吸烟与糖尿病081125.ppt

吸烟与糖尿病 浙医二院 任跃忠 主 要 内 容 糖尿病、吸烟的概况 吸烟(戒烟)与2型糖尿病发病、糖代谢 2型糖尿病的严重并发症 吸烟的概况 众所周知，吸烟会增加患肺癌、心脏病及脑卒中等疾病的危险，还会增加糖尿病的发病危险。 吸烟是可预防的致命原因中的头号杀手，每年会导致约400万人死亡，相当于全球总死亡人数的8.8％ 。预计2025 年高达1000万人/年死于与吸烟有关的疾病。 香烟中约有4000种化台物．其中气相有害物质主要有CO、醛娄、氮氧化物、氰化物等．粒子相中有害物质有尼古丁、焦油等。 主 要 内 容 糖尿病、吸烟的概况 吸烟(戒烟)与2型糖尿病发病、糖代谢 主要讨论内容 吸烟与2型糖尿病发病的流行病学证据 吸烟对2型糖尿病糖代谢的影响 吸烟对女性其他内分泌腺功能的影响 戒烟对糖尿病预后的影响 瑞士洛桑大学的研究人员分析了25份医学报告，这些报告在1992—2006年间发表，它们的时间跨度长达30年，接受调查的人数多达120万。 瑞士研究人员研究发现，与从不吸烟者相比，吸烟者患2型糖尿病的危险要高44％。 他们发现，重度吸烟者患糖尿病的危险会更高，1天至少吸20支烟的人，患糖尿病的危险高达6l％。 Active Smoking and the Risk of Type 2 Diabetes A Systematic Review and Meta-analysis Objective To conduct a systematic review with meta-analysis of studies assessing the association between active smoking and incidence of type 2 diabetes. Data Sources A search of MEDLINE (1966 to May 2007) and EMBASE (1980 to May 2007) databases was supplemented by manual searches of bibliographies of key retrieved articles。 Active Smoking and the Risk of Type 2 Diabetes A Systematic Review and Meta-analysis Results The search yielded 25 prospective cohort studies (N=1.2 million participants) that reported 45 844 incident cases of diabetes during a study follow-up period ranging from 5 to 30 years. （1）The pooled adjusted RR was 1.44 (95% confidence interval [CI], 1.31-1.58). Results were consistent and statistically significant in all subgroups. Active Smoking and the Risk of Type 2 Diabetes A Systematic Review and Meta-analysis （2）The risk of diabetes was greater for heavy smokers (20 cigarettes/day; RR, 1.61; 95% CI, 1.43-1.80) than for lighter smokers (RR,1.29; 95% CI, 1.13-1.48) and lower for former smokers (RR, 1.23; 95% CI, 1.14-1.33) compared with active smokers, consistent with a dose-response phenomenon. Conclusion Active smoking is associated with an increased risk of type 2 diabetes.Future research should attempt to establish whether this association is causal and to clarify its mechanisms. 2型糖尿病与吸烟 2 型糖尿病与吸烟 。 主要讨论内容 吸烟与2型糖尿病发病的流行