Smoking Is a Risk Factor of Coronary Heart Disease through HDL-C in Chinese T2DM Patients: A Mediation Analysis
Objective. To investigate associations between smoking and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus (T2DM) patients. Methods. This is a cross-sectional study. Of 971 T2DM patients aged 14–93 years old in this study, 182 had ever smoked and 789 never smoked. Propen...
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| Veröffentlicht in: | Journal of healthcare engineering 2020, Vol.2020 (2020), p.1-8 |
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| creator | He, Yao Wang, Shuang Yang, Bo Liu, Weiguo Yang, Shanshan Tang, Ru Yang, Zhengguo |
| description | Objective. To investigate associations between smoking and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus (T2DM) patients. Methods. This is a cross-sectional study. Of 971 T2DM patients aged 14–93 years old in this study, 182 had ever smoked and 789 never smoked. Propensity score matching (PSM) reduced the confounding bias between groups. Logistic regression analysis was performed on matched data to evaluate coronary heart disease (CHD) and stroke risk. In addition, the mediation analysis was conducted among smoking exposure, HDL-C, and CHD. Results. A total of 139 pairs of patients who had never and ever smoked were matched. Logistic regression analysis showed that compared with patients who never smoked, those who smoked > 20 cigarettes per day (CPD) had a higher risk of CHD (odds ratio [OR]: 3.09, 95% confidence interval [CI]: 1.21–7.89). Additionally, after adjusting for age, sex, origin, occupation, smoking status, body mass index, waist circumference, and diabetes duration, the OR for CHD with >20 years of cumulative smoking (pack-years) was 2.21 (95% CI: 1.05–4.65). Furthermore, we observed a significant dose-response relationship between CPD and lower high-density lipoprotein cholesterol (HDL-C) (P |
| doi_str_mv | 10.1155/2020/8876812 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7407009</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A638989052</galeid><sourcerecordid>A638989052</sourcerecordid><originalsourceid>FETCH-LOGICAL-c471t-b93e2faf1ef6901654d7e5cc2aab0145be56d08b88f74177941d2b99d968dde63</originalsourceid><addsrcrecordid>eNqNkU1vEzEQhlcIRKvSG2dkiQsSXeqv9QcHpGhDSaVUIChny7ueTUw3drE3VP33OEpa4IYv9mgePZrxW1UvCX5HSNOcU0zxuVJSKEKfVMcUc1xThvXThzfVzVF1mvMPXA7TjBP2vDpiVEquaHNcxW-beOPDCl1mZNFXn2_Qhe2nmFAcUBtTDDbdowXYNKG5z2AzoGmd4na1Rov5sm6RD6hd-wClcU3nV-iLnTyEKb9HM3QFzpcyBjQLdrzPPr-ong12zHB6uE-q7xcfr9tFvfz86bKdLeueSzLVnWZABzsQGITGRDTcSWj6nlrbYcKbDhrhsOqUGiQnUmpOHO20dloo50Cwk-rD3nu77Tbg-jJRsqO5TX5TFjLRevNvJ_i1WcVfRnIsMdZF8OYgSPHnFvJkNj73MI42QNxmQzmjSihGaEFf79GVHcH4MMRi7He4mQmmtNK42VFne6pPMecEw-MwBJtdmGYXpjmEWfBXfy_wCD9EV4C3e6B8vrN3_j91UBgY7B-aKCEwZb8BywGuvQ</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2432868312</pqid></control><display><type>article</type><title>Smoking Is a Risk Factor of Coronary Heart Disease through HDL-C in Chinese T2DM Patients: A Mediation Analysis</title><source>MEDLINE</source><source>PubMed Central Open Access</source><source>Wiley Online Library Open Access</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>He, Yao ; Wang, Shuang ; Yang, Bo ; Liu, Weiguo ; Yang, Shanshan ; Tang, Ru ; Yang, Zhengguo</creator><contributor>Huang, Xiwei</contributor><creatorcontrib>He, Yao ; Wang, Shuang ; Yang, Bo ; Liu, Weiguo ; Yang, Shanshan ; Tang, Ru ; Yang, Zhengguo ; Huang, Xiwei</creatorcontrib><description>Objective. To investigate associations between smoking and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus (T2DM) patients. Methods. This is a cross-sectional study. Of 971 T2DM patients aged 14–93 years old in this study, 182 had ever smoked and 789 never smoked. Propensity score matching (PSM) reduced the confounding bias between groups. Logistic regression analysis was performed on matched data to evaluate coronary heart disease (CHD) and stroke risk. In addition, the mediation analysis was conducted among smoking exposure, HDL-C, and CHD. Results. A total of 139 pairs of patients who had never and ever smoked were matched. Logistic regression analysis showed that compared with patients who never smoked, those who smoked > 20 cigarettes per day (CPD) had a higher risk of CHD (odds ratio [OR]: 3.09, 95% confidence interval [CI]: 1.21–7.89). Additionally, after adjusting for age, sex, origin, occupation, smoking status, body mass index, waist circumference, and diabetes duration, the OR for CHD with >20 years of cumulative smoking (pack-years) was 2.21 (95% CI: 1.05–4.65). Furthermore, we observed a significant dose-response relationship between CPD and lower high-density lipoprotein cholesterol (HDL-C) (P<0.001). Moreover, the mediation analysis showed that the indirect effect mediated by HDL-C accounted for 86% (effect = 0.0187, 95% CI: 0.0100–0.0316). Conclusions. Smoking may be a risk factor for CHD in T2DM patients. T2DM patients should stop smoking or reduce the CPD to prevent the onset of CHD. Moreover, to prevent CHD complications, monitoring HDL-C levels in T2DM patients who smoke may be necessary.</description><identifier>ISSN: 2040-2295</identifier><identifier>ISSN: 2040-2309</identifier><identifier>EISSN: 2040-2309</identifier><identifier>DOI: 10.1155/2020/8876812</identifier><identifier>PMID: 32774825</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian People ; Body Mass Index ; Cholesterol, HDL - metabolism ; Coronary Disease - complications ; Coronary Disease - diagnosis ; Coronary Disease - ethnology ; Coronary heart disease ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - ethnology ; Female ; Humans ; Male ; Mediation ; Mediation Analysis ; Medical research ; Medicine, Experimental ; Middle Aged ; Odds Ratio ; Propensity Score ; Regression Analysis ; Risk Factors ; Smoking - adverse effects ; Smoking cessation programs ; Type 2 diabetes ; Young Adult</subject><ispartof>Journal of healthcare engineering, 2020, Vol.2020 (2020), p.1-8</ispartof><rights>Copyright © 2020 Ru Tang et al.</rights><rights>COPYRIGHT 2020 John Wiley & Sons, Inc.</rights><rights>Copyright © 2020 Ru Tang et al. 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-b93e2faf1ef6901654d7e5cc2aab0145be56d08b88f74177941d2b99d968dde63</citedby><cites>FETCH-LOGICAL-c471t-b93e2faf1ef6901654d7e5cc2aab0145be56d08b88f74177941d2b99d968dde63</cites><orcidid>0000-0002-5612-1122 ; 0000-0001-6205-7895 ; 0000-0003-4168-3496</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407009/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7407009/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,27923,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32774825$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Huang, Xiwei</contributor><creatorcontrib>He, Yao</creatorcontrib><creatorcontrib>Wang, Shuang</creatorcontrib><creatorcontrib>Yang, Bo</creatorcontrib><creatorcontrib>Liu, Weiguo</creatorcontrib><creatorcontrib>Yang, Shanshan</creatorcontrib><creatorcontrib>Tang, Ru</creatorcontrib><creatorcontrib>Yang, Zhengguo</creatorcontrib><title>Smoking Is a Risk Factor of Coronary Heart Disease through HDL-C in Chinese T2DM Patients: A Mediation Analysis</title><title>Journal of healthcare engineering</title><addtitle>J Healthc Eng</addtitle><description>Objective. To investigate associations between smoking and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus (T2DM) patients. Methods. This is a cross-sectional study. Of 971 T2DM patients aged 14–93 years old in this study, 182 had ever smoked and 789 never smoked. Propensity score matching (PSM) reduced the confounding bias between groups. Logistic regression analysis was performed on matched data to evaluate coronary heart disease (CHD) and stroke risk. In addition, the mediation analysis was conducted among smoking exposure, HDL-C, and CHD. Results. A total of 139 pairs of patients who had never and ever smoked were matched. Logistic regression analysis showed that compared with patients who never smoked, those who smoked > 20 cigarettes per day (CPD) had a higher risk of CHD (odds ratio [OR]: 3.09, 95% confidence interval [CI]: 1.21–7.89). Additionally, after adjusting for age, sex, origin, occupation, smoking status, body mass index, waist circumference, and diabetes duration, the OR for CHD with >20 years of cumulative smoking (pack-years) was 2.21 (95% CI: 1.05–4.65). Furthermore, we observed a significant dose-response relationship between CPD and lower high-density lipoprotein cholesterol (HDL-C) (P<0.001). Moreover, the mediation analysis showed that the indirect effect mediated by HDL-C accounted for 86% (effect = 0.0187, 95% CI: 0.0100–0.0316). Conclusions. Smoking may be a risk factor for CHD in T2DM patients. T2DM patients should stop smoking or reduce the CPD to prevent the onset of CHD. Moreover, to prevent CHD complications, monitoring HDL-C levels in T2DM patients who smoke may be necessary.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Asian People</subject><subject>Body Mass Index</subject><subject>Cholesterol, HDL - metabolism</subject><subject>Coronary Disease - complications</subject><subject>Coronary Disease - diagnosis</subject><subject>Coronary Disease - ethnology</subject><subject>Coronary heart disease</subject><subject>Cross-Sectional Studies</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Mediation</subject><subject>Mediation Analysis</subject><subject>Medical research</subject><subject>Medicine, Experimental</subject><subject>Middle Aged</subject><subject>Odds Ratio</subject><subject>Propensity Score</subject><subject>Regression Analysis</subject><subject>Risk Factors</subject><subject>Smoking - adverse effects</subject><subject>Smoking cessation programs</subject><subject>Type 2 diabetes</subject><subject>Young Adult</subject><issn>2040-2295</issn><issn>2040-2309</issn><issn>2040-2309</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><recordid>eNqNkU1vEzEQhlcIRKvSG2dkiQsSXeqv9QcHpGhDSaVUIChny7ueTUw3drE3VP33OEpa4IYv9mgePZrxW1UvCX5HSNOcU0zxuVJSKEKfVMcUc1xThvXThzfVzVF1mvMPXA7TjBP2vDpiVEquaHNcxW-beOPDCl1mZNFXn2_Qhe2nmFAcUBtTDDbdowXYNKG5z2AzoGmd4na1Rov5sm6RD6hd-wClcU3nV-iLnTyEKb9HM3QFzpcyBjQLdrzPPr-ong12zHB6uE-q7xcfr9tFvfz86bKdLeueSzLVnWZABzsQGITGRDTcSWj6nlrbYcKbDhrhsOqUGiQnUmpOHO20dloo50Cwk-rD3nu77Tbg-jJRsqO5TX5TFjLRevNvJ_i1WcVfRnIsMdZF8OYgSPHnFvJkNj73MI42QNxmQzmjSihGaEFf79GVHcH4MMRi7He4mQmmtNK42VFne6pPMecEw-MwBJtdmGYXpjmEWfBXfy_wCD9EV4C3e6B8vrN3_j91UBgY7B-aKCEwZb8BywGuvQ</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>He, Yao</creator><creator>Wang, Shuang</creator><creator>Yang, Bo</creator><creator>Liu, Weiguo</creator><creator>Yang, Shanshan</creator><creator>Tang, Ru</creator><creator>Yang, Zhengguo</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>John Wiley & Sons, Inc</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-5612-1122</orcidid><orcidid>https://orcid.org/0000-0001-6205-7895</orcidid><orcidid>https://orcid.org/0000-0003-4168-3496</orcidid></search><sort><creationdate>2020</creationdate><title>Smoking Is a Risk Factor of Coronary Heart Disease through HDL-C in Chinese T2DM Patients: A Mediation Analysis</title><author>He, Yao ; Wang, Shuang ; Yang, Bo ; Liu, Weiguo ; Yang, Shanshan ; Tang, Ru ; Yang, Zhengguo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-b93e2faf1ef6901654d7e5cc2aab0145be56d08b88f74177941d2b99d968dde63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Asian People</topic><topic>Body Mass Index</topic><topic>Cholesterol, HDL - metabolism</topic><topic>Coronary Disease - complications</topic><topic>Coronary Disease - diagnosis</topic><topic>Coronary Disease - ethnology</topic><topic>Coronary heart disease</topic><topic>Cross-Sectional Studies</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Mediation</topic><topic>Mediation Analysis</topic><topic>Medical research</topic><topic>Medicine, Experimental</topic><topic>Middle Aged</topic><topic>Odds Ratio</topic><topic>Propensity Score</topic><topic>Regression Analysis</topic><topic>Risk Factors</topic><topic>Smoking - adverse effects</topic><topic>Smoking cessation programs</topic><topic>Type 2 diabetes</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>He, Yao</creatorcontrib><creatorcontrib>Wang, Shuang</creatorcontrib><creatorcontrib>Yang, Bo</creatorcontrib><creatorcontrib>Liu, Weiguo</creatorcontrib><creatorcontrib>Yang, Shanshan</creatorcontrib><creatorcontrib>Tang, Ru</creatorcontrib><creatorcontrib>Yang, Zhengguo</creatorcontrib><collection>الدوريات العلمية والإحصائية - e-Marefa Academic and Statistical Periodicals</collection><collection>معرفة - المحتوى العربي الأكاديمي المتكامل - e-Marefa Academic Complete</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of healthcare engineering</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>He, Yao</au><au>Wang, Shuang</au><au>Yang, Bo</au><au>Liu, Weiguo</au><au>Yang, Shanshan</au><au>Tang, Ru</au><au>Yang, Zhengguo</au><au>Huang, Xiwei</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Smoking Is a Risk Factor of Coronary Heart Disease through HDL-C in Chinese T2DM Patients: A Mediation Analysis</atitle><jtitle>Journal of healthcare engineering</jtitle><addtitle>J Healthc Eng</addtitle><date>2020</date><risdate>2020</risdate><volume>2020</volume><issue>2020</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>2040-2295</issn><issn>2040-2309</issn><eissn>2040-2309</eissn><abstract>Objective. To investigate associations between smoking and cardiovascular and cerebrovascular complications in type 2 diabetes mellitus (T2DM) patients. Methods. This is a cross-sectional study. Of 971 T2DM patients aged 14–93 years old in this study, 182 had ever smoked and 789 never smoked. Propensity score matching (PSM) reduced the confounding bias between groups. Logistic regression analysis was performed on matched data to evaluate coronary heart disease (CHD) and stroke risk. In addition, the mediation analysis was conducted among smoking exposure, HDL-C, and CHD. Results. A total of 139 pairs of patients who had never and ever smoked were matched. Logistic regression analysis showed that compared with patients who never smoked, those who smoked > 20 cigarettes per day (CPD) had a higher risk of CHD (odds ratio [OR]: 3.09, 95% confidence interval [CI]: 1.21–7.89). Additionally, after adjusting for age, sex, origin, occupation, smoking status, body mass index, waist circumference, and diabetes duration, the OR for CHD with >20 years of cumulative smoking (pack-years) was 2.21 (95% CI: 1.05–4.65). Furthermore, we observed a significant dose-response relationship between CPD and lower high-density lipoprotein cholesterol (HDL-C) (P<0.001). Moreover, the mediation analysis showed that the indirect effect mediated by HDL-C accounted for 86% (effect = 0.0187, 95% CI: 0.0100–0.0316). Conclusions. Smoking may be a risk factor for CHD in T2DM patients. T2DM patients should stop smoking or reduce the CPD to prevent the onset of CHD. Moreover, to prevent CHD complications, monitoring HDL-C levels in T2DM patients who smoke may be necessary.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>32774825</pmid><doi>10.1155/2020/8876812</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5612-1122</orcidid><orcidid>https://orcid.org/0000-0001-6205-7895</orcidid><orcidid>https://orcid.org/0000-0003-4168-3496</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Asian People Body Mass Index Cholesterol, HDL - metabolism Coronary Disease - complications Coronary Disease - diagnosis Coronary Disease - ethnology Coronary heart disease Cross-Sectional Studies Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - ethnology Female Humans Male Mediation Mediation Analysis Medical research Medicine, Experimental Middle Aged Odds Ratio Propensity Score Regression Analysis Risk Factors Smoking - adverse effects Smoking cessation programs Type 2 diabetes Young Adult |
| title | Smoking Is a Risk Factor of Coronary Heart Disease through HDL-C in Chinese T2DM Patients: A Mediation Analysis |
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