| Summary: | Background
While smoking cessation reduces the risk of cardiovascular disease
(CVD), quitting also increases fasting serum glucose (FSG) levels. The effect
of post-cessation FSG elevation on cardiovascular disease is unknown.
Methods
The study population consisted of 128,208 men without type
2 diabetes from the Korean National Health Insurance System - Health Screening
Cohort database. Change in smoking habits and FSG was determined by the
difference in smoking status and FSG levels from the first (2002 and 2003) and
second (2004 and 2005) health examinations. Quitters were divided into those
with FSG elevation of greater than 10.0 mg/dL and those without FSG elevation.
The study participants were followed-up for cardiovascular disease and CVD-related
death from 2006 to 2013.
Results
Compared to continual smokers, quitters without FSG
elevation had decreased risk of cardiovascular disease (hazard ratio, HR, 0.77,
95% confidence interval, CI, 0.69-0.86), while quitters with FSG elevation did
not (HR 0.86, 95% CI 0.74-1.01). Similarly, quitters without FSG elevation had
decreased risk of CVD-related death (HR 0.71, 95% CI 0.51-0.99) while quitters
with FSG elevation did not (HR 0.86, 95 % CI 0.57-1.29). Both quitters with and
without FSG elevation had decreased risk of myocardial infarction, while only
quitters without FSG elevation had decreased risk of total stroke.
Conclusions
Post-cessation FSG elevation attenuated the beneficiary
risk-reducing effects of quitting on cardiovascular disease and CVD-related
mortality. Extra care should be given to controlling FSG levels among quitters
in order to reduce the risk of cardiovascular disease and CVD-related death.
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