Secondhand Smoke Correlates with Elevated Neutrophil-Lymphocyte Ratio and Has a Synergistic Effect with Physical Inactivity on Increasing Susceptibility to Type 2 Diabetes Mellitus: A Community-Based Case Control Study

Yohanes Andy Rias, Christopher James Gordon, Shu Fen Niu, Bayu Satria Wiratama, Ching Wen Chang, Hsiu Ting Tsai

Research output: Contribution to journalArticle

Abstract

Secondhand smoke (SHS) and physical inactivity are thought to be associated with type 2 diabetes mellitus (T2DM), but the synergistic effect of SHS with physical inactivity and their relationships with T2DM-associated inflammation biomarkers have not been estimated. We investigated the roles of SHS exposure and physical inactivity and their synergistic effect on T2DM risk and their relationships with T2DM associated inflammation biomarkers, neutrophil-lymphocyte ratio (NLR) and white blood cells (WBCs). A case-control study was conducted in total 588 participants (294 case T2DM and 294 healthy controls) from five community clinics in Indonesia. Participants completed a standardized questionnaire on demographic information, smoking status, physical activity habits and food consumption. WBCs and NLR levels were determined using an automated hematology analyzer. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were analyzed using multiple logistic regression model. The synergistic effect was analyzed using additive interaction for logistic regression. Physical inactive people exposed to SHS exhibited a synergistically increased 7.78-fold risk of T2DM compared with people who were not exposed to SHS and who were physically active. SHS is significantly correlated with a high NLR, WBCs and has a synergistic effect with physical inactivity on increasing susceptibility to T2DM.

Original languageEnglish
Article number5696
Pages (from-to)1-16
Number of pages16
JournalInternational journal of environmental research and public health
Volume17
Issue number16
DOIs
Publication statusPublished - Aug 6 2020

Keywords

  • neutrophil–lymphocyte ratio
  • physical inactivity
  • secondhand smoke
  • type 2 diabetes mellitus
  • white blood cells

ASJC Scopus subject areas

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

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