摘要目的:基于前瞻性研究，综合评估亚洲成人吸烟与2?型糖尿病（type 2 diabetes mellitus，T2DM）发病风险的关联性。方法:通过检索中国生物医学文献服务系统、中国知网、维普、万方、PubMed、Web of science、Embase、The Cochrane Library数据库，筛选出截止至2 019?年5?月在亚洲成人中开展的前瞻性研究。获取吸烟状态、吸烟量、T2DM发病人数、效应值等信息，并分别基于不同的吸烟状态、吸烟量、性别和随访时间进行Meta分析。结果:最终纳入31篇文献，共2 159 787?名研究对象，其中有599 340人（27.75%）吸烟，在平均8.3?年的随访中，新诊断124 883?例（5.78%）T2DM患者。与从不吸烟者相比，当前吸烟者和戒烟者的 RR值（95% CI）分别为1.52（1.34~1.72）（ P<0.001）和1.22（1.09~1.37）（ P=0.047）；轻（<20支/d）、中（20~29支/d）和重度（≥30支/d）吸烟者中 RR值及95% CI分别为1.31（1.21~1.53）（ P=0.001）；1.42（1.14~1.76）（ P=0.212）和2.17（1.50~3.16）（ P=0.198）。在男性和女性中 RR值和95% CI分别为1.15（1.08~1.21）（ P<0.001）；1.20（1.11~1.30）（ P=0.038）。此外，与不吸烟者相比，在当前吸烟者中随访时间<8.0?年和≥8.0?年的 RR和95% CI分别为1.57（1.22~2.03）（ P<0.001）和1.47（1.30~1.66）（ P=0.063），在戒烟者中则分别为1.23（1.06~1.43）（ P=0.091）和1.20（1.07~1.34）（ P=0.041）。 结论:基于亚洲成人的前瞻性研究表明吸烟能显著增加T2DM的发生风险，随着吸烟量的增加，风险增大；且相比于男性，女性吸烟者的危险性更大，戒烟时间越长，发病风险越低。

abstractsObjective:To evaluate the association between smoking and the risk of type 2 diabetes (T2DM) incidence among Asian adults based on the prospective studies.Methods:Prospective studies conducted on Asian adults through May, 2019 were retrieved from the following databases: SinoMed, CNKI, VIP, WanFang, PubMed, Web of Science, Embase, and Cochrane Library. Then data were extracted on smoking status, smoking quantity, the number of newly-onset T2DM cases, and effect sizes.Results:A total of 31 studies were included. There were 2 159 787 investigators, 599 340 (27.75%) smokers, and 124 883 (5.78%) T2DM cases identified during the mean follow-up period of 8.3 years. Compared with non-smokers, the combined relativerisk ( RR) and 95% confidence interval ( CI) of current smokers and quitting smokers were 1.52 (1.34- -1.72) ( P<0.001) and 1.22 (1.09- -1.37) ( P=0.047), respectively. The RR and 95% CI of light smokers (<20/day), moderate smokers (20- -29/day), and heavy smokers (≥30/day) were 1.31(1.21- -1.53) ( P=0.001),1.42(1.14- -1.76)( P=0.212), and 2.17(1.50- -3.16) ( P=0.198), respectively. In males and females, the RR and 95% CI were 1.15 (1.08- -1.21) ( P<0.001) and 1.20 (1.11- -1.30) ( P=0.038), respectively. In addition, compared with non-smokers, the RR and 95% CI of current smokers were 1.57 (1.22- -2.03) ( P<0.001) and 1.47 (1.30- -1.66) ( P=0.063) during the follow-up periods of less than and more than 8.0 years, respectively, while the RR and 95% CI of quitters were 1.23 (1.06- -1.43) ( P=0.091)and 1.20 (1.07- -1.34) ( P=0.041), respectively. Conclusions:Prospective studies based on Asian adults have shown that smoking significantly increases the risk of diabetes incidence. That is, as cigarette consumption increases, the risk of diabetes increases accordingly. Moreover, compared to males, the risk for female smokers is greater. In addition, longer durations of smoking cessation are associated with a lower risk of T2DM.