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Whether smoking is an independent risk factor for the development of microalbuminuria has yet to be established. Inconsistencies in previous studies (1–12) might have been due to inadequacies in assessing smoking status of patients (i.e., current, ex-, or never) (13). Moreover, although detailed quantitative assessment is critical for evaluating smoking risks (14), the dose effect of smoking on the development of nephropathy is not known (13). Therefore, we examined a wide variety of smoking parameters to clarify their relationship to microalbuminuria in a cohort of Japanese patients with type 2 diabetes.Data were derived from the ongoing Tsukuba Kawai Diabetes Registry database of the Kawai Clinic, which began collecting patient information in 1995. The Kawai Clinic is a typical diabetes clinic located in a suburb of Tokyo. All type 2 diabetic patients were consecutively registered for this study at their first visit. Study protocol was consistent with the Japanese Government's Ethical Guidelines Regarding Epidemiological Studies in accordance with the Declaration of Helsinki. Data from 357 normoalbuminuric male patients with type 2 diabetes (diagnosed according to the World Health Organization criteria [14]) who had been followed for at least 3 years were analyzed. No data from female patients were included because their smoking frequency was quite low (9.4%). Patients were said to be normoalbuminuric if …

Risk Imparted by Various Parameters of Smoking in Japanese Men With Type 2 Diabetes on Their Development of Microalbuminuria