Abstract 1190: Association of Smoking Status with Incidental Metabolic Syndrome in Men; a 3-year Follow-up Study
Although cigarette smoking has been known to be a risk factor for increased insulin resistance and other metabolic abnormalities, there is no data to assess the association of smoking status with incidental metabolic syndrome (MS). We investigated the incidence of MS and assessed the effect of smoking status on incidental MS. The subjects were 4542 men (median age of 44 years) without MS who were followed for an average of 3 years. For analysis, smoking status was divided into 4 groups, non-smokers, new-smokers, ex-smokers, or sustained-smokers, according to smoking status at baseline and 3-year follow-up. The overall incidence of MS was 10.6%; the incidence of MS in each group was 8.0% in the non-smokers, 7.1% in the new-smokers, 17.1% in the ex-smokers, and 13.9% in sustained-smokers (p<0.0001). In a multivariate logistic regression model (Model 1) adjusting for age, baseline weight, alcohol consumption, exercise, and baseline number of MS components, sustained-smokers and ex-smokers predicted a significant increased odds for incidental MS of 1.68 (95% CI 1.33–2.12) and 2.43 (95% CI 1.80 –3.29), respectively, as compared with non-smokers. When weight change is included (Model 2), the odds ratios were attenuated (1.54[1.21–1.95] ; 1.87[1.37–2.56], respectively). Among sustained-smokers, the odds ratio for incidental MS increased according to the amount or the duration of smoking. Furthermore, ex-smokers had a significant increased odds for incidental MS of 1.45 (95% CI 1.06 –1.98), compared with continuous-smokers (model 1). This was no longer significant after including weight change (model 2). In conclusion, either sustained smoking or smoking cessation in 3 years is a risk factor for incidental metabolic syndrome in men, independent of weight change, as compared with non-smoking. Also smoking cessation in 3 years might be a higher risk factor for incidental MS than sustained smoking. Our study indicates that weight control in men, especially with smoking cessation is critical to attenuate the additional risk for incidental MS.