Association of education and smoking status on risk of diabetes mellitus: A population-based nationwide cross-sectional study

Jin Hyeong Kim, Juhwan Noh, Jae Woo Choi, Eun Cheol Park

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9 Citations (Scopus)

Abstract

Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.

Original languageEnglish
Article number655
JournalInternational journal of environmental research and public health
Volume14
Issue number6
DOIs
Publication statusPublished - 2017 Jun 19

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Smoke
Diabetes Mellitus
Tobacco
Cross-Sectional Studies
Smoking
Education
Population
National Health Programs
Health
Alcohols
Confounding Factors (Epidemiology)
Unemployment
Nutrition Surveys
Korea
Social Class
Life Style
Logistic Models
Odds Ratio
Demography
Hypertension

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

@article{53f6ee3352dc4beeae565fd51e509c90,
title = "Association of education and smoking status on risk of diabetes mellitus: A population-based nationwide cross-sectional study",
abstract = "Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4{\%}) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.",
author = "Kim, {Jin Hyeong} and Juhwan Noh and Choi, {Jae Woo} and Park, {Eun Cheol}",
year = "2017",
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doi = "10.3390/ijerph14060655",
language = "English",
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journal = "International Journal of Environmental Research and Public Health",
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T1 - Association of education and smoking status on risk of diabetes mellitus

T2 - A population-based nationwide cross-sectional study

AU - Kim, Jin Hyeong

AU - Noh, Juhwan

AU - Choi, Jae Woo

AU - Park, Eun Cheol

PY - 2017/6/19

Y1 - 2017/6/19

N2 - Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.

AB - Background: Exposure to smoke, including environmental tobacco smoke (ETS), is a well-known risk factor for diabetes. Low socioeconomic status, especially lack of education, is also a risk factor for diabetes. Therefore, we assessed the association of demographic, socioeconomic, clinical, and behavior risk factor-related variables and smoking status, including ETS exposure, with the prevalence of diabetes. Methods: Data were from the 2007–2013 Korea National Health and Nutritional Evaluation Survey (KNHANES). Multivariable logistic regression examined associations between various lifestyle and health factors and the prevalence of diabetes while controlling for potential confounding variables. Subgroup analysis was performed according to smoking status to determine factors associated with diabetes. Results: Of 19,303 individuals analyzed, 1325 (11.4%) had diabetes. Greater average age, male sex, lower educational level, unemployment, and coexisting health problems were significantly associated with diabetes. Individuals with only elementary, middle, or high school level education had significantly greater odds ratios (p < 0.05) compared to college graduates; smokers and nonsmokers exposed to ETS had significantly greater OR (p < 0.05) than nonsmokers unexposed to ETS. Subgroup analysis of diabetics according to smoking status revealed significant associations (p < 0.05) for diabetic nonsmokers exposed to ETS with female sex, single status, elementary level education, urban residence, National Health Insurance (NHI), hypertension, a lack of alcohol intake, and a lack of moderate physical activity. For diabetic smokers, there were significant associations (p < 0.05) with elementary education, urban residence, a lack of moderate physical activity, a lack of alcohol intake, and NHI. Conclusions: The results suggested that smoking status, as well as ETS exposure, was associated with a higher prevalence of diabetes, especially in populations with less education. Thus, we should direct efforts for controlling diabetes toward individuals with lower levels of education and those who are smokers and nonsmokers exposed to ETS.

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U2 - 10.3390/ijerph14060655

DO - 10.3390/ijerph14060655

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