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Smoking and the risk of LADA : Results from a Swedish population-based case-control study

Rasouli, Bahareh ; Andersson, Tomas ; Carlsson, Per Ola ; Grill, Valdemar ; Groop, Leif LU ; Martinell, Mats ; Storm, Petter LU orcid ; Tuomi, Tiinamaija and Carlsson, Sofia (2016) In Diabetes Care 39(5). p.794-800
Abstract

OBJECTIVE: Smoking is an established risk factor for type 2 diabetes. In contrast, it has been proposed that smoking may reduce the risk of latent autoimmune diabetes in adults (LADA), but studies are scarce. We aimed to study the impact of smoking on LADA and type 2 diabetes risks. RESEARCH DESIGN AND METHODS: We used data from a Swedish case-control study including incident case patients with LADA (GAD antibody [GADA] positive, n = 377) and type 2 diabetes (GADA negative, n = 1,188) and control subjects randomly selected from the population (n = 1,472). We calculated odds ratios (ORs) with 95% CIs by logistic regression, adjusted for age, sex, BMI, family history of diabetes, and alcohol consumption. RESULTS: There was no indication... (More)

OBJECTIVE: Smoking is an established risk factor for type 2 diabetes. In contrast, it has been proposed that smoking may reduce the risk of latent autoimmune diabetes in adults (LADA), but studies are scarce. We aimed to study the impact of smoking on LADA and type 2 diabetes risks. RESEARCH DESIGN AND METHODS: We used data from a Swedish case-control study including incident case patients with LADA (GAD antibody [GADA] positive, n = 377) and type 2 diabetes (GADA negative, n = 1,188) and control subjects randomly selected from the population (n = 1,472). We calculated odds ratios (ORs) with 95% CIs by logistic regression, adjusted for age, sex, BMI, family history of diabetes, and alcohol consumption. RESULTS: There was no indication of reduced risk of LADA in smokers; instead, heavy smoking was associated with an increased risk of LADA (OR 1.37, 95% CI 1.02-1.84). Heavy smokers had higher levels of HOMA of insulin resistance (9.89 vs. 4.38, P = 0.0479) and HOMA of β-cell function (55.7 vs. 42.5, P = 0.0204), but lower levels of GADA (75 vs. 250, P = 0.0445), compared with never smokers. Smokers also displayedanincreased risk oftype2 diabetes (OR in eversmokers 1.53, 95% CI 1.25-1.88). CONCLUSIONS: In this large population of LADA patients, we did not observe a protective effect of smoking on autoimmunity and the risk of LADA. A protective effect could possibly be masked by a smoking-induced aggravation of insulin resistance, akin to the diabetogenic effect seen in individuals with type 2 diabetes.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
ANDIS, diabetes, diabetics
in
Diabetes Care
volume
39
issue
5
pages
7 pages
publisher
American Diabetes Association
external identifiers
  • pmid:27208379
  • wos:000375039000023
  • scopus:84964797394
ISSN
0149-5992
DOI
10.2337/dc15-2348
language
English
LU publication?
yes
id
13c1813b-de81-44b0-ab65-5df09ca1d421
date added to LUP
2016-06-01 10:22:56
date last changed
2025-01-12 06:48:26
@article{13c1813b-de81-44b0-ab65-5df09ca1d421,
  abstract     = {{<p>OBJECTIVE: Smoking is an established risk factor for type 2 diabetes. In contrast, it has been proposed that smoking may reduce the risk of latent autoimmune diabetes in adults (LADA), but studies are scarce. We aimed to study the impact of smoking on LADA and type 2 diabetes risks. RESEARCH DESIGN AND METHODS: We used data from a Swedish case-control study including incident case patients with LADA (GAD antibody [GADA] positive, n = 377) and type 2 diabetes (GADA negative, n = 1,188) and control subjects randomly selected from the population (n = 1,472). We calculated odds ratios (ORs) with 95% CIs by logistic regression, adjusted for age, sex, BMI, family history of diabetes, and alcohol consumption. RESULTS: There was no indication of reduced risk of LADA in smokers; instead, heavy smoking was associated with an increased risk of LADA (OR 1.37, 95% CI 1.02-1.84). Heavy smokers had higher levels of HOMA of insulin resistance (9.89 vs. 4.38, P = 0.0479) and HOMA of β-cell function (55.7 vs. 42.5, P = 0.0204), but lower levels of GADA (75 vs. 250, P = 0.0445), compared with never smokers. Smokers also displayedanincreased risk oftype2 diabetes (OR in eversmokers 1.53, 95% CI 1.25-1.88). CONCLUSIONS: In this large population of LADA patients, we did not observe a protective effect of smoking on autoimmunity and the risk of LADA. A protective effect could possibly be masked by a smoking-induced aggravation of insulin resistance, akin to the diabetogenic effect seen in individuals with type 2 diabetes.</p>}},
  author       = {{Rasouli, Bahareh and Andersson, Tomas and Carlsson, Per Ola and Grill, Valdemar and Groop, Leif and Martinell, Mats and Storm, Petter and Tuomi, Tiinamaija and Carlsson, Sofia}},
  issn         = {{0149-5992}},
  keywords     = {{ANDIS; diabetes; diabetics}},
  language     = {{eng}},
  number       = {{5}},
  pages        = {{794--800}},
  publisher    = {{American Diabetes Association}},
  series       = {{Diabetes Care}},
  title        = {{Smoking and the risk of LADA : Results from a Swedish population-based case-control study}},
  url          = {{http://dx.doi.org/10.2337/dc15-2348}},
  doi          = {{10.2337/dc15-2348}},
  volume       = {{39}},
  year         = {{2016}},
}