Introduction & Objective: American Indian (AIs) have been disproportionately burdened by diabetes. AI adults are twice as likely to have diabetes compared to Whites. However, there is limited research that has been focused on the longitudinal and quantitative relationship between smoking and diabetes among AIs. This study is aimed to evaluate the long-term relationship among smoking and key cardiovascular and diabetes biomarkers among AIs with diabetes.
Methods: This study uses existing data from the Strong Health Study (SHS), which is an on-going and multi-centered cohort study of cardiovascular disease and its risk factors among AIs. Original SHS participants with diabetes and who completed at least 1 follow up assessment are included in this study. The overall sample size is 1359. The exposure of interest is smoking, e.g., numbers of cigarettes smoked per day. The outcome variables are Hemoglobin A1C (HbA1c), fasting glucose (FG), 2-h glucose (2-h FG) and serum lipids including low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG) and total cholesterol (TC). Mixed models are performed to assess the longitudinal relationship.
Results: This study consists of 831 females and 528 males, and the average age is 57.6. Initial numbers of cigarettes smoked per day is positively associated with HbA1c (Relative Risk (RR)=1.02, p<0.05) after adjusting for age, gender, education, marital status, diabetes treatment, physical activity, and waist hip ratio. Similar significant longitudinal associations are observed between numbers of cigarettes smoked per day and TG (RR=8.32, p<0.05) and TC (RR=1.53, p<0.05), and numbers of cigarettes smoked per day is negatively related with HDL (RR=0.84, p<0.05) over time. There is no significant association between numbers of cigarettes smoked per day and FG and LDL levels.
Conclusion: Smoking has significant longitudinal adverse effects on HbA1c, TG, TC and HDL among AIs with diabetes.
C. Li: None.
American Diabetes Association (AWD-231969)
