Prediabetic Smokers likely to have High Risk of Albuminuria

Current global diabetes prevention programmes appear to be glucocentric and do not fully acknowledge the ramifications of cardiorenal risk factors in smokers. A more holistic approach is needed to prevent vascular complications in people with prediabetes and diabetes. Therefore, Dr Debasish Kar and his team conducted a study to investigate the relationship between smoking status and albuminuria in people with prediabetes and diabetes, and explored how this relationship is affected by age, antihypertensive, and cholesterol-lowering medications.

In a cross-sectional study, the researchers included 502,490 participants from the UK Biobank dataset. They further conducted a subgroup analysis investigating the effect of age, smoking status, antihypertensive and cholesterol-lowering medications on this relationship in people with prediabetes and diabetes.

Key findings of the study:

• Compared with non-smokers, the researchers found that the odds of albuminuria in smokers with prediabetes and diabetes were 1.43 and 1.29 respectively.
• They also found that patients younger than 50 with prediabetes and diabetes were at increased risk of albuminuria, compared with those over 50 years old, with OR 1.62 and 1.34, respectively.
• They noted that the odds of albuminuria remained statistically significantly high, in prediabetes and diabetes groups, despite being on anti-hypertensive, and cholesterol-lowering medications.
• They further noted that the odds of albuminuria were not attenuated in ex-smokers either with prediabetes or diabetes.

The authors concluded, "Smokers with prediabetes are at a higher risk of albuminuria than those with diabetes. The risk in ex-smokers did not decline to a statistically significant level, presumably due to insufficient lag period since quitting. Current strategies for cholesterol and hypertension management may not be sufficient to reduce the risk of albuminuria in people both with prediabetes and diabetes. "

They further added, "Smoking cessation and continued abstinence in people with prediabetes and diabetes should be promoted in order to prevent future vascular complications. Screening for albuminuria should be incorporated in the NHS health check."

For further information:

DOI: http://dx.doi.org/10.2139/ssrn.4023228

Keywords:

Smoking cessation, Albuminuria, Prediabetes, Type 2 diabetes, Ex-smoker, Smoker, UK Biobank Dataset, cholesterol-lowering medication, antihypertensives, SSRN Preprints, preprint with The Lancet.