Association of smoking and cardiometabolic parameters with albuminuria in people with type 2 diabetes mellitus

a systematic review and meta-analysis

Debasish Kar (Corresponding Author), Clare Gillies, Mintu Nath, Kamlesh Khunti, Melanie J Davies, Samuel Seidu

Research output: Contribution to journalReview article

3 Citations (Scopus)

Abstract

AIMS: Smoking is a strong risk factor for albuminuria in people with type 2 diabetes mellitus (T2DM). However, it is unclear whether this sequela of smoking is brought about by its action on cardiometabolic parameters or the relationship is independent. The aim of this systematic review is to explore this relationship.

METHODS: Electronic databases on cross-sectional and prospective studies in Medline and Embase were searched from January 1946 to May 2018. Adult smokers with T2DM were included, and other types of diabetes were excluded.

RESULTS: A random effects meta-analysis of 20,056 participants from 13 studies found that the odds ratio (OR) of smokers developing albuminuria compared to non-smokers was 2.13 (95% CI 1.32, 3.45). Apart from smoking, the odds ratio of other risk factors associated with albuminuria were: age 1.24 (95% CI 0.84, 1.64), male sex 1.39 (95% CI 1.16, 1.67), duration of diabetes 1.78 (95% CI 1.32, 2.23), HbA1c 0.63 (95% CI 0.45, 0.81), SBP 6.03 (95% CI 4.10, 7.97), DBP 1.85 (95% CI 1.08, 2.62), total cholesterol 0.06 (95% CI - 0.05, 0.17) and HDL cholesterol - 0.01 (95% CI - 0.04, 0.02), triglyceride 0.22 (95% CI 0.12, 0.33) and BMI 0.40 (95% CI 0.00-0.80). When the smoking status was adjusted in a mixed effect meta-regression model, the duration of diabetes was the only statistically significant factor that influenced the prevalence of albuminuria. In smokers, each year's increase in the duration of T2DM was associated with an increased risk of albuminuria of 0.19 units (95% CI 0.07, 0.31) on the log odds scale or increased the odds approximately by 23%, compared to non-smokers. Prediction from the meta-regression model also suggested that the odds ratios of albuminuria in smokers after a diabetes duration of 9 years and 16 years were 1.53 (95% CI 1.10, 2.13) and 5.94 (95% CI 2.53, 13.95), respectively.

CONCLUSIONS: Continuing to smoke and the duration of diabetes are two strong predictors of albuminuria in smokers with T2DM. With a global surge in younger smokers developing T2DM, smoking cessation interventions at an early stage of disease trajectory should be promoted.

Original languageEnglish
Pages (from-to)839-850
Number of pages12
JournalActa Diabetologica
Volume56
Issue number8
Early online date24 Feb 2019
DOIs
Publication statusPublished - Aug 2019

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Albuminuria
Type 2 Diabetes Mellitus
Meta-Analysis
Smoking
Odds Ratio
Smoking Cessation
Smoke
HDL Cholesterol
Triglycerides
Cross-Sectional Studies
Cholesterol
Databases
Prospective Studies

Keywords

  • Type 2 diabetes mellitus
  • Albuminuria
  • smoking
  • Albuminuria/epidemiology
  • Humans
  • Middle Aged
  • Male
  • Cardiovascular Diseases/blood
  • Diabetes Mellitus, Type 2/complications
  • Smoking/epidemiology
  • Cholesterol, HDL/blood
  • Triglycerides/blood
  • Adult
  • Female

Cite this

Association of smoking and cardiometabolic parameters with albuminuria in people with type 2 diabetes mellitus : a systematic review and meta-analysis. / Kar, Debasish (Corresponding Author); Gillies, Clare; Nath, Mintu; Khunti, Kamlesh; Davies, Melanie J; Seidu, Samuel.

In: Acta Diabetologica, Vol. 56, No. 8, 08.2019, p. 839-850.

Research output: Contribution to journalReview article

Kar, Debasish ; Gillies, Clare ; Nath, Mintu ; Khunti, Kamlesh ; Davies, Melanie J ; Seidu, Samuel. / Association of smoking and cardiometabolic parameters with albuminuria in people with type 2 diabetes mellitus : a systematic review and meta-analysis. In: Acta Diabetologica. 2019 ; Vol. 56, No. 8. pp. 839-850.
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title = "Association of smoking and cardiometabolic parameters with albuminuria in people with type 2 diabetes mellitus: a systematic review and meta-analysis",
abstract = "AIMS: Smoking is a strong risk factor for albuminuria in people with type 2 diabetes mellitus (T2DM). However, it is unclear whether this sequela of smoking is brought about by its action on cardiometabolic parameters or the relationship is independent. The aim of this systematic review is to explore this relationship.METHODS: Electronic databases on cross-sectional and prospective studies in Medline and Embase were searched from January 1946 to May 2018. Adult smokers with T2DM were included, and other types of diabetes were excluded.RESULTS: A random effects meta-analysis of 20,056 participants from 13 studies found that the odds ratio (OR) of smokers developing albuminuria compared to non-smokers was 2.13 (95{\%} CI 1.32, 3.45). Apart from smoking, the odds ratio of other risk factors associated with albuminuria were: age 1.24 (95{\%} CI 0.84, 1.64), male sex 1.39 (95{\%} CI 1.16, 1.67), duration of diabetes 1.78 (95{\%} CI 1.32, 2.23), HbA1c 0.63 (95{\%} CI 0.45, 0.81), SBP 6.03 (95{\%} CI 4.10, 7.97), DBP 1.85 (95{\%} CI 1.08, 2.62), total cholesterol 0.06 (95{\%} CI - 0.05, 0.17) and HDL cholesterol - 0.01 (95{\%} CI - 0.04, 0.02), triglyceride 0.22 (95{\%} CI 0.12, 0.33) and BMI 0.40 (95{\%} CI 0.00-0.80). When the smoking status was adjusted in a mixed effect meta-regression model, the duration of diabetes was the only statistically significant factor that influenced the prevalence of albuminuria. In smokers, each year's increase in the duration of T2DM was associated with an increased risk of albuminuria of 0.19 units (95{\%} CI 0.07, 0.31) on the log odds scale or increased the odds approximately by 23{\%}, compared to non-smokers. Prediction from the meta-regression model also suggested that the odds ratios of albuminuria in smokers after a diabetes duration of 9 years and 16 years were 1.53 (95{\%} CI 1.10, 2.13) and 5.94 (95{\%} CI 2.53, 13.95), respectively.CONCLUSIONS: Continuing to smoke and the duration of diabetes are two strong predictors of albuminuria in smokers with T2DM. With a global surge in younger smokers developing T2DM, smoking cessation interventions at an early stage of disease trajectory should be promoted.",
keywords = "Type 2 diabetes mellitus, Albuminuria, smoking, Albuminuria/epidemiology, Humans, Middle Aged, Male, Cardiovascular Diseases/blood, Diabetes Mellitus, Type 2/complications, Smoking/epidemiology, Cholesterol, HDL/blood, Triglycerides/blood, Adult, Female",
author = "Debasish Kar and Clare Gillies and Mintu Nath and Kamlesh Khunti and Davies, {Melanie J} and Samuel Seidu",
note = "This research was partially funded by the East Midlands Collaboration for Leadership in Applied Health Research and Care (Project 17).",
year = "2019",
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doi = "10.1007/s00592-019-01293-x",
language = "English",
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pages = "839--850",
journal = "Acta Diabetologica",
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TY - JOUR

T1 - Association of smoking and cardiometabolic parameters with albuminuria in people with type 2 diabetes mellitus

T2 - a systematic review and meta-analysis

AU - Kar, Debasish

AU - Gillies, Clare

AU - Nath, Mintu

AU - Khunti, Kamlesh

AU - Davies, Melanie J

AU - Seidu, Samuel

N1 - This research was partially funded by the East Midlands Collaboration for Leadership in Applied Health Research and Care (Project 17).

PY - 2019/8

Y1 - 2019/8

N2 - AIMS: Smoking is a strong risk factor for albuminuria in people with type 2 diabetes mellitus (T2DM). However, it is unclear whether this sequela of smoking is brought about by its action on cardiometabolic parameters or the relationship is independent. The aim of this systematic review is to explore this relationship.METHODS: Electronic databases on cross-sectional and prospective studies in Medline and Embase were searched from January 1946 to May 2018. Adult smokers with T2DM were included, and other types of diabetes were excluded.RESULTS: A random effects meta-analysis of 20,056 participants from 13 studies found that the odds ratio (OR) of smokers developing albuminuria compared to non-smokers was 2.13 (95% CI 1.32, 3.45). Apart from smoking, the odds ratio of other risk factors associated with albuminuria were: age 1.24 (95% CI 0.84, 1.64), male sex 1.39 (95% CI 1.16, 1.67), duration of diabetes 1.78 (95% CI 1.32, 2.23), HbA1c 0.63 (95% CI 0.45, 0.81), SBP 6.03 (95% CI 4.10, 7.97), DBP 1.85 (95% CI 1.08, 2.62), total cholesterol 0.06 (95% CI - 0.05, 0.17) and HDL cholesterol - 0.01 (95% CI - 0.04, 0.02), triglyceride 0.22 (95% CI 0.12, 0.33) and BMI 0.40 (95% CI 0.00-0.80). When the smoking status was adjusted in a mixed effect meta-regression model, the duration of diabetes was the only statistically significant factor that influenced the prevalence of albuminuria. In smokers, each year's increase in the duration of T2DM was associated with an increased risk of albuminuria of 0.19 units (95% CI 0.07, 0.31) on the log odds scale or increased the odds approximately by 23%, compared to non-smokers. Prediction from the meta-regression model also suggested that the odds ratios of albuminuria in smokers after a diabetes duration of 9 years and 16 years were 1.53 (95% CI 1.10, 2.13) and 5.94 (95% CI 2.53, 13.95), respectively.CONCLUSIONS: Continuing to smoke and the duration of diabetes are two strong predictors of albuminuria in smokers with T2DM. With a global surge in younger smokers developing T2DM, smoking cessation interventions at an early stage of disease trajectory should be promoted.

AB - AIMS: Smoking is a strong risk factor for albuminuria in people with type 2 diabetes mellitus (T2DM). However, it is unclear whether this sequela of smoking is brought about by its action on cardiometabolic parameters or the relationship is independent. The aim of this systematic review is to explore this relationship.METHODS: Electronic databases on cross-sectional and prospective studies in Medline and Embase were searched from January 1946 to May 2018. Adult smokers with T2DM were included, and other types of diabetes were excluded.RESULTS: A random effects meta-analysis of 20,056 participants from 13 studies found that the odds ratio (OR) of smokers developing albuminuria compared to non-smokers was 2.13 (95% CI 1.32, 3.45). Apart from smoking, the odds ratio of other risk factors associated with albuminuria were: age 1.24 (95% CI 0.84, 1.64), male sex 1.39 (95% CI 1.16, 1.67), duration of diabetes 1.78 (95% CI 1.32, 2.23), HbA1c 0.63 (95% CI 0.45, 0.81), SBP 6.03 (95% CI 4.10, 7.97), DBP 1.85 (95% CI 1.08, 2.62), total cholesterol 0.06 (95% CI - 0.05, 0.17) and HDL cholesterol - 0.01 (95% CI - 0.04, 0.02), triglyceride 0.22 (95% CI 0.12, 0.33) and BMI 0.40 (95% CI 0.00-0.80). When the smoking status was adjusted in a mixed effect meta-regression model, the duration of diabetes was the only statistically significant factor that influenced the prevalence of albuminuria. In smokers, each year's increase in the duration of T2DM was associated with an increased risk of albuminuria of 0.19 units (95% CI 0.07, 0.31) on the log odds scale or increased the odds approximately by 23%, compared to non-smokers. Prediction from the meta-regression model also suggested that the odds ratios of albuminuria in smokers after a diabetes duration of 9 years and 16 years were 1.53 (95% CI 1.10, 2.13) and 5.94 (95% CI 2.53, 13.95), respectively.CONCLUSIONS: Continuing to smoke and the duration of diabetes are two strong predictors of albuminuria in smokers with T2DM. With a global surge in younger smokers developing T2DM, smoking cessation interventions at an early stage of disease trajectory should be promoted.

KW - Type 2 diabetes mellitus

KW - Albuminuria

KW - smoking

KW - Albuminuria/epidemiology

KW - Humans

KW - Middle Aged

KW - Male

KW - Cardiovascular Diseases/blood

KW - Diabetes Mellitus, Type 2/complications

KW - Smoking/epidemiology

KW - Cholesterol, HDL/blood

KW - Triglycerides/blood

KW - Adult

KW - Female

UR - http://www.mendeley.com/research/association-smoking-cardiometabolic-parameters-albuminuria-people-type-2-diabetes-mellitus-systemati

U2 - 10.1007/s00592-019-01293-x

DO - 10.1007/s00592-019-01293-x

M3 - Review article

VL - 56

SP - 839

EP - 850

JO - Acta Diabetologica

JF - Acta Diabetologica

SN - 0940-5429

IS - 8

ER -