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Metabolic Risk/Epidemiology
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Dose-Dependent Effect of Smoking on Risk of Diabetes Remains after Smoking Cessation: A Nationwide Population-Based Cohort Study in Korea
Se Eun Park, Mi Hae Seo, Jung-Hwan Cho, Hyemi Kwon, Yang-Hyun Kim, Kyung-Do Han, Jin-Hyung Jung, Yong-Gyu Park, Eun-Jung Rhee, Won-Young Lee
Diabetes Metab J. 2021;45(4):539-546.   Published online March 4, 2021
DOI: https://doi.org/10.4093/dmj.2020.0061
  • 8,096 View
  • 193 Download
  • 10 Web of Science
  • 12 Crossref
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
This study aimed to evaluate the dose-dependent effects of smoking on risk of diabetes among those quitting smoking.
Methods
We analyzed clinical data from a total of 5,198,792 individuals age 20 years or older who received health care check-up arranged by the national insurance program of Korea between 2009 and 2016 using the Korean National Health Insurance Service database. Cumulative smoking was estimated by pack-years. Smokers were classified into four categories according to the amount of smoking: light smokers (0.025 to 5 smoking pack-years), medium smokers (5 to 14 smoking pack-years), heavy smokers (14 to 26 smoking pack-years), and extreme smokers (more than 26 smoking pack-years).
Results
During the study period, 164,335 individuals (3.2% of the total population) developed diabetes. Compared to sustained smokers, the risk of diabetes was significantly reduced in both quitters (hazard ratio [HR], 0.858; 95% confidence interval [CI], 0.838 to 0.878) and nonsmokers (HR, 0.616; 95% CI, 0.606 to 0.625) after adjustment for multiple risk factors. The risk of diabetes gradually increased with amount of smoking in both quitters and current smokers. The risk of diabetes in heavy (HR, 1.119; 95% CI, 1.057 to 1.185) and extreme smokers (HR, 1.348; 95% CI, 1.275 to 1.425) among quitters was much higher compared to light smokers among current smokers.
Conclusion
Smoking cessation was effective in reducing the risk of diabetes regardless of weight change. However, there was a potential dose-dependent association between smoking amount and the development of diabetes. Diabetes risk still remained in heavy and extreme smokers even after smoking cessation.

Citations

Citations to this article as recorded by  
  • Dietary and other lifestyle factors and their influence on non-communicable diseases in the Western Pacific region
    Xiaomin Sun, Dong Keon Yon, Tuan Thanh Nguyen, Kumpei Tanisawa, Kumhee Son, Ling Zhang, Jing Shu, Wen Peng, Yuexin Yang, Francesco Branca, Mark L. Wahlqvist, Hyunjung Lim, Youfa Wang
    The Lancet Regional Health - Western Pacific.2024; 43: 100842.     CrossRef
  • The Concentrations of Interleukin-6, Insulin, and Glucagon in the Context of Obesity and Type 2 Diabetes and Single Nucleotide Polymorphisms in IL6 and INS Genes
    Magdalena Król-Kulikowska, Iwona Urbanowicz, Marta Kepinska, Mayank Choubey
    Journal of Obesity.2024; 2024: 1.     CrossRef
  • Chronic cigarette smoking is associated with increased arterial stiffness in men and women: evidence from a large population-based cohort
    Omar Hahad, Volker H. Schmitt, Natalie Arnold, Karsten Keller, Jürgen H. Prochaska, Philipp S. Wild, Andreas Schulz, Karl J. Lackner, Norbert Pfeiffer, Irene Schmidtmann, Matthias Michal, Jörn M. Schattenberg, Oliver Tüscher, Andreas Daiber, Thomas Münzel
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  • Association between Meal Frequency and Type 2 Diabetes Mellitus in Rural Adults: A Large-Scale Cross-Sectional Study
    Bota Baheti, Xiaotian Liu, Mu Wang, Caiyun Zhang, Xiaokang Dong, Ning Kang, Linlin Li, Xing Li, Songcheng Yu, Jian Hou, Zhenxing Mao, Chongjian Wang
    Nutrients.2023; 15(6): 1348.     CrossRef
  • Impaired Lung Function and Lung Cancer Incidence: A Nationwide Population-Based Cohort Study
    Hye Seon Kang, Yong-Moon Park, Seung-Hyun Ko, Seung Hoon Kim, Shin Young Kim, Chi Hong Kim, Kyungdo Han, Sung Kyoung Kim
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  • Smoking cessation and risk of type 2 diabetes
    Jana Malinovská, Jana Urbanová, Veronika Vejtasová, Alexandra Romanová, Sabina Pálová, Syed Taha Naeem, Jan Brož
    Vnitřní lékařství.2022; 68(1): E04.     CrossRef
  • Association between lung function and the risk of atrial fibrillation in a nationwide population cohort study
    Su Nam Lee, Seung-Hyun Ko, Sung-Ho Her, Kyungdo Han, Donggyu Moon, Sung Kyoung Kim, Ki-Dong Yoo, Yu-Bae Ahn
    Scientific Reports.2022;[Epub]     CrossRef
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    Jin Suk Ra
    Osong Public Health and Research Perspectives.2022; 13(2): 142.     CrossRef
  • Smoking and diabetes interplay: A comprehensive review and joint statement
    Vincent Durlach, Bruno Vergès, Abdallah Al-Salameh, Thibault Bahougne, Farid Benzerouk, Ivan Berlin, Carole Clair, Jacques Mansourati, Alexia Rouland, Daniel Thomas, Philippe Thuillier, Blandine Tramunt, Anne-Laurence Le Faou
    Diabetes & Metabolism.2022; 48(6): 101370.     CrossRef
  • Impact of healthy lifestyle on the risk of type 2 diabetes mellitus in southwest China: A prospective cohort study
    Yanli Wu, Xi He, Jie Zhou, Yiying Wang, Lisha Yu, Xuejiao Li, Tao Liu, Jianhua Luo
    Journal of Diabetes Investigation.2022; 13(12): 2091.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Smoking Cessation after Diagnosis of New-Onset Atrial Fibrillation and the Risk of Stroke and Death
    So-Ryoung Lee, Eue-Keun Choi, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, Gregory Y. H. Lip
    Journal of Clinical Medicine.2021; 10(11): 2238.     CrossRef
COVID-19
Article image
Independent Impact of Diabetes on the Severity of Coronavirus Disease 2019 in 5,307 Patients in South Korea: A Nationwide Cohort Study
Sun Joon Moon, Eun-Jung Rhee, Jin-Hyung Jung, Kyung-Do Han, Sung-Rae Kim, Won-Young Lee, Kun-Ho Yoon
Diabetes Metab J. 2020;44(5):737-746.   Published online October 21, 2020
DOI: https://doi.org/10.4093/dmj.2020.0141
  • 10,916 View
  • 203 Download
  • 25 Web of Science
  • 23 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   ePub   
Background
Inconsistent results have been observed regarding the independent effect of diabetes on the severity of coronavirus disease 2019 (COVID-19). We conducted a nationwide population-based cohort study to evaluate the relationship between diabetes and COVID-19 severity in South Korea.
Methods
Patients with laboratory-confirmed COVID-19 aged ≥30 years were enrolled and medical claims data were obtained from the Korean Health Insurance Review and Assessment Service. Hospitalization, oxygen treatment, ventilator application, and mortality were assessed as severity outcomes. Multivariate logistic regression analyses were performed after adjusting for age, sex, and comorbidities.
Results
Of 5,307 COVID-19 patients, the mean age was 56.0±14.4 years, 2,043 (38.5%) were male, and 770 (14.5%) had diabetes. The number of patients who were hospitalized, who received oxygen, who required ventilator support, and who died was 4,986 (94.0%), 884 (16.7%), 121 (2.3%), and 211 (4.0%), respectively. The proportion of patients with diabetes in the abovementioned outcome groups was 14.7%, 28.1%, 41.3%, 44.6%, showing an increasing trend according to outcome severity. In multivariate analyses, diabetes was associated with worse outcomes, with an adjusted odds ratio (aOR) of 1.349 (95% confidence interval [CI], 1.099 to 1.656; P=0.004) for oxygen treatment, an aOR of 1.930 (95% CI, 1.276 to 2.915; P<0.001) for ventilator use, and an aOR of 2.659 (95% CI, 1.896 to 3.729; P<0.001) for mortality.
Conclusion
Diabetes was associated with worse clinical outcomes in Korean patients with COVID-19, independent of other comorbidities. Therefore, patients with diabetes and COVID-19 should be treated with caution.

Citations

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  • Impact of COVID-19 on the Microbiome and Inflammatory Status of Type 2 Diabetes Patients
    Gratiela Gradisteanu Pircalabioru, Georgiana Alexandra Grigore, Ilda Czobor Barbu, Mariana-Carmen Chifiriuc, Octavian Savu
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  • Bidirectional Relationship between Glycemic Control and COVID-19 and Perspectives of Islet Organoid Models of SARS-CoV-2 Infection
    Tongran Zhang, Nannan Wang, Lingqiang Zhu, Lihua Chen, Huisheng Liu
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    Dunya Tomic, Jonathan E. Shaw, Dianna J. Magliano
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  • Anti-SARS-CoV-2 antibody levels predict outcome in COVID-19 patients with type 2 diabetes: a prospective cohort study
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    Thomas Servais, France Laurent, Thomas Roland, Camelia Rossi, Elodie De Groote, Valérie Godart, Ernestina Repetto, Michel Ponchon, Pascale Chasseur, Laurent Crenier, Sandrine Van Eeckhoudt, John Yango, Philippe Oriot, Mirela Morisca Gavriliu, Stéphanie Ro
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    Evangelia Tzeravini, Eleftherios Stratigakos, Chris Siafarikas, Anastasios Tentolouris, Nikolaos Tentolouris
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  • Diabetes Fact Sheet in Korea 2021
    Jae Hyun Bae, Kyung-Do Han, Seung-Hyun Ko, Ye Seul Yang, Jong Han Choi, Kyung Mook Choi, Hyuk-Sang Kwon, Kyu Chang Won
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  • Diabetes Mellitus and COVID-19: Review Article
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    Puneeta Gupta, Meeta Gupta, Neena KAtoch, Ketan Garg, Bhawna Garg
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    Sang Youl Rhee
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    Yahya Mahamat-Saleh, Thibault Fiolet, Mathieu Edouard Rebeaud, Matthieu Mulot, Anthony Guihur, Douae El Fatouhi, Nasser Laouali, Nathan Peiffer-Smadja, Dagfinn Aune, Gianluca Severi
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    Kyuho Kim, Tae Jung Oh
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Epidemiology
Relation between Baseline Height and New Diabetes Development: A Nationwide Population-Based Study
Eun-Jung Rhee, Jung-Hwan Cho, Hyemi Kwon, Se-Eun Park, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Yang-Hyun Kim, Won-Young Lee
Diabetes Metab J. 2019;43(6):794-803.   Published online March 22, 2019
DOI: https://doi.org/10.4093/dmj.2018.0184
  • 5,180 View
  • 59 Download
  • 8 Web of Science
  • 10 Crossref
AbstractAbstract PDFPubReader   
Background

Short stature and leg length are associated with risk of diabetes and obesity. However, it remains unclear whether this association is observed in Asians. We evaluated the association between short stature and increased risk for diabetes using the Korean National Health Screening (KNHS) dataset.

Methods

We assessed diabetes development in 2015 in 21,122,422 non-diabetic Koreans (mean age 43 years) enrolled in KNHS from 2009 to 2012 using International Classification of Diseases 10th (ICD-10) code and anti-diabetic medication prescription. Risk was measured in age- and sex-dependent quintile groups of baseline height (20 to 39, 40 to 59, ≥60 years).

Results

During median 5.6-year follow-up, 532,918 cases (2.5%) of diabetes occurred. The hazard ratio (HR) for diabetes development gradually increased from the 5th (reference) to 1st quintile group of baseline height after adjustment for confounding factors (1.000, 1.076 [1.067 to 1.085], 1.097 [1.088 to 1.107], 1.141 [1.132 to 1.151], 1.234 [1.224 to 1.244]), with similar results in analysis by sex. The HR per 5 cm height increase was lower than 1.00 only in those with fasting blood glucose (FBG) below 100 mg/dL (0.979 [0.975 to 0.983]), and in lean individuals (body mass index [BMI] 18.5 to 23 kg/m2: 0.993 [0.988 to 0.998]; BMI <18.5 kg/m2: 0.918 [0.9 to 0.935]).

Conclusion

Height was inversely associated with diabetes risk in this nationwide study of Korean adults. This association did not differ by sex, and was significant in lean individuals and those with normal FBG levels.

Citations

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  • Association between underweight and risk of heart failure in diabetes patients
    Tae Kyung Yoo, Kyung‐Do Han, Eun‐Jung Rhee, Won‐Young Lee
    Journal of Cachexia, Sarcopenia and Muscle.2024; 15(2): 671.     CrossRef
  • Upper arm length and knee height are associated with diabetes in the middle-aged and elderly: evidence from the China Health and Retirement Longitudinal Study
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Obesity and Metabolic Syndrome
The Risk of Myocardial Infarction and Ischemic Stroke According to Waist Circumference in 21,749,261 Korean Adults: A Nationwide Population-Based Study
Jung-Hwan Cho, Eun-Jung Rhee, Se-Eun Park, Hyemi Kwon, Jin-Hyung Jung, Kyung-Do Han, Yong-Gyu Park, Hye Soon Park, Yang-Hyun Kim, Soon-Jib Yoo, Won-Young Lee
Diabetes Metab J. 2019;43(2):206-221.   Published online December 27, 2018
DOI: https://doi.org/10.4093/dmj.2018.0039
  • 5,993 View
  • 102 Download
  • 22 Web of Science
  • 24 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
Background

Waist circumference (WC) is a well-known obesity index that predicts cardiovascular disease (CVD). We studied the relationship between baseline WC and development of incident myocardial infarction (MI) and ischemic stroke (IS) using a nationwide population-based cohort, and evaluated if its predictability is better than body mass index (BMI).

Methods

Our study included 21,749,261 Koreans over 20 years of age who underwent the Korean National Health Screening between 2009 and 2012. The occurrence of MI or IS was investigated until the end of 2015 using National Health Insurance Service data.

Results

A total of 127,289 and 181,637 subjects were newly diagnosed with MI and IS. The incidence rate and hazard ratio of MI and IS increased linearly as the WC level increased, regardless of adjustment for BMI. When the analyses were performed according to 11 groups of WC, the lowest risk of MI was found in subjects with WC of 70 to 74.9 and 65 to 69.9 cm in male and female, and the lowest risk of IS in subjects with WC of 65 to 69.9 and 60 to 64.9 cm in male and female, respectively. WC showed a better ability to predict CVD than BMI with smaller Akaike information criterion. The optimal WC cutoffs were 84/78 cm for male/female for predicting MI, and 85/78 cm for male/female for predicting IS.

Conclusion

WC had a significant linear relationship with the risk of MI and IS and the risk began to increase from a WC that was lower than expected.

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    Ji Soo Kim, Jihun Song, Seulggie Choi, Sang Min Park
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    Jong Yeon Kim, Sung Min Cho, Youngmin Yoo, Taesic Lee, Jong Koo Kim
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Diabetes Metab J : Diabetes & Metabolism Journal
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