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El tabaquismo activo y el riesgo de diabetes tipo 2: una revisión sistemática y un metanálisis
Carole Willi1, Patrick Bodenmann, William A Ghali
1Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, Switzerland. carole.willi@hospvd.ch
JAMA
|December 13, 2007
Resumen
El tabaquismo activo aumenta significativamente el riesgo de desarrollar diabetes tipo 2. Este metanálisis confirma una relación dosis-respuesta, con un mayor consumo de tabaco que conduce a mayores riesgos.
Área de la Ciencia:
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
- Enfermedades Metabólicas Las enfermedades metabólicas.
Sus antecedentes:
- Los estudios de observación sugieren una relación entre el tabaquismo activo y la incidencia de diabetes tipo 2.
- Comprender esta asociación es crucial para las iniciativas de salud pública.
Objetivo del estudio:
- Revisar sistemáticamente y metaanalizar los estudios sobre el tabaquismo activo y la incidencia de la diabetes tipo 2.
- Para cuantificar la asociación y explorar las relaciones dosis-respuesta.
Principales métodos:
- Búsqueda sistemática en las bases de datos MEDLINE y EMBASE (1966-2007).
- Se incluyeron 25 estudios prospectivos de cohorte (1,2 millones de participantes).
- Riesgos relativos agrupados (RR) utilizando un modelo de efectos aleatorios.
Principales resultados:
- Un RR ajustado agrupado de 1,44 (95% IC, 1,31-1,58) para la diabetes tipo 2 en fumadores activos.
- Se observó un aumento del riesgo en todos los subgrupos, lo que indica hallazgos consistentes.
- Evidencia de una relación dosis-respuesta: los fumadores pesados (≥20 cigarrillos/día) tenían mayores RRs (1.61) que los fumadores más ligeros (1.29).
Conclusiones:
- El tabaquismo activo está definitivamente asociado con un riesgo elevado de diabetes tipo 2.
- Se necesita más investigación para establecer la causalidad y aclarar los mecanismos subyacentes.
- Los hallazgos destacan la importancia de dejar de fumar para la prevención de la diabetes.
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