吸烟对2型糖尿病男性患者血糖控制的影响

目的：探讨吸烟对2型糖尿病男性患者空腹血糖（FBG），餐后2 h 血糖（2hPBG），糖化血红蛋白（HbA1 C）的影响。方法选取2型糖尿病男性患者142例，按吸烟情况分为不吸烟组（从不吸烟，n ＝44），戒烟组（戒烟半年以上，n ＝33），少量吸烟组（每天≤20支，n ＝33），大量吸烟组（每天＞20支，n ＝32），采用现场调查结合病例对照研究的方法，询问患者年龄、糖尿病病程、工作活动强度、吸烟、降糖药的应用等情况，测量血压、身高、体重、腰围、臀围，计算体重指数（BMI）、腰臀比（WHR）等指标，实验室检测葡萄糖（GLU）、2hPBG、HbA1 C，比较各组间血糖、糖化血红蛋白的差异；逐步回归及偏相关分析，了解吸烟对血糖控制影响的显著性及影响程度。结果（1）不吸烟组与大量吸烟组相比 FBG、2hPBG 明显降低（P ＜0．01），HbA1 C 有所降低但差异无统计学意义（P ＞0．05）；不吸烟组与戒烟组比较2hPBG 有所升高（P ＜0．05或 P ＜0．01）；（2）少量吸烟组与大量吸烟组比较 FBG、2hPBG所降低但差异无统计学意义（P ＞0．05）；吸烟组与戒烟组相比 FBG、2hPBG、HbA1 C 均增高（P ＜0．05或P ＜0．01）；（3）吸烟是 HbA1 C 的独立危险因素（P ＜0．05，β＝－0．216），FBG、2hPBG、HbA1 C 与日吸烟量、吸烟年限等无明显相关性（P ＞0．05）。结论吸烟是与年龄、BMI、工作活动强度、DM病程、用药情况等影响无关，为2型糖尿病男性患者血糖控制水平差的独立危险因素；吸烟组与戒烟组，戒烟组与不吸烟组之间血糖控制指标（FBG、2hPBG、HbA1 C）等的差异，表明大量吸烟不利于2型糖尿病男性患者血糖的控制，戒烟对2型糖尿病男性患者血糖控制有明显的积极的作用，在餐后血糖的控制上甚至优于从不吸烟患者。

Effect of smoking on the glycemic control of male patients with type 2 diabetes

Objective To explore the effect of smoking on the fasting blood glucose (FBG),2-hour postprandial blood glucose (2hPBG),hemoglobin A1C (HbA1 C)in the male type 2 diabetes.Methods Totally 142 male patients with type 2 diabetes were cho-sen and assigned into four groups,including non-smokers,former smokers,current mild(≤20 per day)smokers and heavy (>20 per day)smokers.All of them were investigated about the age,diabetes pathogenesis,exercise,smoking,antidibetics used and checked with FBG,2hPBG,HbA1 C and so on.The differences of FBG,2hPBG,HbA1 C among these four groups were compared by the methods of re-gression analysis and partial correlation to evaluate the relationships of smoking with blood glucose.Results FBG,2hPBG of non-smokers were higher than the heavy smokers and 2hPBG was higher than former smokers(P <0.05 or P <0.01 ).Compared with for-mer smokers,FBG,2hPBG,HbA1 C of current smokers were higher (P <0.05 or P <0.01).Smoking was an independent risk factor for HbA1 C(P <0.05,Β=-0.216).Conclusions Smoking,independent of age,body mass index,blood pressure,exercise,diabetes pathogenesis,and antidiabetic drugs,is an important risk factor for the diabetic male patients’control of glycemic.Smoking is harmful to the type 2 diabetics’glycemic control and smoking cessation has a significant positive effect on the control of blood sugar,especially on the control of 2hPBG.