Maija Feodoroff1,2,3, Valma Harjutsalo1,2,3,4, Carol Forsblom1,2,3, Lena Thorn1,2,3, Johan Wadén1,2,3, Nina Tolonen1,2,3, Raija Lithovius1,2,3, Per-Henrik Groop5,6,7,8. 1. Folkhälsan Research Center, Folkhälsan Institute of Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014, Helsinki, Finland. 2. Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. 3. Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. 4. Diabetes Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland. 5. Folkhälsan Research Center, Folkhälsan Institute of Genetics, Biomedicum Helsinki, University of Helsinki, Haartmaninkatu 8, P.O. Box 63, 00014, Helsinki, Finland. per-henrik.groop@helsinki.fi. 6. Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. per-henrik.groop@helsinki.fi. 7. Research Program Unit, Diabetes and Obesity, University of Helsinki, Helsinki, Finland. per-henrik.groop@helsinki.fi. 8. The Baker IDI Heart and Diabetes Institute, Melbourne, VIC, Australia. per-henrik.groop@helsinki.fi.
Abstract
AIMS: To evaluate the effect of cumulative smoking on the development of diabetic nephropathy. METHODS: Study included 3613 patients with type 1 diabetes, participating in the Finnish Diabetic Nephropathy Study. The 12-year cumulative risk of microalbuminuria, macroalbuminuria and end-stage renal disease (ESRD) was estimated for current, ex- and nonsmokers. Cox regression analyses, with multivariable adjustments for other risk factors for diabetic nephropathy, were used to evaluate the risk at different stages of diabetic nephropathy based on the cumulative amount of smoking in pack-years. RESULTS: The 12-year cumulative risk of microalbuminuria was 18.9 % (95 % CI 14.6-23.0, P < 0.0001) for current smokers and 15.1 % (10.3-19.6, P = 0.087) for ex-smokers, compared with 10.0 % (7.8-12.1) for nonsmokers. The corresponding risks of macroalbuminuria were 14.4 % (95 % CI 10.8-17.9, P < 0.0001), 6.1 % (3.5-8.6, P = 0.082) and 4.7 % (3.0-6.4), respectively. The 12-year cumulative risk of ESRD was 10.3 % (95 % CI 8.4-12.4, P < 0.0001) for current smokers and 10.0 % (7.9-12.3, P < 0.0001) for ex-smokers, compared with 5.6 % (4.6-6.7) for nonsmokers. In the current smokers, one pack-year increased the risk of macroalbuminuria with a HR of 1.025 (1.010-1.041) and the risk of ESRD with a HR of 1.014 (1.001-1.026) compared with nonsmokers, in the fully adjusted model. In the ex-smokers, the risk of macroalbuminuria and ESRD was no different from the risk in nonsmokers after multivariable adjustment. CONCLUSIONS: Current smoking is a risk factor for the progression of diabetic nephropathy and the risk increases with the increasing dose of smoking. Ex-smokers seem to carry a similar risk of progression of diabetic nephropathy as nonsmokers.
AIMS: To evaluate the effect of cumulative smoking on the development of diabetic nephropathy. METHODS: Study included 3613 patients with type 1 diabetes, participating in the Finnish Diabetic Nephropathy Study. The 12-year cumulative risk of microalbuminuria, macroalbuminuria and end-stage renal disease (ESRD) was estimated for current, ex- and nonsmokers. Cox regression analyses, with multivariable adjustments for other risk factors for diabetic nephropathy, were used to evaluate the risk at different stages of diabetic nephropathy based on the cumulative amount of smoking in pack-years. RESULTS: The 12-year cumulative risk of microalbuminuria was 18.9 % (95 % CI 14.6-23.0, P < 0.0001) for current smokers and 15.1 % (10.3-19.6, P = 0.087) for ex-smokers, compared with 10.0 % (7.8-12.1) for nonsmokers. The corresponding risks of macroalbuminuria were 14.4 % (95 % CI 10.8-17.9, P < 0.0001), 6.1 % (3.5-8.6, P = 0.082) and 4.7 % (3.0-6.4), respectively. The 12-year cumulative risk of ESRD was 10.3 % (95 % CI 8.4-12.4, P < 0.0001) for current smokers and 10.0 % (7.9-12.3, P < 0.0001) for ex-smokers, compared with 5.6 % (4.6-6.7) for nonsmokers. In the current smokers, one pack-year increased the risk of macroalbuminuria with a HR of 1.025 (1.010-1.041) and the risk of ESRD with a HR of 1.014 (1.001-1.026) compared with nonsmokers, in the fully adjusted model. In the ex-smokers, the risk of macroalbuminuria and ESRD was no different from the risk in nonsmokers after multivariable adjustment. CONCLUSIONS: Current smoking is a risk factor for the progression of diabetic nephropathy and the risk increases with the increasing dose of smoking. Ex-smokers seem to carry a similar risk of progression of diabetic nephropathy as nonsmokers.
Authors: Edgar A Jaimes; Ming-Sheng Zhou; Mohammed Siddiqui; Gabriel Rezonzew; Runxia Tian; Surya V Seshan; Alecia N Muwonge; Nicholas J Wong; Evren U Azeloglu; Alessia Fornoni; Sandra Merscher; Leopoldo Raij Journal: Am J Physiol Renal Physiol Date: 2021-01-18
Authors: Eunjin Lee Tracy; Cynthia A Berg; Ashley C Baker; Daniel Mello; Michelle L Litchman; Deborah J Wiebe Journal: Child Health Care Date: 2018-10-22
Authors: Niina Sandholm; Natalie Van Zuydam; Emma Ahlqvist; Thorhildur Juliusdottir; Harshal A Deshmukh; N William Rayner; Barbara Di Camillo; Carol Forsblom; Joao Fadista; Daniel Ziemek; Rany M Salem; Linda T Hiraki; Marcus Pezzolesi; David Trégouët; Emma Dahlström; Erkka Valo; Nikolay Oskolkov; Claes Ladenvall; M Loredana Marcovecchio; Jason Cooper; Francesco Sambo; Alberto Malovini; Marco Manfrini; Amy Jayne McKnight; Maria Lajer; Valma Harjutsalo; Daniel Gordin; Maija Parkkonen; Jaakko Tuomilehto; Valeriya Lyssenko; Paul M McKeigue; Stephen S Rich; Mary Julia Brosnan; Eric Fauman; Riccardo Bellazzi; Peter Rossing; Samy Hadjadj; Andrzej Krolewski; Andrew D Paterson; Jose C Florez; Joel N Hirschhorn; Alexander P Maxwell; David Dunger; Claudio Cobelli; Helen M Colhoun; Leif Groop; Mark I McCarthy; Per-Henrik Groop Journal: J Am Soc Nephrol Date: 2016-09-19 Impact factor: 10.121