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Insulin resistance and β-cell function in smokers : Results from the EGIR-RISC European multicentre study

Gottsäter, M. LU ; Balkau, B.; Hatunic, M.; Gabriel, R.; Anderwald, C. H.; Dekker, J.; Lalic, N. and Nilsson, P. M. LU (2017) In Diabetic Medicine 34(2). p.223-228
Abstract

Aims: Tobacco smoking is known to increase the long-term risk of developing Type 2 diabetes mellitus, but the mechanisms involved are poorly understood. This observational, cross-sectional study aims to compare measures of insulin sensitivity and β-cell function in current, ex- and never-smokers. Methods: The study population included 1246 people without diabetes (mean age 44 years, 55% women) from the EGIR-RISC population, a large European multicentre cohort. Insulin sensitivity was measured using a hyperinsulinaemic, euglycaemic clamp and the homeostatic model assessment - insulin resistance (HOMA-IR) index. Two β-cell function parameters were derived from measures during an oral glucose tolerance test: the early insulin response... (More)

Aims: Tobacco smoking is known to increase the long-term risk of developing Type 2 diabetes mellitus, but the mechanisms involved are poorly understood. This observational, cross-sectional study aims to compare measures of insulin sensitivity and β-cell function in current, ex- and never-smokers. Methods: The study population included 1246 people without diabetes (mean age 44 years, 55% women) from the EGIR-RISC population, a large European multicentre cohort. Insulin sensitivity was measured using a hyperinsulinaemic, euglycaemic clamp and the homeostatic model assessment - insulin resistance (HOMA-IR) index. Two β-cell function parameters were derived from measures during an oral glucose tolerance test: the early insulin response index and β-cell glucose sensitivity. Additionally, the areas under the curve during the oral glucose tolerance test were calculated for glucose, insulin and C-peptide. Results: According to smoking habits, there were differences in insulin sensitivity, which was lower in women who smoked, and in β-cell glucose sensitivity, which was lower in men who smoked, but these associations lost significance after adjustment. However, after adjustment, the areas under the glucose and the C-peptide curves during the oral glucose tolerance test were significantly higher in men who smoked. Conclusions: Smoking habits were not independently associated with insulin sensitivity or β-cell function in a healthy middle-aged European population. Health-selection bias, methodological shortcomings or a true lack of causal links between smoking and impaired insulin sensitivity/secretion are possible explanations. The mechanisms behind the observed increased glucose and C-peptide areas under the curve during the oral glucose tolerance test in male smokers need to be further evaluated.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Diabetic Medicine
volume
34
issue
2
pages
223 - 228
publisher
Wiley-Blackwell
external identifiers
  • scopus:84994410785
  • wos:000394136800011
ISSN
0742-3071
DOI
10.1111/dme.13172
language
English
LU publication?
yes
id
85fd577b-ae91-4e40-8270-c5c34914a5a3
date added to LUP
2016-12-05 10:53:41
date last changed
2018-03-04 04:56:08
@article{85fd577b-ae91-4e40-8270-c5c34914a5a3,
  abstract     = {<p>Aims: Tobacco smoking is known to increase the long-term risk of developing Type 2 diabetes mellitus, but the mechanisms involved are poorly understood. This observational, cross-sectional study aims to compare measures of insulin sensitivity and β-cell function in current, ex- and never-smokers. Methods: The study population included 1246 people without diabetes (mean age 44 years, 55% women) from the EGIR-RISC population, a large European multicentre cohort. Insulin sensitivity was measured using a hyperinsulinaemic, euglycaemic clamp and the homeostatic model assessment - insulin resistance (HOMA-IR) index. Two β-cell function parameters were derived from measures during an oral glucose tolerance test: the early insulin response index and β-cell glucose sensitivity. Additionally, the areas under the curve during the oral glucose tolerance test were calculated for glucose, insulin and C-peptide. Results: According to smoking habits, there were differences in insulin sensitivity, which was lower in women who smoked, and in β-cell glucose sensitivity, which was lower in men who smoked, but these associations lost significance after adjustment. However, after adjustment, the areas under the glucose and the C-peptide curves during the oral glucose tolerance test were significantly higher in men who smoked. Conclusions: Smoking habits were not independently associated with insulin sensitivity or β-cell function in a healthy middle-aged European population. Health-selection bias, methodological shortcomings or a true lack of causal links between smoking and impaired insulin sensitivity/secretion are possible explanations. The mechanisms behind the observed increased glucose and C-peptide areas under the curve during the oral glucose tolerance test in male smokers need to be further evaluated.</p>},
  author       = {Gottsäter, M. and Balkau, B. and Hatunic, M. and Gabriel, R. and Anderwald, C. H. and Dekker, J. and Lalic, N. and Nilsson, P. M.},
  issn         = {0742-3071},
  language     = {eng},
  number       = {2},
  pages        = {223--228},
  publisher    = {Wiley-Blackwell},
  series       = {Diabetic Medicine},
  title        = {Insulin resistance and β-cell function in smokers : Results from the EGIR-RISC European multicentre study},
  url          = {http://dx.doi.org/10.1111/dme.13172},
  volume       = {34},
  year         = {2017},
}