Cigarette Smoking Is Associated With Low Glomerular Filtration Rate in Male Patients With Type 2 Diabetes
- Salvatore De Cosmo, MD1,
- Olga Lamacchia, MD2,
- Anna Rauseo, MD1,
- Raffaella Viti, MD1,
- Loreto Gesualdo, MD3,
- Alessandra Pilotti, MD2,
- Vincenzo Trischitta, MD14 and
- Mauro Cignarelli, MD2
- 1Unit of Endocrinology, Scientific Institute “Casa Sollievo della Sofferenza” San Giovanni Rotondo, Foggia, Italy
- 2Unit of Endocrinology and Metabolic Diseases, Department of Medical Sciences, University of Foggia, Italy
- 3Unit of Nephrology, Department of Molecular Medicine, University of Foggia, Italy
- 4Department of Clinical Sciences, University “ La Sapienza,“ Rome, Italy
- Address correspondence and reprint requests to Mauro Cignarelli, MD, Unit of Endocrinology and Metabolic Diseases, Department of Medical Sciences, University of Foggia, via Luigi Pinto, 71100 Foggia, Italy. E-mail: m.cignarelli{at}unifg.it
Abstract
OBJECTIVE—The relationship between cigarette smoking and renal dysfunction in diabetes has predominantly been documented in patients with type 1 diabetes. The aim of the present study was to explore the relationship between cigarette smoking and glomerular filtration rate (GFR) in a large cross-sectional study carried out in male subjects with type 2 diabetes. The role of metabolic syndrome in modulating this relationship was also investigated.
RESEARCH DESIGN AND METHODS—One hundred fifty-eight current smokers and 158 never smokers with type 2 diabetes were consecutively recruited. Low GFR was defined as GFR <60 ml/min per 1.73 m2.
RESULTS—The proportion of patients affected by low GFR was significantly higher in current smokers (20.9 vs. 12.0%, P = 0.03). The adjusted risk (odds ratio [OR]) of low GFR in current smokers was 2.20 (95% CI 1.14–4.26, P = 0.02) and markedly higher in patients from the first tertile of disease duration (4.27 [1.26–14.40], P = 0.02). When metabolic syndrome was added to the statistical model exploring the relationship between smoking and low GFR, the risk of low GFR showed a small change, although it did not become any more significant (1.84 [0.98–3.45], P = 0.06). Current smokers showed even higher free oxygen radical test unit values (560.0 ± 91.5 vs. 442.7 ± 87.2, P < 0.0001).
CONCLUSIONS—In a large population of male patients with type 2 diabetes, the risk of low GFR is markedly enhanced by smoking and is at least partially mediated by metabolic syndrome.
- ACR, albumin-to-creatinine ratio
- e-GFR, estimated glomerular filtration rate
- FORT, free oxygen radical test
- GFR, glomerular filtration rate
Footnotes
-
S.D.C. and O.L. contributed equally to this work.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
-
- Accepted July 20, 2006.
- Received May 8, 2006.
- DIABETES CARE
