{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:45:04Z","timestamp":1790084704328,"version":"4.0.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The effect of smoking on coronary artery plaques examined by coronary computed tomography angiography (CCTA) in type 2 diabetes mellitus (DM) patients is not fully understood. This study explored the effect of smoking on coronary artery plaques by comparing the characteristics of plaques between diabetes patients with and without a smoking history and among those with different smoking durations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>In total, 1058 DM patients found to have coronary plaques on CCTA were categorized into the smoker (n=448) and nonsmoker groups (n=610). Smokers were stratified by smoking duration [\u226420 years (n=115), 20~40 years (n=233) and &amp;gt;40 years (n=100)]. The plaque types, luminal stenosis [obstructive (&amp;lt;50%) or nonobstructive (\u226550%) stenosis], segment involvement score (SIS), and segment stenosis score (SSS) of the CCTA data were compared among groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to nonsmokers, smokers demonstrated increased odds ratios (ORs) of any noncalcified plaques (OR=1.423; P=0.014), obstructive plaques (OR=1.884; P&amp;lt;0.001), multivessel disease (OR=1.491; P=0.020), SIS\u22654 (OR=1.662; P&amp;lt;0.001), and SSS\u22657 (OR=1.562; P=0.001). Compared to diabetes patients with a smoking duration \u226420 years, those with a smoking duration of 20~40 years and &amp;gt;40 years had higher OR of any mixed plaques (OR=2.623 and 3.052, respectively; Ps&amp;lt;0.001), obstructive plaques (OR=2.004 and 2.098; P=0.003 and 0.008, respectively), multivessel disease (OR=3.171 and 3.784; P&amp;lt;0.001 and P=0.001, respectively), and SSS\u22657 (OR=1.605 and 1.950; P=0.044 and 0.020, respectively). Diabetes with a smoking duration &amp;gt;40 years had a higher OR of SIS\u22654 (OR=1.916, P=0.034).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Smoking is independently associated with the presence of noncalcified, obstructive, and more extensive coronary artery plaques in diabetes patients, and a longer smoking duration is significantly associated with a higher risk of mixed, obstructive, and more extensive plaques.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2021.750773","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T08:36:51Z","timestamp":1635928611000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Effect of Smoking on Coronary Artery Plaques in Type 2 Diabetes Mellitus: Evaluation With Coronary Computed Tomography Angiography"],"prefix":"10.3389","volume":"12","author":[{"given":"Yu","family":"Jiang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tong","family":"Pang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-lei","family":"Qian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-feng","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi-gang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"B1","volume-title":"IDF Diabetes Atlas","year":"2019"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1800256","article-title":"Risk Factors, Mortality, and Cardiovascular Outcomes in Patients With Type 2 Diabetes","volume":"379","author":"Rawshani","year":"2018","journal-title":"N Engl J Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.jacc.2019.05.049","article-title":"Cigarette Smoking, Smoking Cessation, and Long-Term Risk of 3 Major Atherosclerotic Diseases","volume":"74","author":"Ding","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1016\/j.diabres.2019.05.035","article-title":"The Global Prevalence of Tobacco Use in Type 2 Diabetes Mellitus Patients: A Systematic Review and Meta-Analysis","volume":"154","author":"Roderick","year":"2019","journal-title":"Diabetes Res Clin Pract"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.017926","article-title":"Relation of Smoking With Total Mortality and Cardiovascular Events Among Patients With Diabetes Mellitus: A Meta-Analysis and Systematic Review","volume":"132","author":"Pan","year":"2015","journal-title":"Circulation"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1111\/1753-0407.12625","article-title":"Association Between Smoking and Glycemic Control in Diabetic Patients: Results From the Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal (REACTION) Study","volume":"10","author":"Peng","year":"2018","journal-title":"J Diabetes"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2020.02.47","article-title":"Cardiovascular Risk of Smoking and Benefits of Smoking Cessation","volume":"12","author":"Gallucci","year":"2020","journal-title":"J\u00a0Thorac Dis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy581","article-title":"Coronary Computed Tomography Angiography for Heart Team Decision-Making in Multivessel Coronary Artery Disease","volume":"39","author":"Collet","year":"2018","journal-title":"Eur Heart J"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2010.12.032","article-title":"Comparative Analysis of Coronary Artery Disease Assessed by Coronary CT Angiography Between Patients With Type 2 Diabetes Mellitus and non-Diabetic Patients","volume":"147","author":"Chu","year":"2011","journal-title":"Int J Cardiol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1186\/1475-2840-9-74","article-title":"Characteristics of Coronary Artery Disease in Symptomatic Type 2 Diabetic Patients: Evaluation With CT Angiography","volume":"9","author":"Chu","year":"2010","journal-title":"Cardiovasc Diabetol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2016.11.016","article-title":"Association of Tobacco Use and Cessation With Coronary Atherosclerosis","volume":"257","author":"Cheezum","year":"2017","journal-title":"Atherosclerosis"},{"key":"B12","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1161\/01.cir.51.4.5","article-title":"A Reporting System on Patients Evaluated for Coronary Artery Disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association","volume":"51","author":"Austen","year":"1975","journal-title":"Circulation"},{"key":"B13","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/s12933-019-0924-z","article-title":"Serial Coronary Computed Tomography Angiography-Verified Coronary Plaque Progression: Comparison of Stented Patients With or Without Diabetes","volume":"18","author":"Shi","year":"2019","journal-title":"Cardiovasc Diabetol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2016.04.005","article-title":"CAD-RADS\u2122 Coronary Artery Disease \u2014 Reporting and Data System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT), the American College of Radiology (ACR) and the North American Society for Cardiovascular Imaging (NASCI)","volume":"10","author":"Cury","year":"2016","journal-title":"J Cardiovasc Comput Tomogr"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2337\/dc18-0476","article-title":"The Association of Severe Diabetic Retinopathy With Cardiovascular Outcomes in Long-Standing Type 1 Diabetes: A Longitudinal Follow-Up","volume":"41","author":"Pongrac Barlovic","year":"2018","journal-title":"Diabetes Care"},{"key":"B16","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1161\/ATVBAHA.116.306256","article-title":"Pathology of Human Coronary and Carotid Artery Atherosclerosis and Vascular Calcification in Diabetes Mellitus","volume":"37","author":"Yahagi","year":"2017","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"993","DOI":"10.1016\/j.jcmg.2018.05.022","article-title":"Current Smoking and Prognosis After Acute ST-Segment Elevation Myocardial Infarction: New Pathophysiological Insights","volume":"12","author":"Haig","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2016.12.010","article-title":"Quit Smoking to Outsmart Atherogenesis: Molecular Mechanisms Underlying Clinical Evidence","volume":"257","author":"Gambardella","year":"2017","journal-title":"Atherosclerosis"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1161\/ATVBAHA.113.300156","article-title":"Smoking and Cardiovascular Disease: Mechanisms of Endothelial Dysfunction and Early Atherogenesis","volume":"34","author":"Messner","year":"2014","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2021.674622","article-title":"Cigarette Smoking is Related to Endothelial Dysfunction of Resistance, But Not Conduit Arteries in the General Population\u2014Results From the Gutenberg Health Study","volume":"8","author":"Hahad","year":"2021","journal-title":"Front Cardiovasc Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2020.08.009","article-title":"Macrophage Infiltrates in Coronary Plaque Erosion and Cardiovascular Outcome in Patients With Acute Coronary Syndrome","volume":"311","author":"Montone","year":"2020","journal-title":"Atherosclerosis"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3348\/kjr.2020.0103","article-title":"Prognostic Value of Coronary CT Angiography for Predicting Poor Cardiac Outcome in Stroke Patients Without Known Cardiac Disease or Chest Pain: The Assessment of Coronary Artery Disease in Stroke Patients Study","volume":"21","author":"Yoon","year":"2020","journal-title":"Korean J Radiol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"e2011444","DOI":"10.1001\/jamanetworkopen.2020.11444","article-title":"Association of Cardiovascular Disease Risk Factor Burden With Progression of Coronary Atherosclerosis Assessed by Serial Coronary Computed Tomographic Angiography","volume":"3","author":"Han","year":"2020","journal-title":"JAMA Netw Open"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2018.02.025","article-title":"Plaque Morphology as Predictor of Late Plaque Events in Patients With Asymptomatic Type 2 Diabetes: A Long-Term Observational Study","volume":"12","author":"Halon","year":"2019","journal-title":"JACC Cardiovasc Imaging"},{"key":"B25","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.atherosclerosis.2020.05.017","article-title":"Calcium Deposition Within Coronary Atherosclerotic Lesion: Implications for Plaque Stability","volume":"306","author":"Jinnouchi","year":"2020","journal-title":"Atherosclerosis"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2016.01.040","article-title":"Long-Term Prognostic Value of Coronary CT Angiography in Asymptomatic Type 2 Diabetes Mellitus","volume":"9","author":"Kang","year":"2016","journal-title":"JACC Cardiovasc Imaging"},{"key":"B27","doi-asserted-by":"publisher","first-page":"2995","DOI":"10.1016\/j.jacc.2017.10.029","article-title":"Surgical Versus Percutaneous Coronary Revascularization in Patients With Diabetes and Acute Coronary Syndromes","volume":"70","author":"Ramanathan","year":"2017","journal-title":"J Am Coll Cardiol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30423-9","article-title":"Mortality After Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention With Stenting for Coronary Artery Disease: A Pooled Analysis of Individual Patient Data","volume":"391","author":"Head","year":"2018","journal-title":"Lancet"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1253\/circj.cj-11-1353","article-title":"Effects of Cumulative Smoking Exposure and Duration of Smoking Cessation on Carotid Artery Structure","volume":"76","author":"Kweon","year":"2012","journal-title":"Circ J"},{"key":"B30","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1097\/EDE.0000000000000437","article-title":"Risk of Cardiovascular Disease From Cumulative Cigarette Use and the Impact of Smoking Intensity","volume":"27","author":"Lubin","year":"2016","journal-title":"Epidemiology"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntw290","article-title":"Greater Coronary Heart Disease Risk With Lower Intensity and Longer Duration Smoking Compared With Higher Intensity and Shorter Duration Smoking: Congruent Results Across Diverse Cohorts","volume":"19","author":"Lubin","year":"2017","journal-title":"Nicotine Tob Res"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.750773\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T08:36:53Z","timestamp":1635928613000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2021.750773\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,11,3]]},"references-count":31,"alternative-id":["10.3389\/fendo.2021.750773"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2021.750773","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,11,3]]},"article-number":"750773"}}