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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. bahareh.rasouli@ki.se  
  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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