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February 6, 1991, Vol 265, No. 5 >
ARTICLE | February 6, 1991

Cigarette Smoking Increases the Risk of Albuminuria Among Subjects With Type I Diabetes FREE

H. Peter Chase, MD; Satish K. Garg, MD; Guillermo Marshall, PhD; Christine L. Berg; Sherrie Harris, BSN; William E. Jackson, MD; Richard E. Hamman, MD, DrPH
[+] Author Affiliations

Reprint requests to Barbara Davis Center for Childhood Diabetes, 4200 E Ninth Ave, Box B140, Denver, CO 80262 (Dr Chase).


JAMA. 1991;265(5):614-617. doi:10.1001/jama.1991.03460050068022
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References

The effect of cigarette smoking on diabetic renal and retinal complications was evaluated in 359 young subjects with insulin-dependent diabetes mellitus. The prevalence of increased albumin excretion rates was 2.8 times higher in smokers than nonsmokers. Mean glycohemoglobin levels and duration of diabetes were also significant factors in the development of diabetic nephropathy and retinopathy in a logistic regression model. Smoking remained a significant factor in the logistic regression model for albuminuria (but not retinopathy) when controlled for glycohemoglobin level, duration of diabetes, age, gender, and blood pressure. The progression of albuminuria and of retinopathy was also greater in smokers. Albuminuria improved significantly when subjects ceased smoking. It is concluded that cigarette smoking is an independent risk factor and is associated with the development and progression of early diabetic renal damage (albuminuria) and with the worsening of retinal disease in young subjects with diabetes.

(JAMA. 1991;265:614-617)

REFERENCES

1 +
Borch-Johnsen K, Andersen PK, Deckert T.  The effect of proteinuria on relative mortality in type 1 (insulin-dependent) diabetes mellitus . Diabetologia. 1985;;28:590-596.
2 +
Chase HP, Jackson WE, Hoops SL, Cockerham RS, Archer PG, O'Brien D.  Glucose control and the renal and retinal complications of insulin-dependent diabetes . JAMA. 1989;;261:1155-1160.
3 +
McCance DR, Hadden DR, Atkinson AB, Archer DB, Kennedy L.  Long-term glycaemic control and diabetic retinopathy . Lancet. 1989;;2:824-828.
4 +
Chase HP, Garg SK, Harris S, Hoops SL, Marshall G.  High-normal blood pressure and early diabetic nephropathy . Arch Intern Med. 1990;;150:639-641.
5 +
Mogensen CE, Christensen CK.  Blood pressure changes and renal function in incipient and overt diabetic nephropathy . Hypertension. 1985;;7( (suppl 2) ):64-73.
6 +
Chase HP, Garg SK, Jackson WE, et al.  Blood pressure and retinopathy in type I diabetes . Ophthalmology. 1990;;97:155-159.
7 +
Norden G, Nyberg G.  Smoking and diabetic nephropathy . Acta Med Scand. 1984;;215:257-261.
8 +
Orchard TJ, Dorman JS, Maser RE, et al.  Factors associated with avoidance of severe complications after 25 years of IDDM: Pittsburgh Epidemiology of Diabetes Complications Study 1 . Diabetes Care. 1990;;13:741-747.
9 +
Rose GA, Blackburn H. Cardiovascular Survey Methods . Geneva, Switzerland: World Health Organization; 1968;:160-162.
10 +
Osberg I, Chase HP, Garg SK, et al.  Effects of storage time and temperature on measurement of small concentrations of albumin in urine . Clin Chem. 1990;;36:1428-1430.
11 +
Viberti GC, Hill RD, Jarrett RJ, Mahmud U, Argyropoulous A, Keen H.  Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus . Lancet. 1982;;1:1430-1432.
12 +
Klein BE, Davis MD, Segal P, et al.  Diabetic retinopathy: assessment of severity and progression . Ophthalmology. 1984;;91:10-17.
13 +
Diabetic Retinopathy Study Research Group.  Report 7: a modification of the Airlie House classification of diabetic retinopathy . Invest Ophthalmol Vis Sci. 1981;;21:210-226.
14 +
Voors AW, Foster TA, Frerichs RR, Webber LS, Berenson GS.  Studies of blood pressures in children, ages 5-14 years, in a total biracial community: the Bogalusa Heart Study . Circulation. 1976;;54:319-327.
15 +
SAS/STAT Guide to Personal Computers . 6th ed. Cary, NC: SAS Institute Inc; 1987;.
16 +
Agresti A.  Multinomial response models . In: Categorical Data Analysis . New York, NY: John Wiley & Sons Inc; 1990;:306-346.
17 +
Muhlhauser I, Sawicki P, Berger M.  Cigarette smoking as a risk factor for macroproteinuria and proliferative retinopathy in type I (insulin-dependent) diabetes . Diabetologia. 1986;;29:500-502.
18 +
Lundman BM, Asplund K, Norberg A.  Smoking and metabolic control in patients with insulin-dependent diabetes mellitus . J Intern Med. 1990;;227:101-106.
19 +
Rudehill A, Fianco-Cereceda A, Hemseu A, Stensdotter M, Pernow J, Lundberg JM.  Cigarette smoke-induced elevation of plasma neuropeptide Y levels in humans . Clin Physiol. 1989;;9:243-248.
20 +
Klein R, Klein BEK, Davis MD.  Is cigarette smoking associated with diabetic retinopathy? Am J Epidemiol. 1983;;118:228-238.
21 +
Centers for Disease Control.  Chronic disease reports: death from diabetes—United States, 1986 . MMWR. 1989;;38:543-546.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Borch-Johnsen K, Andersen PK, Deckert T.  The effect of proteinuria on relative mortality in type 1 (insulin-dependent) diabetes mellitus . Diabetologia. 1985;;28:590-596.
2 +
Chase HP, Jackson WE, Hoops SL, Cockerham RS, Archer PG, O'Brien D.  Glucose control and the renal and retinal complications of insulin-dependent diabetes . JAMA. 1989;;261:1155-1160.
3 +
McCance DR, Hadden DR, Atkinson AB, Archer DB, Kennedy L.  Long-term glycaemic control and diabetic retinopathy . Lancet. 1989;;2:824-828.
4 +
Chase HP, Garg SK, Harris S, Hoops SL, Marshall G.  High-normal blood pressure and early diabetic nephropathy . Arch Intern Med. 1990;;150:639-641.
5 +
Mogensen CE, Christensen CK.  Blood pressure changes and renal function in incipient and overt diabetic nephropathy . Hypertension. 1985;;7( (suppl 2) ):64-73.
6 +
Chase HP, Garg SK, Jackson WE, et al.  Blood pressure and retinopathy in type I diabetes . Ophthalmology. 1990;;97:155-159.
7 +
Norden G, Nyberg G.  Smoking and diabetic nephropathy . Acta Med Scand. 1984;;215:257-261.
8 +
Orchard TJ, Dorman JS, Maser RE, et al.  Factors associated with avoidance of severe complications after 25 years of IDDM: Pittsburgh Epidemiology of Diabetes Complications Study 1 . Diabetes Care. 1990;;13:741-747.
9 +
Rose GA, Blackburn H. Cardiovascular Survey Methods . Geneva, Switzerland: World Health Organization; 1968;:160-162.
10 +
Osberg I, Chase HP, Garg SK, et al.  Effects of storage time and temperature on measurement of small concentrations of albumin in urine . Clin Chem. 1990;;36:1428-1430.
11 +
Viberti GC, Hill RD, Jarrett RJ, Mahmud U, Argyropoulous A, Keen H.  Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus . Lancet. 1982;;1:1430-1432.
12 +
Klein BE, Davis MD, Segal P, et al.  Diabetic retinopathy: assessment of severity and progression . Ophthalmology. 1984;;91:10-17.
13 +
Diabetic Retinopathy Study Research Group.  Report 7: a modification of the Airlie House classification of diabetic retinopathy . Invest Ophthalmol Vis Sci. 1981;;21:210-226.
14 +
Voors AW, Foster TA, Frerichs RR, Webber LS, Berenson GS.  Studies of blood pressures in children, ages 5-14 years, in a total biracial community: the Bogalusa Heart Study . Circulation. 1976;;54:319-327.
15 +
SAS/STAT Guide to Personal Computers . 6th ed. Cary, NC: SAS Institute Inc; 1987;.
16 +
Agresti A.  Multinomial response models . In: Categorical Data Analysis . New York, NY: John Wiley & Sons Inc; 1990;:306-346.
17 +
Muhlhauser I, Sawicki P, Berger M.  Cigarette smoking as a risk factor for macroproteinuria and proliferative retinopathy in type I (insulin-dependent) diabetes . Diabetologia. 1986;;29:500-502.
18 +
Lundman BM, Asplund K, Norberg A.  Smoking and metabolic control in patients with insulin-dependent diabetes mellitus . J Intern Med. 1990;;227:101-106.
19 +
Rudehill A, Fianco-Cereceda A, Hemseu A, Stensdotter M, Pernow J, Lundberg JM.  Cigarette smoke-induced elevation of plasma neuropeptide Y levels in humans . Clin Physiol. 1989;;9:243-248.
20 +
Klein R, Klein BEK, Davis MD.  Is cigarette smoking associated with diabetic retinopathy? Am J Epidemiol. 1983;;118:228-238.
21 +
Centers for Disease Control.  Chronic disease reports: death from diabetes—United States, 1986 . MMWR. 1989;;38:543-546.

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