Bahareh Rasouli1, Tomas Andersson2, Per-Ola Carlsson3, Valdemar Grill4, Leif Groop5, Mats Martinell6, Petter Storm5, Tiinamaija Tuomi7, Sofia Carlsson8. 1. Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden bahareh.rasouli@ki.se. 2. Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden. 3. Department of Medical Sciences, Uppsala University, Uppsala, Sweden. 4. NTNU Institute of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway Department of Endocrinology, Trondheim University Hospital, Trondheim, Norway. 5. Department of Clinical Sciences in Malmö, Clinical Research Centre, Lund University, Malmö, Sweden. 6. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. 7. Division of Endocrinology, Helsinki University Hospital; Finnish Institute for Molecular Medicine and Research Program for Diabetes and obesity, University of Helsinki; and Folkhalsan Research Center, Helsinki, Finland. 8. Epidemiology Unit, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Abstract
OBJECTIVE: Smoking is an established risk factor for type 2 diabetes. In contrast, it has been proposed that smoking may reduce the risk of latent autoimmune diabetes in adults (LADA), but studies are scarce. We aimed to study the impact of smoking on LADA and type 2 diabetes risks. RESEARCH DESIGN AND METHODS: We used data from a Swedish case-control study including incident case patients with LADA (GAD antibody [GADA] positive, n = 377) and type 2 diabetes (GADA negative, n = 1,188) and control subjects randomly selected from the population (n = 1,472). We calculated odds ratios (ORs) with 95% CIs by logistic regression, adjusted for age, sex, BMI, family history of diabetes, and alcohol consumption. RESULTS: There was no indication of reduced risk of LADA in smokers; instead, heavy smoking was associated with an increased risk of LADA (OR 1.37, 95% CI 1.02-1.84). Heavy smokers had higher levels of HOMA of insulin resistance (9.89 vs. 4.38, P = 0.0479) and HOMA of β-cell function (55.7 vs. 42.5, P = 0.0204), but lower levels of GADA (75 vs. 250, P = 0.0445), compared with never smokers. Smokers also displayed an increased risk of type 2 diabetes (OR in ever smokers 1.53, 95% CI 1.25-1.88). CONCLUSIONS: In this large population of LADA patients, we did not observe a protective effect of smoking on autoimmunity and the risk of LADA. A protective effect could possibly be masked by a smoking-induced aggravation of insulin resistance, akin to the diabetogenic effect seen in individuals with type 2 diabetes.
OBJECTIVE: Smoking is an established risk factor for type 2 diabetes. In contrast, it has been proposed that smoking may reduce the risk of latent autoimmune diabetes in adults (LADA), but studies are scarce. We aimed to study the impact of smoking on LADA and type 2 diabetes risks. RESEARCH DESIGN AND METHODS: We used data from a Swedish case-control study including incident case patients with LADA (GAD antibody [GADA] positive, n = 377) and type 2 diabetes (GADA negative, n = 1,188) and control subjects randomly selected from the population (n = 1,472). We calculated odds ratios (ORs) with 95% CIs by logistic regression, adjusted for age, sex, BMI, family history of diabetes, and alcohol consumption. RESULTS: There was no indication of reduced risk of LADA in smokers; instead, heavy smoking was associated with an increased risk of LADA (OR 1.37, 95% CI 1.02-1.84). Heavy smokers had higher levels of HOMA of insulin resistance (9.89 vs. 4.38, P = 0.0479) and HOMA of β-cell function (55.7 vs. 42.5, P = 0.0204), but lower levels of GADA (75 vs. 250, P = 0.0445), compared with never smokers. Smokers also displayed an increased risk of type 2 diabetes (OR in ever smokers 1.53, 95% CI 1.25-1.88). CONCLUSIONS: In this large population of LADA patients, we did not observe a protective effect of smoking on autoimmunity and the risk of LADA. A protective effect could possibly be masked by a smoking-induced aggravation of insulin resistance, akin to the diabetogenic effect seen in individuals with type 2 diabetes.
Authors: Rebecka Hjort; Josefin E Löfvenborg; Emma Ahlqvist; Lars Alfredsson; Tomas Andersson; Valdemar Grill; Leif Groop; Elin P Sørgjerd; Tiinamaija Tuomi; Bjørn Olav Åsvold; Sofia Carlsson Journal: J Clin Endocrinol Metab Date: 2019-10-01 Impact factor: 5.958
Authors: Jessica Edstorp; Yuxia Wei; Emma Ahlqvist; Lars Alfredsson; Valdemar Grill; Leif Groop; Bahareh Rasouli; Elin P Sørgjerd; Per M Thorsby; Tiinamaija Tuomi; Bjørn O Åsvold; Sofia Carlsson Journal: Diabetologia Date: 2022-07-28 Impact factor: 10.460