Influence of smoking and diet on glycated haemoglobin and 'pre-diabetes' categorisation: a cross-sectional analysis

Vlassopoulos, A., Lean, M.E.J. and Combet, E. (2013) Influence of smoking and diet on glycated haemoglobin and 'pre-diabetes' categorisation: a cross-sectional analysis. BMC Public Health, 13(1013), (doi:10.1186/1471-2458-13-1013)

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Abstract

<p>Background: The new HbA1c criteria for diagnosis of pre-diabetes have been criticised for misdiagnosis. It is possible that some elevation of HbA1c is not driven by hyperglycaemia. This study assesses associations of HbA1c, commonly assumed to relate solely to glucose concentration, with (i) smoking, a major source of reactive oxygen species (ROS) and (ii) fruit & vegetables consumption associated with improved redox status.</p> <p>Methods: One-way ANOVA, Chi-squared and multivariate linear regressions, adjusted for all known confounders were used to explore associations of HbA1c with self-reported smoking status and fruit & vegetables consumptions in the Scottish Health Surveys 2003–2010, among individuals without known diabetes and HbA1c < 6.5%.</p> <p>Results: Compared to non-smokers (n = 2831), smokers (n = 1457) were younger, consumed less fruit & vegetables, had lower physical activity levels, lower BMI, higher HbA1c and CRP (p < 0.05). HbA1c was higher in smokers by 0.25 SDs (0.08%), and 0 · 38 SDs higher (0.14%) in heavy smokers (>20cigarettes/day) than non-smokers (p < 0.001 both). Smokers were twice as likely to have HbA1c in the ‘pre-diabetic’ range (5.7-6.4%) (p < 0.001, adj.model). Prediabetes and low grade inflammation did not affect the associations. For every extra 80 g vegetable portion consumed, HbA1c was 0.03 SDs (0.01%) lower (p = 0.02), but fruit consumption did not impact on HbA1c, within the low range of consumptions in this population.</p> <p>Conclusion: This study adds evidence for to relate smoking (an oxidative stress proxy) to protein glycation in normoglycaemic subjects, with implications for individuals exposed to ROS and for epidemiological interpretation of HbA1c.</p>

Item Type:Articles
Keywords:Smoking, HbA1c, Oxidative stress, Pre-diabetes, Vegetables, Nutrition
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Lean, Professor Michael and Combet Aspray, Dr Emilie and Vlassopoulos, Dr Antonios
Authors: Vlassopoulos, A., Lean, M.E.J., and Combet, E.
Subjects:R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
University Services > Learning and Teaching Services Division
Journal Name:BMC Public Health
Publisher:BioMed Central
ISSN:1471-2458
ISSN (Online):1471-2458
Copyright Holders:Copyright © 2013 The Authors
First Published:First published in BMC Public Health 13(1013)
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
557721Dietary intervention in obese pregnancies: impact on glycation, inflammation and newborn adiposityEmilie Combet AsprayYorkhill Children's Foundation (YORKH-CHIL)L Weaver 28/07/MVLS MED -HUMAN NUTRITION