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Table 3 Association of diabetes, elevated fasting glucose, elevated OGTT-2 h glucose, and elevated HbA1c with CVD events among current, former, and never smokers

From: Interaction between smoking and diabetes in relation to subsequent risk of cardiovascular events

Category

No. of participants

Person-years

Cases

HR (95% CI)

P for interactionc

Adjusted for CVD risk factorsa

Further adjusted for baseline BMI, and BMI change

Further adjusted for passive smokingb

Diabetes

      

0.034

Current smokers

       

 No diabetes

14,874

54,483

402

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

 Diabetes

4523

16,226

233

1.60 (1.35–1.89)

1.61 (1.36–1.91)

1.61 (1.36–1.91)

Former smokers

      

 No diabetes

4136

15,002

128

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

 Diabetes

1913

6889

112

1.67 (1.28–2.16)

1.71 (1.31–2.22)

1.70 (1.31–2.22)

Never smokers

      

 No diabetes

77,971

281,612

1604

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

 Diabetes

22,764

81,515

943

1.38 (1.27–1.50)

1.37 (1.26–1.49)

1.37 (1.26–1.49)

Elevated fasting glucose

      

0.11

 Current smokers

       

  Fasting glucose < 126 mg/dL

16,722

61,110

484

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  Fasting glucose ≥ 126 mg/dL

2653

9522

147

1.69 (1.40–2.05)

1.71 (1.41–2.07)

1.71 (1.41–2.07)

 Former smokers

      

  Fasting glucose < 126 mg/dL

4931

17,868

172

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  Fasting glucose ≥ 126 mg/dL

1110

3997

68

1.61 (1.21–2.15)

1.66 (1.24–2.22)

1.66 (1.24–2.22)

 Never smokers

      

  Fasting glucose < 126 mg/dL

89,021

321,598

2011

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  Fasting glucose ≥ 126 mg/dL

11,624

41,208

532

1.47 (1.34–1.63)

1.46 (1.33–1.61)

1.46 (1.33–1.61)

Elevated OGTT-2 h glucose

      

0.28

 Current smokers

       

  OGTT-2 h glucose < 200 mg/dL

16,273

59,462

464

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  OGTT-2 h glucose ≥ 200 mg/dL

3035

10,918

163

1.56 (1.30–1.88)

1.57 (1.31–1.90)

1.57 (1.31–1.90)

 Former smokers

      

  OGTT-2 h glucose < 200 mg/dL

4697

16,999

160

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  OGTT-2 h glucose ≥ 200 mg/dL

1282

4646

75

1.44 (1.09–1.91)

1.45 (1.10–1.93)

1.45 (1.10–1.93)

 Never smokers

      

  OGTT-2 h glucose < 200 mg/dL

85,342

307,942

1844

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  OGTT-2 h glucose ≥ 200 mg/dL

14,869

53,371

684

1.44 (1.32–1.58)

1.43 (1.31–1.57)

1.44 (1.31–1.58)

Elevated HbA1c

      

0.011

 Current smokers

       

  HbA1c < 6.5%

16,402

59,910

467

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  HbA1c ≥ 6.5%

2955

10,652

167

1.69 (1.41–2.04)

1.72 (1.42–2.07)

1.72 (1.43–2.07)

 Former smokers

      

  HbA1c < 6.5%

4800

17,404

159

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  HbA1c ≥ 6.5%

1237

4446

78

1.77 (1.34–2.34)

1.83 (1.38–2.43)

1.83 (1.38–2.43)

 Never smokers

      

  HbA1c < 6.5%

85,759

309,451

1899

1.00 [Ref.]

1.00 [Ref.]

1.00 [Ref.]

  HbA1c ≥ 6.5%

14,849

53,219

643

1.39 (1.27–1.52)

1.38 (1.25–1.51)

1.37 (1.25–1.51)

  1. 126,181 participants were included in the analysis. The numbers of missing values are 120 for fasting glucose, 683 for OGTT-2 h glucose, and 179 for HbA1c
  2. aAdjusted for age, sex, education attainment (less than high school, high school or further education), family history of diabetes (yes, no), family history of CVD (yes, no), fruits and vegetables intake (< 4.5 cup/day, ≥ 4.5 cup/day), physical activity (active, insufficiently active, inactive), alcohol consumption, hypertension (yes, no), and dyslipidemia (yes, no)
  3. bAdjusted for CVD risk factors as listed above, as well as baseline BMI, BMI change during follow-up, and passive smoking exposure in childhood and adulthood
  4. cInteractions of diabetes, elevated fasting glucose, elevated OGTT-2 h glucose, and elevated HbA1c with smoking status in relation to CVD events were adjusted for CVD risk factors as listed above, as well as baseline BMI, BMI change during follow-up, and passive smoking exposure in childhood and adulthood
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Cardiovascular Diabetology

ISSN: 1475-2840