喫煙と2型糖尿病のリスク:体系的なレビューとメタ解析

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

まとめ

喫煙は,2型糖尿病を発症するリスクを大幅に高めます. このメタアナリシスは,より重度の喫煙がより高いリスクにつながり,用量反応関係があることを確認しています.

科学分野:

エピデミオロジーエピデミオロジー
公衆衛生は公衆衛生である.
メタボリック疾患

背景:

観察研究では,喫煙と2型糖尿病の発生率との関連が示唆されています.
この関連性を理解することは,公衆衛生イニシアチブにとって極めて重要です.

研究の目的:

喫煙と2型糖尿病の発生率に関する研究を体系的にレビューし,メタ分析する.
アソシエーションを定量化し,用量反応関係を探求する.

主な方法:

MEDLINEとEMBASEのデータベースを体系的に検索する (1966-2007年).
25件の前向きなコホート研究 (120万人の参加者) を含む.
ランダム効果モデルを用いた相対リスク (RRs) のプール.

主要な成果:

アクティブ喫煙者における2型糖尿病の総調整RRは1.44 (95%CI,1.31-1.58) でした.
すべてのサブグループで増加したリスクが観察され,一貫した結果を示しています.
大量の喫煙者 (≥20タバコ/日) は,軽い喫煙者 (1.29) よりも高いRR (1.61) を有していた.

結論:

喫煙は,2型糖尿病の危険性が高いと断定されている.
原因関係を確立し,根本的なメカニズムを解明するためにさらなる研究が必要です.
発見は,糖尿病の予防のために禁煙の重要性を強調しています.

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