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 and Hsiu Ting Tsai
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Yohanes Andy Rias: School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
Christopher James Gordon: Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown 2050, NSW, Australia
Shu Fen Niu: Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan
Bayu Satria Wiratama: Department of Epidemiology and Biostatistics, Faculty of Medicine Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta 55281, Indonesia
Ching Wen Chang: Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei 11031, Taiwan
Hsiu Ting Tsai: School of Nursing, College of Nursing, Taipei Medical University, Taipei 11031, Taiwan

IJERPH, 2020, vol. 17, issue 16, 1-16

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.

Keywords: neutrophil–lymphocyte ratio; physical inactivity; secondhand smoke; type 2 diabetes mellitus; white blood cells (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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