Effects of smoking and its cessation on creatinine- and cystatin C-based estimated glomerular filtration rates and albuminuria in male patients with type 2 diabetes mellitus: the Fukuoka Diabetes Registry

Abstract

Cigarette smoking is an important modifiable risk factor for lifestyle diseases. The smoking rate remains high, and the prevalence of diabetes mellitus is increasing in Asian countries; however, few studies have examined the effects of smoking on chronic kidney disease (CKD) in Asian diabetic patients. The aim of the present study was to investigate the association between smoking and its cessation with CKD and its components in patients with type 2 diabetes. A total of 2770 Japanese male patients with type 2 diabetes aged ⩾20 years were divided according to the amount of cigarette smoking and the years since cessation. The associations with CKD, the urinary albumin-creatinine ratio (UACR) and the estimated glomerular filtration rate (eGFR) were cross-sectionally examined. The proportions of CKD and the mean UACR dose-dependently increased with increases in both the number of cigarettes per day and the Brinkman index compared with the never smokers. The creatinine-based eGFR also increased with increases in the amount of smoking, whereas the cystatin C-based eGFR decreased, and their average did not significantly change. These parameters exhibited inverse associations with the years after smoking cessation compared with the association with the amount of smoking. A dose-dependent association of active smoking and a graded inverse association of the years since quitting with CKD enhance the merit of smoking cessation in patients with type 2 diabetes.

Association of Serum PSP/REG Iαwith Renal Function in Type 2 Diabetes Mellitus

“…Researchers have reported that cigarette smoking has been identified as a modifiable risk factor for diseases because of its contrary effects. The amount of smoking and smoking habit may also have effects on the results; this is called a dose-response relationship [30]. In general conditions, T2DM patients with renal impairment could realize the damage caused by cigarettes.…”

Interactions between genetic polymorphisms of glucose metabolizing genes and smoking and alcohol consumption in the risk of type 2 diabetes mellitus

“…Both smoking and alcohol can induce an increased risk of cardiovascular disease, which is an established independent risk for insulin resistance and T2DM (Briasoulis et al 2012;Cosselman et al 2015;Mostofsky et al 2016;Pan et al 2015). Furthermore, it has been reported that cigarette smoking (Briasoulis et al 2012;Cosselman et al 2015;Mostofsky et al 2016;Pan et al 2015) (Akter et al 2015;Mostofsky et al 2016).…”

Increased Microalbuminuria Risk in Male Cigarette Smokers: Results from the “Olivetti Heart Study” after 8 Years Follow-Up

“…However, albuminuria is also a risk factor for CVD in people with and without diabetes [15]. Among possible mechanisms, an early smoking-associated glomerular hyperfiltration [8], due to alterations in kidney hemodynamics, blood pressure and impairment of kidney microvasculature [16], associated to a subsequently renal dysfunction was hypothesized.…”

“…Recently, Ohkuma et al demonstrated a dose and time dependent relation between cigarette smoking and increase of chronic kidney disease (CKD) incidence and urinary albumin–creatinine ratio, in patients with type 2 diabetes [8]. …”