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01.12.2018 | Research | Ausgabe 1/2018 Open Access

Diabetology & Metabolic Syndrome 1/2018

Hookah smoking is strongly associated with diabetes mellitus, metabolic syndrome and obesity: a population-based study

Diabetology & Metabolic Syndrome > Ausgabe 1/2018
Sara Saffar Soflaei, Susan Darroudi, Maryam Tayefi, Abolfazl Nosrati Tirkani, Mohsen Moohebati, Mahmoud Ebrahimi, Habibollah Esmaily, Seyed Mohammad Reza Parizadeh, Ali Reza Heidari-Bakavoli, Gordon A. Ferns, Majid Ghayour-Mobarhan
Wichtige Hinweise
Sara Saffar Soflaei, Susan Darroudi and Maryam Tayefi contributed equally to this work



The adverse effects of cigarette smoking have been widely studied before, whilst the effects of hookah smoking has received less attention, although it is a common habit in the Middle East. Here we have investigated the effects of cigarette and hookah smoking on biochemical characteristics in a representative population sample derived from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study, from Northeastern Iran.

Study design

A total of 9840 subjects from the MASHAD population study were allocated to five groups; non-smokers (6742), ex-smokers (976), cigarette smokers (864), hookah smokers (1067), concomitant cigarette and hookah smokers (41).


Baseline characteristics were recorded in a questionnaire. Biochemical characteristics were measured by routine methods. Data were analyzed using SPSS software and p < 0.05 was considered significant.


After adjustment for age and sex; the presence of CVD, obesity, metabolic syndrome, DM and dyslipidemia were significantly (p < 0.001) related to smoking status. After multivariate analysis, HDL (p < 0.001), WBC (p < 0.001), MCV (p < 0.05), PLT (p < 0.01) and RDW (p < 0.001), and the presence of CVD (p < 0.01), obesity (p < 0.001), metabolic syndrome (p < 0.05) and DM (p < 0.01) remained significant between cigarette smokers and non-smokers. Between hookah smokers and non-smokers; uric acid (p < 0.001), PLT (p < 0.05) and RDW (p < 0.05), and the presence of obesity (p < 0.01), metabolic syndrome (p < 0.001), diabetes (p < 0.01) and dyslipidemia (p < 0.01) remained significant after logistic regression.


There was a positive association between hookah smoking and metabolic syndrome, diabetes, obesity and dyslipidemia which was not established in cigarette smoking.
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