Skip to main content
Top

12-09-2018 | Retinopathy | Article

The association of smoking and risk of diabetic retinopathy in patients with type 1 and type 2 diabetes: a meta-analysis

Journal: Endocrine

Authors: Xiaoling Cai, Yifei Chen, Wenjia Yang, Xueying Gao, Xueyao Han, Linong Ji

Publisher: Springer US

Abstract

Purpose

To clarify the relevance between smoking and diabetic retinopathy in patients with type 1 and type 2 diabetes mellitus.

Methods

Published evidence were searched in MEDLINE and EMBASE from the databases began until Feb. 2017. Studies evaluating the association between smoking and diabetic retinopathy or evaluating the risk factors of diabetic retinopathy including smoking were included.

Results

Totally 73 studies were identified, among which 19 studies included type 1 diabetes patients and 56 studies included type 2 diabetes patients. In type 1 diabetes, compare with non-smokers, the risk of diabetic retinopathy significantly increased in smokers (risk ratio (RR) = 1.23, 95% CI 1.14, 1.33, P < 0.001), and the risk of proliferative diabetic retinopathy also significantly increased in smokers (RR = 1.48, 95% CI 1.20, 1.81, P < 0.001). In type 2 diabetes, compare with non-smokers, the risk of diabetic retinopathy significantly decreased in smokers (RR = 0.92, 95% CI 0.86, 0.98, P = 0.02) and the risk of proliferative diabetic retinopathy also significantly decreased in smokers (RR = 0.68, 95% CI 0.61, 0.74, P < 0.001).

Conclusions

Compare with non-smokers, the risk of diabetic retinopathy significantly increased in smokers with type 1 diabetes while significantly decreased in smokers with type 2 diabetes. However, this result did not change the importance of smoking cessation for public health.
Literature
1.
American Diabetes, A., Microvascular complications and foot care: standards of medical care in diabetes-2018. Diabetes Care 41(Suppl 1), S105–S118 (2018).
2.
R. Klein, Hyperglycemia and microvascular and macrovascular disease in diabetes. Diabetes Care 18(2), 258–268 (1995)CrossRef
3.
R.O. Estacio, E. McFarling, S. Biggerstaff, B.W. Jeffers, D. Johnson, R.W. Schrier, Overt albuminuria predicts diabetic retinopathy in Hispanics with NIDDM. Am. J. Kidney Dis. 31(6), 947–953 (1998)CrossRef
4.
M.C. Leske, S.Y. Wu, A. Hennis, Hyman. B, Nemesure. L, Yang. A.P, Schachat; Barbados Eye Study, G., Hyperglycemia, blood pressure, and the 9-year incidence of diabetic retinopathy: the Barbados Eye Studies. Ophthalmology 112(5), 799–805 (2005).CrossRef
5.
E.Y. Chew, M.D. Davis, R.P. Danis, J.F. Lovato, L.H. Perdue, C. Greven, S. Genuth, D.C. Goff, L.A. Leiter, F. Ismail-Beigi, W.T. Ambrosius, Action to Control Cardiovascular Risk in Diabetes Eye Study Research, G., The effects of medical management on the progression of diabetic retinopathy in persons with type 2 diabetes: the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study. Ophthalmology 121(12), 2443–2451 (2014).CrossRef
6.
I.M. Stratton, E.M. Kohner, S.J. Aldington, R.C. Turner, R.R. Holman, S.E. Manley, D.R. Matthews, UKPDS 50:risk factors for incidence and progression of retinopathy in Type II diabetes over 6 years from diagnosis. Diabetologia 44(2), 156–163 (2001).CrossRef
7.
W. Zhu, Y.F. Meng, Y. Wu, M. Xu, J. Lu, Association of alcohol intake with risk of diabetic retinopathy: a metaanalysis of observational studies. Sci. Rep 7(1), 4 (2017).CrossRef
8.
F. Costa, R. Soares, Nicotine: a pro-angiogenic factor. Life Sci 84(23-24), 785–790 (2009).CrossRef
9.
P.B. Morgado, H.C. Chen, V. Patel, L. Herbert, E.M. Kohner, The acute effect of smoking on retinal blood flow in subjects with and without diabetes. Ophthalmology 101(7), 1220–1226 (1994)CrossRef
10.
I.D. Nicholl, R. Bucala, Advanced glycation endproducts and cigarette smoking. Cell Mol. Biol. 44(7), 1025–1033 (1998)PubMed
11.
M.E. Paetkau, T.A. Boyd, B. Winship, M. Grace, Cigarette smoking and diabetic retinopathy. Diabetes 26(1), 46–49 (1977)CrossRef
12.
I. Muhlhauser, P. Sawicki, M. Berger, Cigarette-smoking as a risk factor for macroproteinuria and proliferative retinopathy in type 1 (insulin-dependent) diabetes. Diabetologia 29(8), 500–502 (1986)CrossRef
13.
L.A. Kingsley, J.S. Dorman, B.H. Doft, T.J. Orchard, R.E. LaPorte, L.H. Kuller, A.L. Drash, An epidemiologic approach to the study of retinopathy: the Pittsburgh diabetic morbidity and retinopathy studies. Diabetes Res. Clin. Pract. 4(2), 99–109 (1988)CrossRef
14.
M.C. Schumacher, K.R. Smith, Diabetes in Utah among adults: interaction between diabetes and other risk factors for microvascular and macrovascular complications. Am. J. Public Health 78(9), 1195–1201 (1988)CrossRef
15.
K.M. West, L.S. Erdreich, J.A. Stober, Absence of a relationship between smoking and diabetic microangiopathy. Diabetes Care 3(2), 250–252 (1980)CrossRef
16.
A.H. Barnett, J.R. Britton, B.A. Leatherdale, Study of possible risk factors for severe retinopathy in non-insulin dependent diabetes. Br. Med. J. 287(6391), 529 (1983)CrossRef
17.
L. Yanko, U. Goldbourt, I.C. Michaelson, A. Shapiro, S. Yaari, Prevalence and 15-year incidence of retinopathy and associated characteristics in middle-aged and elderly diabetic men. Br. J. Ophthalmol. 67(11), 759–765 (1983)CrossRef
18.
S. Telmer, J.S. Christiansen, A.R. Andersen, J. Nerup, T. Deckert, Smoking habits and prevalence of clinical diabetic microangiopathy in insulin-dependent diabetics. Acta Med. Scand. 215(1), 63–68 (1984)CrossRef
19.
L.I. Rand, A.S. Krolewski, L.M. Aiello, J.H. Warram, R.S. Baker, T. Maki, Multiple factors in the prediction ofrisk of proliferative diabetic retinopathy. N. Engl. J. Med 313(23), 1433–1438 (1985).CrossRef
20.
D.J. Ballard, L.J. Melton 3rd, M.S. Dwyer, J.C. Trautmann, C.P. Chu, W.M. O’Fallon, P.J. Palumbo, Risk factors for diabetic retinopathy: a population-based study in Rochester, Minnesota. Diabetes Care 9(4), 334–342 (1986)CrossRef
21.
S.E. Moss, R. Klein, B.E. Klein, Association of cigarette smoking with diabetic retinopathy. Diabetes Care 14(2), 119–126 (1991)CrossRef
22.
G. Marshall, S.K. Garg, W.E. Jackson, D.L. Holmes, H.P. Chase, Factors influencing the onset and progression of diabetic retinopathy in subjects with insulin-dependent diabetes mellitus. Ophthalmology 100(8), 1133–1139 (1993)CrossRef
23.
J.M. Sparrow, B.K. McLeod, T.D. Smith, M.K. Birch, A.R. Rosenthal, The prevalence of diabetic retinopathy and maculopathy and their risk factors in the non-insulin-treated diabetic patients of an English town. Eye 7(Pt 1), 158–163 (1993).CrossRef
24.
M.S. Chen, C.S. Kao, C.J. Chang, T.J. Wu, C.C. Fu, C.J. Chen, T.Y. Tai, Prevalence and risk factors of diabetic retinopathy among noninsulin-dependent diabetic subjects. Am. J. Ophthalmol. 114(6), 723–730 (1992)CrossRef
25.
S.E. Moss, R. Klein, B.E. Klein, Cigarette smoking and ten-year progression of diabetic retinopathy. Ophthalmology 103(9), 1438–1442 (1996)CrossRef
26.
Callaghan, B. C., Little, A. A., Feldman, E. L., Hughes, R. A., Enhanced glucose control for preventing and treating diabetic neuropathy. Cochrane Database Syst. Rev. 6, CD007543 (2012).
27.
X. Zeng, Y. Zhang, J.S. Kwong, C. Zhang, S. Li, F. Sun, Y. Niu, L. Du, The methodological quality assessmenttools for preclinical and clinical studies, systematic review and meta-analysis, and clinical practice guideline: asystematic review. J. Evid. Based Med 8(1), 2–10 (2015).CrossRef
28.
G. Wells, The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://​www.​ohri.​ca/​programs/​clinical_​epidemiology/​oxford.​asp (2011).
29.
J.P.Higgins, D.G. Altman, P.C. Gotzsche, P. Juni, D. Moher, A.D. Oxman, J. Savovic, K.F. Schulz, L. Weeks, J.A. Sterne, G. Cochrane Bias Methods; Cochrane Statistical Methods, G., The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ 343, d5928 (2011).CrossRef
30.
D.F. Stroup, J.A. Berlin, S.C. Morton, I. Olkin, G.D. Williamson, D. Rennie, D. Moher, B.J. Becker, T.A. Sipe, S.B. Thacker, Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in Epidemiology (MOOSE) group. JAMA 283(15), 2008–2012 (2000)CrossRef
31.
I. Muhlhauser, R. Bender, U. Bott, V. Jorgens, M. Grusser, W. Wagener, H. Overmann, M. Berger, Cigarette smoking and progression of retinopathy and nephropathy in type 1 diabetes. Diabet. Med 13(6), 536–543 (1996).CrossRef
32.
B. Karamanos, M. Porta, M. Songini, Z. Metelko, Z. Kerenyi, G. Tamas, R. Rottiers, L.K. Stevens, J.H. Fuller, Different risk factors of microangiopathy in patients with type I diabetes mellitus of short versus long duration. The EURODIAB IDDM Complications Study. Diabetologia 43(3), 348–355 (2000)CrossRef
33.
N. Chaturvedi, J.M. Stephenson, J.H. Fuller, The relationship between smoking and microvascular complications in the EURODIAB IDDM Complications Study. Diabetes Care 18(6), 785–792 (1995)CrossRef
34.
Diabetes, C., Complications Trial /Epidemiology of Diabetes, I., Complications Research, G., J.M. Lachin, N.H.White, D.P. Hainsworth, W. Sun, P.A. Cleary, D.M. Nathan, Effect of intensive diabetes therapy on the progressionof diabetic retinopathy in patients with type 1 diabetes: 18 years of follow-up in the DCCT/EDIC. Diabetes 64(2),631–642 (2015).
35.
H.P. Hammes, W. Kerner, S. Hofer, O. Kordonouri, K. Raile, R.W. Holl, D.P.-W.S. Group, Diabetic retinopathyin type 1 diabetes-a contemporary analysis of 8784 patients. Diabetologia 54(8), 1977–1984 (2011).CrossRef
36.
V.H. Tam, E.P. Lam, B.C. Chu, K.K. Tse, L.M. Fung, Incidence and progression of diabetic retinopathy in Hong Kong Chinese with type 2 diabetes mellitus. J. Diabetes Complicat 23(3), 185–193 (2009).CrossRef
37.
S.T. Tseng, S.T. Chou, B.H. Low, F.L. Su, Risk factors associated with diabetic retinopathy onset and progression in diabetes patients: a Taiwanese cohort study. Int. J. Clin. Exp. Med. 8(11), 21507–21515 (2015)PubMedPubMedCentral
38.
Z.L. Zhong, S. Chen, Plasma plasminogen activator inhibitor-1 is associated with end-stage proliferative diabetic retinopathy in the Northern Chinese Han population. Exp. Diabetes Res 2012, 350852 (2012).PubMedPubMedCentral
39.
A. Leone, Biochemical markers of cardiovascular damage from tobacco smoke. Curr. Pharm. Des. 11(17), 2199–2208 (2005)CrossRef
40.
M. Brownlee, H. Vlassara, A. Cerami, Nonenzymatic glycosylation and the pathogenesis of diabetic complications. Ann. Intern. Med. 101(4), 527–537 (1984)CrossRef
41.
J.L. Wautier, P.J. Guillausseau, Advanced glycation end products, their receptors and diabetic angiopathy. Diabetes Metab. 27(5 Pt 1), 535–542 (2001)PubMed
42.
Y. Solberg, M. Rosner, M. Belkin, The association between cigarette smoking and ocular diseases. Surv. Ophthalmol. 42(6), 535–547 (1998)CrossRef
43.
Hypertension in Diabetes Study (HDS): II Increased risk of cardiovascular complications in hypertensive type 2 diabetic patients. J. Hypertens. 11(3), 319–325 (1993).

Be confident that your patient care is up to date

Medicine Matters is being incorporated into Springer Medicine, our new medical education platform. 

Alongside the news coverage and expert commentary you have come to expect from Medicine Matters diabetes, Springer Medicine's complimentary membership also provides access to articles from renowned journals and a broad range of Continuing Medical Education programs. Create your free account »