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A meta-analysis of passive smoking and risk of developing Type 2 Diabetes Mellitus

https://doi.org/10.1016/j.diabres.2014.09.019Get rights and content

Abstract

Aims

To assess passive smoking as a risk factor for developing type 2 Diabetes Mellitus (T2DM).

Methods

A search of PubMed, Web of Knowledge, Elsevier ScienceDirect and Springer (up to March, 2014) databases were performed using subject and random words. Two authors independently extracted the data. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. The odds ratio (ORs) for the association was determined using a fix-effects model. Subgroup and sensitivity analyses were performed and publication bias was assessed.

Result

7 prospective studies were included in this meta-analysis which included a total of 162,001 subjects. The overall OR for developing T2DM for passive smoking was 1.33 (95% confidence interval (CI) 1.20–1.46), with no significant heterogeneity between studies. The result was stable in the subgroup and sensitivity analyses, however there was evidence of publication bias. After the “fill and trim” method, the recalculated OR was 1.27 (95%CI 1.16–1.40).

Conclusions

Passive smoking is a risk factor of T2DM even in those who were not themselves active smokers.

Introduction

Smoking is a risk factor for many diseases and is one of the leading causes of avoidable death globally [1]. Exposure to secondhand smoke is common in many countries but the magnitude of the problem worldwide is poorly described [2]. Type 2 Diabetes Mellitus (T2DM) is a serious condition associated with many complications. A number of studies have reported a positive association between active smoking and T2DM and it was widely accepted that cigarette smoking is an independent and modifiable risk factor for T2DM [3], [4]. As smoking increased, the rate of diabetes increased for both middle-aged and elderly men and women [5], [6]. Some studies on the association between passive smoking and risk of T2DM have reported different results. Recently, a meta-analysis by Wang et al. [7] concluded that passive smoking was associated with a significantly increased risk of type 2 diabetes. We performed this study to further investigate a possible association of passive smoking as a risk factor for developing T2DM.

Section snippets

Data searches

PubMed, Web of Knowledge, Elsevier ScienceDirect and Springer databases were searched for related literature up to March 2014. Firstly the paper was chosen if it was related to association between passive smoking and T2DM by using searching words (subject word and random word) for search method.

The searching words were (type 2 Diabetes Mellitus OR T2DM OR type 2 diabetes OR non-insulin dependent diabetes OR hyperglycemia OR glucose metabolism disorders OR metabolic syndrome OR impaired fasting

Literature search

The result of study search was showed in Fig. 1. We initially identified 842 papers and removed 110 duplicate papers. After examining titles and abstracts of the 732 papers, 40 potentially relevant papers were selected. The reasons for removing the other 692 papers included that the outcome was not about T2DM. Finally seven studies [4], [9], [10], [11], [12], [13], [14] were elected for the meta-analysis because others did not express results with OR (HR, RR) and 95% CI.

Study characteristics

The main characteristics

Discussion

There are more than 7000 chemical components in tobacco smoke, hundreds of which are harmful to health. Smoking is prevalent all over the world and an estimated 6 million people die of smoking and environmental tobacco exposure every year [15]. In addition there is no safety level of tobacco exposure. Therefore, banning cigarette smoking in public places is one strategy for avoiding exposure to secondhand smoking. In Europe, Australia and New Zealand, much progress is being made in prohibiting

Conflict of interest

The authors declare that they have no conflict of interest.

References (17)

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