Inflammatory parameters and insulin resistance and cigarette smoking in type 2 diabetes mellitus
Yusuf Kayar1, Mehmet Agin2, Nurcan Unver3
1Bezmialem Vakıf University, Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey
2Van Training and Research Hospital, Department of Pediatrics, Van, Turkey
3Bezmialem Vakıf University, Faculty of Medicine, Department of Pathology, Istanbul, Turkey
Aim: Smoking remains a global problem and it is known as a cause of many diseases. Globally, tobacco use is the most important cause of preventable morbidity and mortality. The aim of this study is to evaluate the impact of smoking on insulin parameters and inflammatory markers, and the variation of these parameters according to the duration of smoking cessation in patients who quit smoking.
Material and Methods: 612 patients aged 18-70 years (n = 612) who were undergoing treatment and follow-up for type 2 diabetes mellitus were included in this study. The patients were categorized into 3 groups (i.e., smokers, ex-smokers, and nonsmokers). Test results ofof hemoglobin A1c (HbA1c), cholesterol, triglyceride, high density lipoprotein (HDL) levels, low density lipoprotein, leukocyte count, C-reactive protein, fibrinogen, and ferritin levels were obtained. Body mass indexes (BMI) and blood pressure were also measured.
Results: Smoking was significantly associated with the male gender, HbA1c, HDL level, BMI, waist circumference, the homeostatic model assessment-insulin resistance (HOMA-IR) core, and inflammatory markers. Current smokers who smoked ≥20 packs/year demonstrated poorer metabolic results compared to those who smoked 0-10 pack(s)/year. The metabolic parameters were worse in ex-smokers who quit smoking <1 year ago compared to ex-smokers who quit 1-5 years, 5-10 years, and >10 years ago.
Conclusion: We demonstrated that smoking increased insulin resistance, metabolic syndrome, and inflammation. Smoking was also observed to worsen glycemic control by further increasing insulin resistance in diabetic patients.