TY - JOUR
T1 - Association Between Incident Type 2 Diabetes and Opium Use
T2 - Mediation by Body Mass and Adiposity
AU - Nalini, Mahdi
AU - Poustchi, Hossein
AU - Roshandel, Gholamreza
AU - Kamangar, Farin
AU - Khoshnia, Masoud
AU - Gharavi, Abdolsamad
AU - Brennan, Paul
AU - Boffetta, Paolo
AU - Dawsey, Sanford M.
AU - Abnet, Christian C.
AU - Malekzadeh, Reza
AU - Etemadi, Arash
N1 - Publisher Copyright:
© 2023 Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
PY - 2023/12/1
Y1 - 2023/12/1
N2 - Opiates can affect glucose metabolism and obesity, but no large prospective study (to our knowledge) has investigated the association between long-term opium use, body mass index (BMI; weight (kg)/height (m)2), and incident type 2 diabetes mellitus (T2DM). We analyzed prospective data from 50,045 Golestan Cohort Study participants in Iran (enrollment: 2004-2008). After excluding participants with preexisting diseases, including diabetes, we used adjusted Poisson regression models to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for T2DM in opium users compared with nonusers, using mediation analysis to assess the BMI-mediated association of opium use with incident T2DM. Of 40,083 included participants (mean age = 51.4 (standard deviation, 8.8) years; 56% female), 16% were opium users (median duration of use, 10 (interquartile range), 4-20) years). During follow-up (until January 2020), 5,342 incident T2DM cases were recorded, including 8.5% of opium users and 14.2% of nonusers. Opium use was associated with an overall decrease in incident T2DM (IRR = 0.83, 95% CI: 0.75, 0.92), with a significant dose-response association. Most (84.3%) of this association was mediated by low BMI or waist circumference, and opium use did not have a direct association with incident T2DM (IRR = 0.97, 95% CI: 0.87, 1.08). Long-term opium use was associated with lower incidence of T2DM, which was mediated by low body mass and adiposity.
AB - Opiates can affect glucose metabolism and obesity, but no large prospective study (to our knowledge) has investigated the association between long-term opium use, body mass index (BMI; weight (kg)/height (m)2), and incident type 2 diabetes mellitus (T2DM). We analyzed prospective data from 50,045 Golestan Cohort Study participants in Iran (enrollment: 2004-2008). After excluding participants with preexisting diseases, including diabetes, we used adjusted Poisson regression models to estimate incidence rate ratios (IRRs) and 95% confidence intervals (CIs) for T2DM in opium users compared with nonusers, using mediation analysis to assess the BMI-mediated association of opium use with incident T2DM. Of 40,083 included participants (mean age = 51.4 (standard deviation, 8.8) years; 56% female), 16% were opium users (median duration of use, 10 (interquartile range), 4-20) years). During follow-up (until January 2020), 5,342 incident T2DM cases were recorded, including 8.5% of opium users and 14.2% of nonusers. Opium use was associated with an overall decrease in incident T2DM (IRR = 0.83, 95% CI: 0.75, 0.92), with a significant dose-response association. Most (84.3%) of this association was mediated by low BMI or waist circumference, and opium use did not have a direct association with incident T2DM (IRR = 0.97, 95% CI: 0.87, 1.08). Long-term opium use was associated with lower incidence of T2DM, which was mediated by low body mass and adiposity.
KW - body mass index
KW - diabetes mellitus, type 2
KW - incidence
KW - obesity
KW - opium
KW - prevention
UR - http://www.scopus.com/inward/record.url?scp=85178649746&partnerID=8YFLogxK
U2 - 10.1093/aje/kwad166
DO - 10.1093/aje/kwad166
M3 - Article
C2 - 37552966
AN - SCOPUS:85178649746
SN - 0002-9262
VL - 192
SP - 2050
EP - 2062
JO - American Journal of Epidemiology
JF - American Journal of Epidemiology
IS - 12
ER -