p<0.05). Multivariate logistic regression demonstrated that compared with subjects who remained normoglycemic, the odds ratio of incident IFG among former and current smokers (vs. never) was 1.68 (95% confidence interval: 0.99–2.80) and 2.35 (95% confidence interval: 1.17–4.72) (p trend=0.008), respectively.

Conclusion

Smoking was positively associated with incident IFG after accounting for several putative risk factors.

key words: Cigarette Smoking, Impaired Fasting Glucose, Epidemiology, Risk Factors

Selected Abbreviations and Acronyms: T2DM, type 2 diabetes mellitus, IFG, impaired fasting glucose, FPG, fasting plasma glucose, RR, relative risk, CI, confidence interval, IGT, impaired glucose tolerance, BMI, body mass index, NGT, normoglycemia, OGTT, oral glucose tolerance test, HTN, hypertension, OR, odds ratio, AR, attributable risk, PA, physical activity

a Department of Social and Preventive Medicine, State University of New York at Buffalo, Charlotte

b Department of Mathematics and Statistics, University of North Carolina, Charlotte

Address correspondence and reprint requests to: Lisa Rafalson, PhD, Department of Social and Preventive Medicine, School of Public Health and Health Professions, State University of New York at Buffalo, 3435 Main St., Farber Hall, Room 270, Buffalo, NY 14214.

PII: S1047-2797(09)00044-1

doi:10.1016/j.annepidem.2009.01.013

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