{"doi":"10.1093/aje/kwad166","title":"Association Between Incident Type 2 Diabetes and Opium Use: Mediation by Body Mass and Adiposity","abstract":"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.","journal":"American Journal of Epidemiology","year":2023,"id":355768,"datarank":0.26876392038420827,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.0,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9393,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":275784,"name":"Hossein Poustchi","orcid":"0000-0003-4566-3628","position":1,"is_corresponding":false},{"id":22770,"name":"Gholamreza Roshandel","orcid":"0000-0002-5494-0722","position":2,"is_corresponding":false},{"id":109603,"name":"Farin Kamangar","orcid":"0000-0003-4169-7978","position":3,"is_corresponding":false},{"id":275785,"name":"Masoud Khoshnia","orcid":"0000-0001-7352-8058","position":4,"is_corresponding":false},{"id":276718,"name":"Abdolsamad Gharavi","orcid":null,"position":5,"is_corresponding":false},{"id":13291,"name":"Paul Brennan","orcid":"0000-0002-0518-8714","position":6,"is_corresponding":false},{"id":265963,"name":"Paolo Boffetta","orcid":"0000-0002-3811-2791","position":7,"is_corresponding":false},{"id":275790,"name":"Sanford M. Dawsey","orcid":"0000-0003-2185-0533","position":8,"is_corresponding":false},{"id":217938,"name":"Christian C. Abnet","orcid":"0000-0002-3008-7843","position":9,"is_corresponding":false},{"id":22644,"name":"Reza Malekzadeh","orcid":"0000-0003-1043-3814","position":10,"is_corresponding":false},{"id":48371,"name":"Arash Etemadi","orcid":"0000-0002-3458-1072","position":11,"is_corresponding":false},{"id":484866,"name":"Mahdi Nalini","orcid":"0000-0002-7464-9756","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T01:13:21.145955Z","pmid":"37552966","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}