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Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes
Studies have demonstrated the adverse effects of smoking on the risk of microvascular complications; however, few have also examined the potential mediating effects of glycemic control. Using data from the Diabetes Control and Complications Trial (DCCT 1983–1993), we describe the acute and long-term...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322792/ https://www.ncbi.nlm.nih.gov/pubmed/30615671 http://dx.doi.org/10.1371/journal.pone.0210367 |
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author | Braffett, Barbara H. Rice, Madeline Murguia Young, Heather A. Lachin, John M. |
author_facet | Braffett, Barbara H. Rice, Madeline Murguia Young, Heather A. Lachin, John M. |
author_sort | Braffett, Barbara H. |
collection | PubMed |
description | Studies have demonstrated the adverse effects of smoking on the risk of microvascular complications; however, few have also examined the potential mediating effects of glycemic control. Using data from the Diabetes Control and Complications Trial (DCCT 1983–1993), we describe the acute and long-term risks of smoking on glycemic control and microvascular complications in a well-characterized cohort of participants with type 1 diabetes. The DCCT recorded self-reported smoking behaviors, glycemic exposure based on HbA1c, and complications status. Generalized linear mixed models were used to assess whether time-dependent measurements of smoking predict HbA1c levels. Cox proportional hazard models were used to assess time-dependent smoking exposures as predictors of retinopathy and nephropathy. During a mean of 6.5 years of follow-up, current smokers had consistently higher HbA1c values and were at a higher risk of retinopathy and nephropathy compared with former and never smokers. These risk differences were attenuated after adjusting for HbA1c suggesting that the negative association of smoking on glycemic control is partially responsible for the adverse association of smoking on the risk of complications in type 1 diabetes. These findings support the potential for a beneficial effect of smoking cessation on complications in type 1 diabetes. |
format | Online Article Text |
id | pubmed-6322792 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-63227922019-01-19 Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes Braffett, Barbara H. Rice, Madeline Murguia Young, Heather A. Lachin, John M. PLoS One Research Article Studies have demonstrated the adverse effects of smoking on the risk of microvascular complications; however, few have also examined the potential mediating effects of glycemic control. Using data from the Diabetes Control and Complications Trial (DCCT 1983–1993), we describe the acute and long-term risks of smoking on glycemic control and microvascular complications in a well-characterized cohort of participants with type 1 diabetes. The DCCT recorded self-reported smoking behaviors, glycemic exposure based on HbA1c, and complications status. Generalized linear mixed models were used to assess whether time-dependent measurements of smoking predict HbA1c levels. Cox proportional hazard models were used to assess time-dependent smoking exposures as predictors of retinopathy and nephropathy. During a mean of 6.5 years of follow-up, current smokers had consistently higher HbA1c values and were at a higher risk of retinopathy and nephropathy compared with former and never smokers. These risk differences were attenuated after adjusting for HbA1c suggesting that the negative association of smoking on glycemic control is partially responsible for the adverse association of smoking on the risk of complications in type 1 diabetes. These findings support the potential for a beneficial effect of smoking cessation on complications in type 1 diabetes. Public Library of Science 2019-01-07 /pmc/articles/PMC6322792/ /pubmed/30615671 http://dx.doi.org/10.1371/journal.pone.0210367 Text en © 2019 Braffett et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Braffett, Barbara H. Rice, Madeline Murguia Young, Heather A. Lachin, John M. Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes |
title | Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes |
title_full | Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes |
title_fullStr | Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes |
title_full_unstemmed | Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes |
title_short | Mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes |
title_sort | mediation of the association of smoking and microvascular complications by glycemic control in type 1 diabetes |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322792/ https://www.ncbi.nlm.nih.gov/pubmed/30615671 http://dx.doi.org/10.1371/journal.pone.0210367 |
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