Impact of smoking to the development of lipid alterations in patients with Type 2 diabetes	
M. Nishnianidze1, R. Kurashvili2, T. Gvaladze1, G. Kurashvili1, E. Skhiladze1.
1National Center for Diabetes Research, Clinical Research, Tbilisi, Georgia.
2National Center for Diabetes Research, Tbilisi, Georgia.
Background
 Cardiovascular disease is the leading cause of death among the patients with type 2 diabetes (DM2). It is associated with lipid profile abnormalities. Recently the interactions of smoking with diabetes and other cardiovascular risk factors have attracted much interest.
Aim
The aim of our study was to investigate lipid profile indices according to the smoking status in patients with DM2.
Method
We investigate data obtained from 582 patients with DM2, among them 410 men and 172 women ( mean age 56.7±11.42years; mean duration of diabetes 6.31±6.69years; mean BMI  32±6.1kg/m2;  HBA1c<9%). Fasting lipid profile was evaluated by standard methods. Patients were divided into 3 groups: Gr. 1 men with a history of smoking (n=210); Gr. 2 men without of a history of smoking n=200; and Gr.3 women with a history of smoking n=172.
Results
Plasma cholesterol level was statistically higher (p=0.006) in the Gr.1 compared to Gr.2 (6.17+2.8vs 4.7+0.57mmol/L, as well as low-density lipoprotein cholesterol (LDL-C) (4.03+0.77vs3.04+0.61mmol/L; p=0.000) and triglycerides (TG) (5.68+2.6vs2.95+1.54mmol/L; p=0.000). High-density lipoprotein cholesterol (HDL-C)  was statistically lower (p=0.028) in the Gr.1 than in the Gr.2(1 0.84+0.5vs0.89+0.7mmol/L). Data obtained when compared the groups of smoker men and smoker women shows that plasma cholesterol, LDL-C and HDL-C levels are similar in these two groups ( p=0.110; p=0.184; p=0.272, respectively). Triglycerides was significantly increased (p=0.035) in women with a history of smoking (2.95+1.54vs2.15+0.52mmol/L).
Discussion
This study suggests that in patients with DM2 smoking status results in deep disturbances of lipid profile. The prevalence of significant lipid profile disorders is higher among patients with a history of smoking. HDL-C is lower and other parameters (such as triglycerides, LDL-C and plasma cholesterol) are elevated in this contingent.  Diabetic women are more prone to triglyceride abnormalities than men. Thus, more attention should be paid to educate people with diabetes to stop smoking, especially women.

Impact of smoking to the development of lipid alterations in patients with type 2 diabetes