J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 10, Number 6, June 2018, pages 478-485

Smoking Cessation Ameliorates Microalbuminuria With Reduction of Blood Pressure and Pulse Rate in Patients With Already Diagnosed Diabetes Mellitus

Figure 1. Comparison of CO concentration during 3-month smoking cessation program between smoking cessation group and smoking group. Data are represented as mean ± SD. Asterisk denotes P < 0.0001 as compared to the baseline level; (filled square) smoking cessation group and (filled circle) smoking group.

Figure 2. Changes of systolic and diastolic blood pressures and pulse rate. (a) Systolic blood pressure (BPsys). (b) Diastolic blood pressure (BPdia), (c) Pulse rate (PR). Data are represented as mean ± SD. Single and double asterisks denote P < 0.05 and P < 0.01, respectively as compared to the baseline level; (filled square) smoking cessation group and (filled circle) smoking group.

Figure 3. Changes of albuminuria. Subjects who had microalbuminuria (30 to 300 mg/gCr) at baseline (Before) were followed at 12 months (After); (a) Smoking cessation group (filled diamond) and (b) smoking group (filled circle).

Figure 4. Changes of body weight and HbA1c. (a) Body weight (kg). (b) HbA1c (%). Data are represented as mean ± SD. Single and double asterisks denote P < 0.05 and P < 0.01, respectively as compared to the baseline level; (filled square) smoking cessation group and (filled circle) smoking group.

**Table 1.** Baseline Characteristics of Study Participants for the Overall Sample and Sub-Groups
Variables	Overall sample (n = 35)	Smoking cessation group (n = 18)	Smoking group (n = 17)	P value
BMI: body mass index; OAD: oral anti-diabetes drug; BP: blood pressure; CO: carbon monoxide; FTND: Fagerstrom Test for Nicotine Dependence; TDS: Tobacco Dependence Screener. †P < 0.05, ‡P < 0.01
Age (years) (mean ± SD)	56.7 ± 11.0	57.2 ± 11.6	56.2 ± 10.6	0.7824
Sex (males, %)	85.7	88.9	82.4	0.5808
Body weight (kg) (mean ± SD)	67.4 ± 10.4	65.2 ± 8.0	69.7 ± 12.4	0.2100
BMI (kg/m²) (mean ± SD)	24.9 ± 3.9	24.6 ± 3.4	25.2 ± 4.4	0.6532
Diabetes onset (years) (median (IQR))	46 (36 - 50)	48.5 (34.3 - 51.3)	43 (36.5 - 48)	0.8920
Diabetes duration (years) (median (IQR))	12 (6 - 21)	13 (6.8 - 20.3)	12 (5.5 - 22)	0.6105
HbA1c (%) (mean ± SD)	7.1 ± 0.9	6.9 ± 1.0	7.3 ± 0.8	0.2343
Insulin (%)	51.4	55.6	47.1	0.6152
Number of OADs (median (IQR))	1 (0 - 2)	1 (0 - 2)	1 (0 - 2.5)	0.7531
Systolic BP (mm Hg) (mean ± SD)	130.2 ± 10.3	130.6 ± 9.9	129.8 ± 11.0	0.8239
Diastolic BP (mm Hg) (mean ± SD)	76.2 ± 9.1	76.3 ± 9.2	76.1 ± 9.3	0.9447
Pulse rate (bpm) (mean ± SD)	81.5 ± 12.1	79.9 ± 9.7	83.3 ± 14.3	0.4125
Antihypertensive medication (%)	51.4	50.0	52.9	0.8619
eGFR (mL/min/1.73m²) (mean ± SD)	69.8 ± 17.8	67.8 ± 21.6	72.0 ± 13.0	0.4926
Proteinuria (%)	51.4	55.6	47.1	0.6150
Microalbuminuria (%)	42.9	44.4	36.4	0.8452
Pack-years (median (IQR))	41.0 (28.0 - 64.8)	43.0 (24.5 - 65.8)	39.0 (29.0 - 61.5)	0.7672
Cigarettes/day (median (IQR))	20.0 (20.0 - 30.0)	20.0 (20.0 - 31.3)	20.0 (20.0 - 32.5)	0.4547
Expiratory CO (ppm) (mean ± SD)	23.5 ± 11.2	19.2 ± 9.8	28.0 ± 10.9	0.0169†
FTND (median (IQR))	6.0 (4.0 - 7.0)	4.5 (2.3 - 6.8)	7.0 (6.0 - 7.5)	0.0066‡
TDS (median (IQR))	8.0 (7.0 - 9.0)	8.0 (5.0 - 8.5)	9.0 (8.0 - 10.0)	0.0020‡
Housemate smoking (%)	20.0	11.1	29.4	0.1761
Psychiatric treatment (%)	37.1	22.2	52.9	0.0601

Table 1. Baseline Characteristics of Study Participants for the Overall Sample and Sub-Groups

Variables

Overall sample (n = 35)

Smoking cessation group (n = 18)

Smoking group (n = 17)

P value

BMI: body mass index; OAD: oral anti-diabetes drug; BP: blood pressure; CO: carbon monoxide; FTND: Fagerstrom Test for Nicotine Dependence; TDS: Tobacco Dependence Screener. †P < 0.05, ‡P < 0.01

Age (years) (mean ± SD)

56.7 ± 11.0

57.2 ± 11.6

56.2 ± 10.6

0.7824

Sex (males, %)

85.7

88.9

82.4

0.5808

Body weight (kg) (mean ± SD)

67.4 ± 10.4

65.2 ± 8.0

69.7 ± 12.4

0.2100

BMI (kg/m²) (mean ± SD)

24.9 ± 3.9

24.6 ± 3.4

25.2 ± 4.4

0.6532

Diabetes onset (years) (median (IQR))

46 (36 - 50)

48.5 (34.3 - 51.3)

43 (36.5 - 48)

0.8920

Diabetes duration (years) (median (IQR))

12 (6 - 21)

13 (6.8 - 20.3)

12 (5.5 - 22)

0.6105

HbA1c (%) (mean ± SD)

7.1 ± 0.9

6.9 ± 1.0

7.3 ± 0.8

0.2343

Insulin (%)

51.4

55.6

47.1

0.6152

Number of OADs (median (IQR))

1 (0 - 2)

1 (0 - 2.5)

0.7531

Systolic BP (mm Hg) (mean ± SD)

130.2 ± 10.3

130.6 ± 9.9

129.8 ± 11.0

0.8239

Diastolic BP (mm Hg) (mean ± SD)

76.2 ± 9.1

76.3 ± 9.2

76.1 ± 9.3

0.9447

Pulse rate (bpm) (mean ± SD)

81.5 ± 12.1

79.9 ± 9.7

83.3 ± 14.3

0.4125

Antihypertensive medication (%)

51.4

50.0

52.9

0.8619

eGFR (mL/min/1.73m²) (mean ± SD)

69.8 ± 17.8

67.8 ± 21.6

72.0 ± 13.0

0.4926

Proteinuria (%)

51.4

55.6

47.1

0.6150

Microalbuminuria (%)

42.9

44.4

36.4

0.8452

Pack-years (median (IQR))

41.0 (28.0 - 64.8)

43.0 (24.5 - 65.8)

39.0 (29.0 - 61.5)

0.7672

Cigarettes/day (median (IQR))

20.0 (20.0 - 30.0)

20.0 (20.0 - 31.3)

20.0 (20.0 - 32.5)

0.4547

Expiratory CO (ppm) (mean ± SD)

23.5 ± 11.2

19.2 ± 9.8

28.0 ± 10.9

0.0169†

FTND (median (IQR))

6.0 (4.0 - 7.0)

4.5 (2.3 - 6.8)

7.0 (6.0 - 7.5)

0.0066‡

TDS (median (IQR))

8.0 (7.0 - 9.0)

8.0 (5.0 - 8.5)

9.0 (8.0 - 10.0)

0.0020‡

Housemate smoking (%)

20.0

11.1

29.4

0.1761

Psychiatric treatment (%)

37.1

22.2

52.9

0.0601