Relationships of Cotinine and Self-Reported Cigarette Smoking With Hemoglobin \(A_{1c}\) in the U.S.

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Relationships of Cotinine and Self-Reported Cigarette Smoking With Hemoglobin \(A_{1c}\) in the U.S.

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Title: Relationships of Cotinine and Self-Reported Cigarette Smoking With Hemoglobin \(A_{1c}\) in the U.S.
Author: Clair, Carole; Bitton, Asaf; Meigs, James Benjamin; Rigotti, Nancy Ann

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Citation: Clair, Carole, Asaf Bitton, James B. Meigs, and Nancy A. Rigotti. 2011. Relationships of cotinine and self-reported cigarette smoking with hemoglobin \(A_{1c}\) in the U.S. Diabetes Care 34(10): 2250-2255.
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Abstract: OBJECTIVE: Whether nicotine leads to a persistent increase in blood glucose levels is not clear. Our objective was to assess the relationship between cotinine, a nicotine metabolite, and glycated hemoglobin (Hb\(A_{1c}\)), an index of recent glycemia. RESEARCH DESIGN AND METHODS: We used cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2008. We limited our analysis to 17,287 adults without diabetes. We created three cotinine categories: <0.05 ng/mL, 0.05–2.99 ng/mL, and ≥3 ng/mL. RESULTS: Using self-report, 25% of the sample were current smokers, 24% were former smokers, and 51% were nonsmokers. Smokers had a higher mean Hb\(A_{1c}\) (5.36% ± 0.01 SE) compared with never smokers (5.31% ± 0.01) and former smokers (5.31% ± 0.01). In a similar manner, mean Hb\(A_{1c}\) was higher among participants with cotinine ≥3 ng/mL (5.35% ± 0.01) and participants with cotinine 0.05–2.99 ng/mL (5.34% ± 0.01) compared with participants with cotinine <0.05 ng/mL (5.29% ± 0.01). In multivariable-adjusted analysis, we found that both a cotinine ≥3 ng/mL and self-reported smoking were associated with higher Hb\(A_{1c}\) compared with a cotinine <0.05 ng/mL or not smoking. People with a cotinine level ≥3 ng/mL had a relative 5% increase in Hb\(A_{1c}\) compared with people with a cotinine level <0.05 ng/mL, and smokers had a relative 7% increase in Hb\(A_{1c}\) compared with never smokers. CONCLUSIONS: Our study suggests that cotinine is associated with increased Hb\(A_{1c}\) in a representative sample of the U.S. population without diabetes.
Published Version: doi:10.2337/dc11-0710
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3177720/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:10504379
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