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Author (up) Rasouli, B.; Grill, V.; Midthjell, K.; Ahlbom, A.; Andersson, T.; Carlsson, S. url  doi
  Title Smoking is associated with reduced risk of autoimmune diabetes in adults contrasting with increased risk in overweight men with type 2 diabetes: a 22-year follow-up of the HUNT study Type Journal Article
  Year 2013 Publication Diabetes Care Abbreviated Journal Diabetes Care  
  Volume 36 Issue 3 Pages 604-610  
  Keywords Adult; Diabetes Mellitus, Type 1/*epidemiology/*etiology; Diabetes Mellitus, Type 2/*epidemiology; Female; Humans; Male; Middle Aged; Overweight/*epidemiology; Smoking/*adverse effects; Young Adult  
  Abstract OBJECTIVE: To investigate the association between smoking habits and risk of autoimmune diabetes in adults and of type 2 diabetes. RESEARCH DESIGN AND METHODS: We used data from the three surveys of the Nord-Trondelag Health Study, spanning 1984-2008 and including a cohort of 90,819 Norwegian men (48%) and women (52%) aged >/=20 years. Incident cases of diabetes were identified by questionnaire and classified as type 2 diabetes (n = 1,860) and autoimmune diabetes (n = 140) based on antibodies to glutamic decarboxylase (GADA) and age at onset of diabetes. Hazard ratios (HRs) adjusted for confounders were estimated by Cox proportional hazards regression models. RESULTS: The risk of autoimmune diabetes was reduced by 48% (HR 0.52 [95% CI 0.30-0.89]) in current smokers and 58% in heavy smokers (0.42 [0.18-0.98]). The reduced risk was positively associated with number of pack-years. Heavy smoking was associated with lower levels of GADA (P = 0.001) and higher levels of C-peptide (964 vs. 886 pmol/L; P = 0.03). In contrast, smoking was associated with an increased risk of type 2 diabetes, restricted to overweight men (1.33 [1.10-1.61]). Attributable proportion due to an interaction between overweight and heavy smoking was estimated to 0.40 (95% CI 0.23-0.57). CONCLUSIONS: In this epidemiological study, smoking is associated with a reduced risk of autoimmune diabetes, possibly linked to an inhibitory effect on the autoimmune process. An increased risk of type 2 diabetes was restricted to overweight men.  
  Address Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 0149-5992 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:23172971; PMC3579345 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 1569  
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