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07-07-2022 | Risk factors | News

Smoking ‘important risk factor’ for albuminuria in people with prediabetes

Author: Claire Barnard

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medwireNews: Smoking is associated with an increased risk for albuminuria in both people with prediabetes and those with diabetes, but quitting may not immediately circumvent this risk, researchers report.

Debasish Kar (University of Sheffield, UK) and co-authors say that their findings “are important for public health policy,” because “[c]urrent diabetes prevention models, without smoking cessation intervention, and without screening for vascular complications such as albuminuria” may lead to late identification of complications when they are less amenable to intervention.

“Smokers with prediabetes and diabetes should be supported not only to quit smoking, but also to remain abstinent,” they recommend.

The UK Biobank study included a total of 502,490 people with a mean age of 57 years. In all, 23.5% of the 152,896 individuals with available data had albuminuria, while prediabetes and diabetes were reported in 4.3% and 3.9%, respectively, of the 456,293 people with available data. Just over half (54.4%) of the study population were never-smokers, while 34.4% were ex-smokers and 10.5% current smokers.

In both the prediabetes and diabetes groups, smoking was an “important risk factor for albuminuria,” report the study authors. Specifically, current smokers had a significantly higher risk for albuminuria than never-smokers, with respective odds ratios (ORs) of 1.21 and 1.26 in those with prediabetes and diabetes after adjustment for potentially confounding factors. These associations were attenuated, but still statistically significant, when comparing ex-smokers with never-smokers, at ORs of 1.07 and 1.09 in the prediabetes and diabetes groups, respectively.

These findings suggest that “[s]moking cessation may not reverse the risk immediately after quitting,” say Kar et al. They caution, however, that “[t]he cross-sectional design of the study could not elucidate how long the quitters need to remain abstinent for their risk to decline to the level of [never]-smokers.”

The team also evaluated the relationship between smoking status, cardiorenal risk factors, and albuminuria, finding that socioeconomic deprivation, male sex, glycated hemoglobin level, waist circumference, and blood pressure were significantly associated with albuminuria risk in ex-smokers.

“After smoking cessation, quitters may have an increased waist circumference,” and these findings suggest that “[m]onitoring waist circumference in quitters may identify those who are at a higher risk of albuminuria,” remark the researchers.

They say their results highlight the importance of multifactorial intervention initiated early in the metabolic syndrome disease trajectory to reduce the risk for microalbuminuria and subsequent development of vascular complications.

“Smoking cessation, active weight management, glycemic control, and hypertension managements are the key components of the multifactorial intervention,” they write in eClinicalMedicine.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2022 Springer Healthcare Ltd, part of the Springer Nature Group

EClinicalMedicine 2022; 51: 101544

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