Plasma lipid and lipoprotein profiles of cigarette smokers from randomly selected families: enhancement of hyperlipidemia and depression of high-density lipoprotein

Impact of switching from cigarette smoking to tobacco heating system use on biomarkers of potential harm in a randomized trial

BACKGROUND

Smoking cessation reduces the risk of developing smoking-related diseases. Although smoking prevalence has declined, many continue smoking cigarettes. Switching completely to smoke-free alternatives like the Tobacco Heating System (THS) 2.2-a heated tobacco product for which there is evidence demonstrating significantly reduced formation and exposure to harmful chemicals compared to cigarettes-has the potential to reduce the harm caused by continuing to smoke cigarettes.

METHODS

We conducted a 6-month clinical study (NCT02396381) with a 6-month extension (NCT02649556), initially randomizing 984 adult smokers to continue smoking or switch to THS (non-mentholated), of which 672 continued into the extension study. Endpoints were evaluated at baseline and at 3, 6, and 12 months. We longitudinally assessed biomarkers of potential harm (BoPHs) known to be reversible upon smoking cessation as indicators of pathways involved in the pathogenesis of cardiovascular or respiratory diseases and carcinogenicity. The need to cough and safety profile were also assessed. Impact on eight key BoPHs was used as a proxy to evaluate harm reduction potential.

RESULTS

At 12 months, comparison of BoPH levels between the predominant THS use and cigarette smoking groups showed a positive effect in favor of switching, partially or in full, to THS.

CONCLUSION

These results provide additional evidence of the harm reduction potential of THS for smokers who would otherwise continue smoking, but they need to be verified in long-term confirmatory studies.

CLINICAL TRIAL REGISTRATION

Clinicaltrials.gov Identifier: NCT0264955. Date of registration: January 7, 2016 https://clinicaltrials.gov/ct2/show/NCT02649556.

Oral Candidiasis of Tobacco Smokers: A Literature Review

The mouth is a vital point of entry into the human body, the health of the mouth entails mental, physical as well as social well-being. Studying diseases, microbiota and environmental conditions of the mouth is important to maintain oral health and all body. The smoke of tobacco cigarettes is one of the worst habits that affect the health of the mouth and the body. Therefore, this review has been conducted to study the effect of smoking on the balance of the oral microbiota and the opportunistic organisms, one of the most important of them <i>Candida</i>. Although a few studies have found that cigarette smoking does not influence carriage by <i>Candida</i> significantly. However, most of the studies had results completely contrary to that, smoking cigarettes affect <i>Candida</i> pathogenic characteristics such as a transition from yeast to hyphal form, biofilm formation and, virulence-related gene expressions. Tobacco is not only an inducer of the transition process but it considers an excellent medium for this process. Furthermore, smoking was significantly associated with <i>Candida</i> pathogenicity in patients with clinically suspected oral leukoplakia and smoking worsens oral candidiasis and dampens epithelial cell defense response. Nicotine significantly altered the composition and proportion of yeast cells, as well as the extracellular polysaccharide amounts which increase biofilm matrix and thickness which could promote oral candidiasis. Smoking has the potential to alter the oral condition and cause severe oxidative stress, thereby damaging the epithelial barrier of the mouth. These oxidative molecules during smoking activate epithelial cells proteins called oxidative stress-sensing proteins. If some of these proteins induced, widely thought to have anti-inflammatory properties, inhibit the secretion of pro-inflammatory cytokines and are linked to inflammation and oxidative stress is thought to be a possible therapeutic objective and a crucial regulator for smoking-related oral diseases and mouth candidiasis for instance leukoplakia. Also, it is transported into the cell nucleus in the existence of additional electrophilic chemicals to activate antioxidant enzyme gene expression. Therefore, smoking cigarettes destroys oral health and consequently destroys the health of the whole body.

Electronic Cigarette Use and the Risk of Cardiovascular Diseases

Electronic cigarettes or e-cigarettes are the most frequently used tobacco product among adolescents. Despite the widespread use of e-cigarettes and the known detrimental cardiac consequences of nicotine, the effects of e-cigarettes on the cardiovascular system are not well-known. Several in vitro and in vivo studies delineating the mechanisms of the impact of e-cigarettes on the cardiovascular system have been published. These include mechanisms associated with nicotine or other components of the aerosol or thermal degradation products of e-cigarettes. The increased hyperlipidemia, sympathetic dominance, endothelial dysfunction, DNA damage, and macrophage activation are prominent effects of e-cigarettes. Additionally, oxidative stress and inflammation are unifying mechanisms at many levels of the cardiovascular impairment induced by e-cigarette exposure. This review outlines the contribution of e-cigarettes in the development of cardiovascular diseases and their molecular underpinnings.

Juice from Fructus Rosae Roxburghii normalizes blood lipids in mice with diet-induced hyperlipidemia*†

Fructus Rosae Roxburghii (FRR) as a dietary supplement is considered to possess anti-atherosclerosis (AS), and hyperlipidemia (HLP) is material basis for AS formation, so the effects and molecular mechanism of FRR on diet-induced hyperlipidemic mice were explored. In Diet IV2 group, hepatic steatosis was significantly relieved; meanwhile, TC, TG, LDL-C, HDL-C, and ASI in serum were regulated to control level. Thirty-seven DCEG in Diet I, Diet II, and Diet IV2 groups were obtained by RNA-seq analysis. Relative mRNA levels were further determined by qRT-PCR, of which 28 genes were matched with those detected by RNA-seq. Ten DCEP were verified by targeted quantitative proteomic analysis, but expressive patterns of only six proteins were correlated with qRT-PCR data. These DCEG and DCEP played important roles in regulating the biosynthesis of BAs and steroids, fatty acid metabolism, and LPO production. They might cooperatively regulate the function of HDL or RCT by PPAR signaling pathway under the FRR action. As we know, it is the first time the potential anti-atherosclerotic mechanism of FRR regulating the blood lipids was explored.

Predictors of the Prevalence of Dyslipidemia and Influencing Factors for Young Health Examination Cohort: A Cross-Sectional Survey

Objectives: The objective of this study was to estimate the prevalence of dyslipidemia and associated influencing factors in young adults in the southeastern coastal area of China. Methods: This study adopted a cross-sectional survey and included 7,859 young people who underwent examinations at three hospitals in Wenzhou, Zhejiang Province, China. All subjects completed a questionnaire in the form of face-to-face interviews and underwent anthropometric measurements and biochemical tests. The continuous data are presented as the means ± standard deviations and were compared using Student's t-tests. The categorical variables are presented as proportions. The influencing factors associated with dyslipidemia were evaluated through a multivariate logistic regression. Results: The prevalence of dyslipidemia among young adults aged 18-45 years in the southeastern coast of China was high with 7.1, 15.0, 22.9, and 4.0% for high-total cholesterol (TC), high-triglyceride (TG), low-high-density lipoprotein cholesterol (HDL-C), and high-low-density lipoprotein cholesterol (LDL-C). Among those with dyslipidemia, a statistically significant difference in sex was observed, and all types of dyslipidemia were associated with smoking and alcohol consumption. However, those with high-TG, high-LDL, and low-HDL levels did not significantly differ in education level or occupation. The presence of dyslipidemia was significantly associated with increased age, the male sex (OR: 1.85, 95% CI: 1.39-2.21), smoking (OR: 2.02, 95% CI: 1.98-2.13), alcohol consumption (OR: 1.33, 95% CI: 1.16-1.63), overweight or obesity (OR: 2.01, 95% CI: 1.79-2.41), and intellectual work (OR: 1.36, 95% CI: 1.11-1.72). Conclusion: The prevalence of dyslipidemia among young adults aged 18-45 years in the southeastern coast of China was high. To prevent dyslipidemia at an early age, it is essential to conduct effective intervention programs targeting risk factors and to implement routine screening programs.

Proteomic analysis of liver in diet-induced Hyperlipidemic mice under Fructus Rosa roxburghii action

Fructus Rosae Roxburghii (FRR) has been considered as edible and medicinal fruit possessing antiatherosclerotic effect, but the mechanism is still unclear. HLP is material basis for AS formation. Under FRR action, TC, TG, LDL, HDL and ASI in serum were regulated to control level. Differentially expressed proteins in liver were analyzed by using TMT labeling and LC-MS/MS for better understanding the effect and molecular mechanism of FRR on diet-induced hyperlipidemic mice. In total, 4460 proteins were quantified, of which 469 proteins showed dramatic changes between each group. According to molecular functions, 25 differentially co-expressed proteins were divided into five categories: substance metabolism, energy transformation and signal transduction, transcription and translation, immune defense. 15 key proteins involved lipids metabolism, which were identified as Cyp7a1, Cyp3a11, Tm7sf2, COAT2, CSAD, RBP3, Lpin1, Dhrs4, Aldh1b1, GK, Acot 4, TSC22D1, PGFS, EHs, GSTM1. This suggested that FRR could maintain metabolic homeostasis by regulating the metabolism of fatty acids, biosynthesis of BAs and steroids, and production of LPOs. 20 oxidative lipids further confirmed their importance regulating lipids metabolism. It's first time potential antiatherosclerotic mechanism of FRR regulating blood lipids was explored from protein level, which is of great significance to explore new drug targets for AS. SIGNIFICANCE: Under the action of FRR juice, the blood lipids in mice were regulated to control level. By TMT proteomic analysis, the effect and molecular mechanism of FRR on diet-induced hyperlipidemic mice were further explored. 25 differentially co-expressed proteins obtained in three diet groups might cooperatively regulate the lipids metabolism and hepatic function of mice, thus maintaining the metabolism homeostasis. By lipidomics analysis, 20 oxidative lipids further confirmed the importance of ω-3 and ω-6 PUFAs in regulating the lipids metabolism. These findings provide an improved understanding for the regulation of FRR on the blood lipids and explores potential metabolic targets for AS prevention.

Effects of cigarette smoking on blood lipids in Korean men: Cardiovascular and Metabolic Diseases Etiology Research Center cohort

BACKGROUND/AIMS

Cigarette smoking and abnormal blood lipids are major risk factors for cardiovascular disease. The results of previous studies on the relationship between cigarette smoking and dyslipidemia are controversial. In the present study, we investigated the independent association between cigarette smoking and blood lipid levels in a male Korean population.

METHODS

A total of 1,932 men aged from 30 to 64 years old participated in the Cardiovascular and Metabolic Diseases Etiology Research Center cohort study. Smoking history was obtained by in-person interviews. In all regression models, measurements of triglyceride levels were log-transformed.

RESULTS

Triglyceride levels were higher in current smokers than in never-smokers (median: 149 mg/dL vs. 115 mg/dL, p < 0.001) even after adjusting age, body mass index, alcohol intake, systolic blood pressure, fasting glucose, physical activity, and nutrition intake (β = 0.14, p < 0.001). We further divided people into heavy and light smokers using 20 pack-years as the cut-off. Higher triglyceride were found in current heavy smokers (β = 0.18, p < 0.001), current light smokers (β = 0.13, p < 0.001), as well as in past heavy smokers (β = 0.08, p = 0.037), as compared to never-smokers. Moreover, significantly lower high-density lipoprotein cholesterol (HDL-C) were observed in current heavy smokers (β = -2.27 mg/dL, p = 0.009).

CONCLUSION

Cigarette smoking is associated with higher triglyceride in Korean men, with the most dramatic effect seen in current smokers with a smoking history of more than 20 pack-years. HDL-C were also lower in current smokers with more than 20 pack-years.

Smoking results in accumulation of ectopic fat in the liver

OBJECTIVE

An association between smoking and nonalcoholic fatty liver disease has been reported. However, objective quantification of intrahepatic fat via magnetic resonance spectroscopy (MRS) in relation to smoking has rarely been performed in previous studies. Moreover, the possible pathways via which smoking could induce ectopic fat accumulation have not yet been addressed. The current study aimed to examine the association between smoking status and intrahepatic fat quantity and explore the possible mediating effects of triglycerides (TG) and adiponectin.

SUBJECTS AND METHODS

Magnetic resonance imager (MRI) spectra were analyzed to quantify intrahepatic fat in 45 men who were on average 62.3 years of age. Smoking status and alcohol intake were self-reported. Accelerometers were used to record daily total physical activity. Fasting blood TG and adiponectin levels were measured enzymatically. Differences in mean intrahepatic fat values according to smoking status were assessed using analysis of covariance.

RESULTS

A stepwise increase in mean intrahepatic fat was observed between never, former, and current smokers, respectively, independent of age, physical activity, alcohol intake, and body mass index (BMI) (P=0.005). Adjustment for TG and adiponectin significantly attenuated this association (P=0.074).

CONCLUSION

Current smoking was significantly associated with increased intrahepatic fat, which may be a result of adipocyte dysfunction, manifested as high circulating TG concentrations and low adiponectin levels.

Oxidant-antioxidant status and assessment of cardiovascular morbidity in Pan Masala containing Tobacco users: a cross-sectional study

OBJECTIVE

Pan Masala containing Tobacco (PMT) use contributes significantly to the overall world tobacco burden especially in south Asian country like Nepal. Oxidative stress caused by it may leads to cardiovascular disease, peripheral vascular disease, hypertension, etc. Therefore, this work proposes to study the antioxidant and oxidative stress along with cardiovascular morbidity in PMT users.

RESULTS

Hundred PMT users and 80 non-user controls with age and sex matched were enrolled. There was a significant difference in blood pressure, albumin, uric acid, vitamin C, vitamin E, malondialdehyde (MDA), total cholesterol, triglycerides, low density lipoprotein cholesterol between the two groups (p < 0.001). We observed statistically significant (p < 0.001) decrease in antioxidant and increase oxidative stress in PMT users. Duration and quantity of PMT user were significantly associated with the MDA level.

Plasma lipid abnormalities in Pakistani population: trends, associated factors, and clinical implications

Previous studies have reported increased prevalence of coronary heart disease (CHD) in Indians and South Asian settlers in North America. This increased burden of CHD among South Asians is mainly caused by dyslipidemia. To the best of our knowledge, none of the previous works has studied the patterns and prevalence of dyslipidemia in the Pakistani population. The present work aimed to study the plasma lipid trends and abnormalities in a population-based sample of urban and rural Pakistanis. The study included 238 participants (108 males,130 females). Plasma lipid profiles of the participants were determined using standard protocols. We observed that 63% of the study population displayed irregularities in at least one major lipid-fraction including total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), or triglycerides (TG). The most common form of isolated-dyslipidemia was low HDL-C (17.3%) followed by high TG (11.2%). Several overlaps between high TC, LDL-C, TG and low HDL-C were also noted. Gender, urbanization, and occupational class were all observed to have an impact on lipid profiles. Briefly, male, urban, and blue-collar participants displayed higher prevalence of dyslipidemia compared to female, rural, and white-collar participants, respectively. In comparison to normal subjects, dyslipidemic subjects displayed significantly higher values for different anthropometric variables including body mass index (BMI), body fat percentage, and waist circumference. The present work provides a comprehensive estimation of the prevalence of dyslipidemia and CHD risk in the Pakistani population. This information will be helpful for better healthcare planning and resource allocation in Pakistan.

Association of smoking with prevalence of common diseases and metabolic abnormalities in community-dwelling Japanese individuals

Smoking is a significant risk factor for cardiovascular diseases (CVDs). Given that certain common pathologies, including hypertension, dyslipidemia and type 2 diabetes mellitus, are major risk factors for CVDs, the association of smoking with CVDs may be attributable, at least in part, to its effects on common diseases. The aim of the present study was to determine the association of smoking with the prevalence of common diseases and metabolic abnormalities in community-dwelling Japanese individuals. The study included 5,959 subjects (1,302 current smokers, 1,418 past smokers and 3,239 nonsmokers) recruited to the Inabe Health and Longevity Study, a longitudinal genetic epidemiological study of atherosclerotic, cardiovascular and metabolic diseases. Various metabolic parameters and prevalence of common diseases were compared between smokers and nonsmokers using multivariable regression or logistic regression analysis with adjustments for age. Analysis indicated significantly higher serum concentrations of triglycerides and lower concentrations of high-density lipoprotein (HDL)-cholesterol in current smokers compared with nonsmokers in men and women. Serum concentrations of creatinine and systolic blood pressure were significantly lower and estimated glomerular filtration rate was higher in male current smokers. In addition, body weight was higher in female current smokers. In multivariable logistic regression analysis, smoking was significantly associated with the prevalence of dyslipidemia [P=6.3×10^-10; odds ratio (OR), 1.81], hypertriglyceridemia (P=2.3×10^-20; OR, 2.39), hypo-HDL-cholesterolemia (P=2.0×10^-9; OR, 2.14), metabolic syndrome (P=0.0003; OR, 1.61) and chronic kidney disease (P=4.4×10^-15; OR, 0.54) in men, but not in women. The results indicated that smoking is significantly associated with various metabolic abnormalities and prevalence of common diseases in Japanese individuals, with certain sex differences, which may lead to accelerated development of CVDs.

Smoking, Adolescents and Health: Isfahan Healthy Heart Programme-Heart Health Promotion from Childhood

To evaluate the effect of some environmental factors on smoking, and to assess some health hazards of smoking in adolescents, this cross-sectional study was performed among 1950 students, ages11-18, selected by multi-stage random sampling from three cities in Iran. According to self-administered questionnaires, 12.9% of boys and 4% of girls reported to be smoker (OR=3.34, 95%CI: 2.33, 4.77, p<0.001). The mean values of total-and LDL-cholesterol were higher in smokers and their HDL-C was lower than non-smokers (163.33± 33.83, 90.73± 31 and 46.7± 12.24 vs.156± 29.53, 85±26.5 and 49.4±13.7 mg/dl, respectively, p<0.05). The mean systolic and diastolic blood pressures were higher in smokers than non-smokers (110.7± 14.5, 67.6± 11.55 vs. 104.9± 14.3, 63.2± 10.8 mmHg, respectively, p<0.05). The smokers had higher BMI than non-smokers (20.34 ±3.84 vs.19.55 ± 3.66, p<0.05). The mean food consumption frequency was lower for fruits and vegetables and higher for fat/salty snacks and fast foods in smokers than non-smokers. Logistic regression analysis showed significant association between sex, age, the number of family members and number of smokers in the family and smoking in students. The findings of this study have implications for future tobacco prevention strategies through community-based interventions. Asia Pac JPublic Health 2004; 16(1): 15-22.

Effect of gender, age, diet and smoking status on chronomics of circulating plasma lipid components in healthy Indians

BACKGROUND

Circulating lipid components were studied under near-normal tropical conditions (around Lucknow) in 162 healthy volunteers - mostly medical students, staff members and members of their families (103 males and 59 females; 7 to 75y), subdivided into 4 age groups: A (7-20y; N=42), B (21-40y; N=60), C (41-60y; N=35) and D (61-75y; N=25).

METHODS

Blood samples were collected from each subject every 6h for 24h (4 samples). Plasma was separated and total cholesterol, high-density-lipoprotein (HDL) cholesterol, phospholipids and total lipids were measured spectrophotometrically. Data from each subject were analyzed by cosinor. We examined by multiple-analysis of variance how the MESOR (Midline Estimating Statistic Of Rhythm, a rhythm-adjusted mean) and the circadian amplitude of these variables is affected by gender, age, diet (vegetarian vs. omnivore), and smoking status.

RESULTS

In addition to effects of gender and age, diet and smoking were found to affect the MESOR of circulating plasma lipid components in healthy Indians residing in northern India. Age also affected the circadian amplitude of these variables.

CONCLUSION

These results indicate the possibility of using non-pharmacological interventions to improve a patient's metabolic profile before prescribing medication under near normal tropical conditions. They also add information that may help refine cut-off values in the light of factors shown here to affect blood lipids.

Comparison between electronic cigarette refill liquid and nicotine on metabolic parameters in rats

AIMS

Nicotine is known to promote body weight loss and to disturb glucose homeostasis and lipoprotein metabolism. Electronic cigarettes, as a substitute to nicotine, are becoming increasingly popular, although there is no evidence regarding their safety. Considering the dearth of information about e-cigarette toxicity, the present study was designed to compare nicotine alone to e-liquid with or without nicotine on metabolic parameters in Wistar rats.

MAIN METHODS

For this purpose, e-liquid with or without nicotine and nicotine alone (0.5mg/kg of body weight) were administered intra-peritoneally during 28 days.

KEY FINDINGS

Our results show a significant decrease in food and energy intake after nicotine or e-liquid with nicotine exposure, when compared to control or e-liquid without nicotine. Analysis of lipid status identified a significant decrease in cholesterol and LDL levels in e-cigarette groups, suggesting an improvement in lipid profile. Interestingly, e-liquid without nicotine induced hyperglycemia which is negatively correlated to hepatic glycogen level, acting like nicotine alone. Furthermore, an increase in liver biomarkers was observed in all treated groups. qRT-PCR analysis showed GSK3β up-regulation in e-liquid with nicotine as well as, surprisingly, in e-liquid without nicotine exposure. In contrast, PEPCK genes were only up-regulated in e-liquid with nicotine.

SIGNIFICANCE

While some features observed in rats may not be observed in human smokers, most of our data are consistent with, e-liquid per se i.e. without nicotine, not being neutral from a metabolic stand point since disrupting glucose homeostasis in rats.

Revisiting the dyslipidemia associated with acute leukemia

BACKGROUND

Previous studies appreciate the leukemia-associated alterations in plasma lipid profiles but fail to provide a consistent pattern of lipid anomalies in leukemia patients. These inconsistencies could be due to overlooking the effects of related confounding risk-factors and comorbidities.

METHODS

The plasma lipid profiles of acute-leukemia and control groups were compared.

RESULTS

We observed that acute lymphocytic leukemia (ALL) patients display significantly higher triglycerides and very low-density lipoproteins, whereas, acute myeloid leukemia (AML) patients display significantly lower high-density lipoproteins. To assess the confounding effects of related risk factors gender-, age- and BMI-based analyses were performed. We observed that the aforementioned significant differences in the lipid profiles of leukemia patients were restricted to female participants of the respective groups. Moreover, a significant decrease in total cholesterol and low-density lipoprotein levels was observed only in male participants of the AML population. Various age-specific trends in plasma lipid profile of the leukemia patients were also observed. BMI-based analysis did not display many significant differences from the overall analyses. In addition to comparing the absolute values of plasma lipids in leukemia and control groups we also compared and observed significant differences in prevalence of various isolated- and mixed-dyslipidemias in these groups.

CONCLUSIONS

These findings may help in outlining the prevalence and types of dyslipidemia in leukemia patients that may emerge as diagnostic/prognostic factors for the management of acute leukemia.

Gender-dependent association of HSD11B1 single nucleotide polymorphisms with glucose and HDL-C levels

In this study, we investigated the influence of two SNPs (rs846910 and rs12086634) of the HSD11B1 gene that encodes 11β-hydroxysteroid dehydrogenase type 1(11β-HSD1), the enzyme that catalyzes the conversion of cortisol to cortisone, on variables associated with obesity and metabolic syndrome in 215 individuals of both sexes from southern Brazil. The HSD11B1 gene variants were genotyped using the TaqMan SNP genotyping assay. Glucose, triglycerides, total cholesterol, HDL-cholesterol and LDL-cholesterol were measured by standard automated methods. Significant results were found in women, with carriers of the G allele of SNP rs12086634 having higher glucose levels than non-carriers. Carriers of the A allele of SNP rs846910 had higher levels of HDL-cholesterol. The involvement of both polymorphisms as independent factors in determining the levels of glucose and HDL-cholesterol was confirmed by multiple regression analysis (β = 0.19 ±0.09, p = 0.03 and β= 0.22 ± 0.10, p = 0.03, respectively). Our findings suggest that the HSD11B1SNPs studied may indirectly influence glucose and HDL-cholesterol metabolism in women, possibly through down-regulation of the HSD11B1 gene by estrogen.

Effects of Hibiscus sabdariffa L. on serum lipids: a systematic review and meta-analysis

ETHNOPHARMACOLOGICAL RELEVANCE

Prevention of cardiovascular disease by modifying its major risk factors, including serum cholesterol levels, is an important strategy. Hibiscus sabdariffa L. has been promoted for reducing cholesterol levels, but its reported impact on cholesterol levels has been inconsistent. The study aimed to assess systematically the evidence and quality of current research on the effect of Hibiscus sabdariffa L. on blood lipids and its adverse effects.

MATERIALS AND METHODS

Electronic databases were searched up to June 2013 for relevant randomised controlled trials (RCTs). Journals and conference proceedings were also searched. The quality of the selected trials was assessed using the Cochrane Risk of Bias Assessment Tool. The efficacy results of similar studies were pooled if they used the same comparator. Outcomes examined were levels of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol and triglycerides.

RESULTS

Six studies involving 474 subjects met our inclusion criteria. These studies varied in terms of the types of interventions, comparators used, and duration of trials. Overall, Hibiscus sabdariffa L. did not produce any significant effect on any of the outcomes examined, when compared with placebo, black tea or diet. With short-term use it is well tolerated.

CONCLUSIONS

The available evidence from RCTs does not support the efficacy of Hibiscus sabdariffa L. in lowering serum lipids. Further rigorously designed trials with larger sample sizes are warranted to confirm the effects of HS on serum lipids.

Effect of tobacco smoking and smoking cessation on plasma lipoproteins and associated major cardiovascular risk factors: a narrative review

Cigarette smoking, active or passive, kills about 6 million people each year worldwide. Cardiovascular disease (CVD) is responsible for 40% of all smoking-related deaths, lung cancer accounts for 20% of all smoking-related deaths, and chronic obstructive pulmonary disease is related to another 20% of deaths. In this narrative review we consider the relationship between cigarette smoking and CVD. We discuss disease states and/or CVD risk factors related to smoking, such as dyslipidaemia, vascular inflammation, endothelial dysfunction, arterial stiffness, insulin resistance, type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and non-alcoholic fatty liver disease (NAFLD) as well as their complex interrelations. Smoking cessation can correct abnormalities related to smoking; however, success rates are relatively low. In cases of inability to quit, measures to minimize the adverse effects of smoking specifically related to CVD should be taken. Smokers should receive best practice treatment, according to guidelines, as for non-smokers.

Inhibition of apolipoprotein A-I gene by the aryl hydrocarbon receptor: a potential mechanism for smoking-associated hypoalphalipoproteinemia

AIMS

Smokers have lower plasma concentrations of high-density lipoprotein (HDL) cholesterol and apolipoprotein A-I (apo A-I) compared with nonsmokers. To determine the molecular basis of this observation, the effect of activation of the aryl hydrocarbon receptor (AhR) on apo A-I gene expression was examined.

MAIN METHODS

HepG2 cells were treated with AhR receptor agonists benzo(a)pyrene (BaP) and CAY10465, and AhR receptor antagonist CAY10464 and apo A-I protein, mRNA levels and promoter activity were measured. The effect of nicotine on apo A-I protein secretion was also tested. Using a series or apo A-I gene promoter deletion constructs, a xenobiotic response element (XRE) was identified.

KEY FINDINGS

Treatment of HepG2 cells with the AhR receptor agonists BaP and CAY10465, inhibited apo A-I protein synthesis while nicotine, which does not bind AhR had no effect. Benzo(a)pyrene treatment also suppressed apo A-I mRNA and gene promoter activity. Treatment of HepG2 cells with the AhR receptor antagonist CAY10464 reversed the suppressive effect of BaP on apo A-I gene expression. A putative xenobiotic response element (XRE) was identified between nucleotides -325 and -186 (relative to the transcriptional start site, +1).

SIGNIFICANCE

These results suggest that the cigarette smoking related environmental contaminant BaP promotes hypoalphalipoproteinemia in part through activation of the hepatic AhR.

Gender differences in the association between smoking and dyslipidemia: 2005 Korean National Health and Nutrition Examination Survey

BACKGROUND

Smoking has been reported to be associated with abnormal lipid metabolism. However, it remains uncertain whether adverse metabolic effects of smoking on dyslipidemia differ with gender. The objective of this study was to investigate the association between smoking and dyslipidemia in men and women.

METHODS

We analyzed data from 2166 men and 3003 women aged ≥20 years assessed in the Third Korea National Health and Nutrition Examination Survey (2005). Dyslipidemia was defined according to the National Cholesterol Education Program-Adult Treatment Panel III.

RESULTS

The prevalence of dyslipidemia was higher in men than in women. The odds ratios (95% confidence interval) of dyslipidemia associated with current smoking were 1.35 (0.98-1.85) in men and 1.92 (1.19-3.10) in women (p for interaction with gender <0.001). After stratification by components of dyslipidemia, women smokers showed higher odds ratios of having high triglyceride and low high-density lipoprotein cholesterol than men smokers. The association between current heavy-smoking (≥20 pack-years) and dyslipidemia was stronger in women than in men.

CONCLUSIONS

The association between smoking and dyslipidemia was significantly different between men and women. Women smokers might be more susceptible to develop dyslipidemia than men smokers.

Lipid and lipoprotein profiles among middle aged male smokers: a study from southern India

Objectives

The objectives were to investigate into the relationship between lipid profile including Apolipoprotein-A1 (Apo-A1) and Apolipoprotein-B (Apo-B) and smokers and to relate them with smoking pack years.

Materials and Methods

A total of 274 active male smokers without any other illnesses and age matched male healthy control subjects (78) with similar socio-cultural background were assessed for clinical details, dietary habits, physical activities, smoking and alcohol consumption. Standard methods were adopted to check the lipid levels. The data were analyzed statistically.

Results

Their ages ranged from 40 to 59 years, systolic BP from 110 to 130 mmHg, and diastolic BP from 76 to 88 mmHg. All of them had similar pattern of diet (vegetarianism with occasional meat). None was on any medication influences lipid level. Their physical activity was moderate. Number of pack years varied from 10 to 14 (mild), 15 to 19 (moderate) and 20 and above (heavy) among 69, 90 and 115 cases, whose mean ages were 43, 44 and 49 respectively. The mean (+SD) values in mg/dl of total cholesterol (TC), Triglyceride (TGL), Apo-B, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and Apo-A1 in mg/dl among mild/ moderate/ heavy smokers and control subjects were 198 (30.6)/ 224 (27.2)/ 240 (24.3) and 160 (20.4); 164(42.6)/ 199 (39.5)/ 223(41.7) and 124 (31.6); 119 (24.9)/ 121 (27)/ 127 (28.3) and 116 (21.4); 94 (19.7)/ 104 (21.8)/ 120 (20.5) and 82 (17.6); 42 (5.9)/ 39 (3.1)/ 35(4.4) and 48 (5.3); and 120 (17)/ 119 (21)/ 115 (25) and 126 (19), respectively. In smokers, there was a rise in TC, TGL, LDL, Apo-B and fall in HDL and Apo-A; these changes were significant (P < 0.05).

Conclusion

Number of pack years was directly proportional to abnormal lipid profile. It is also concluded that changes in Apo-A1 and Apo-B were more significant when compared to HDL and LDL cholesterol among smokers. In the view of double risk for smokers (smoking and altered lipid profile) efforts may be made to introduce smoking cessation program.

Modification by acrolein, a component of tobacco smoke and age-related oxidative stress, mediates functional impairment of human apolipoprotein E

Oxidative damage to proteins such as apolipoprotein B-100 increases the atherogenicity of low-density lipoproteins (LDL). However, little is known about the potential oxidative damage to apolipoprotein E (apoE), an exchangeable antiatherogenic apolipoprotein. ApoE plays an integral role in lipoprotein metabolism by regulating the plasma cholesterol and triglyceride levels. Hepatic uptake of lipoproteins is facilitated by apoE's ability to bind with cell surface heparan sulfate proteoglycans and to lipoprotein receptors via basic residues in its 22 kDa N-terminal domain (NT). We investigated the effect of acrolein, an aldehydic product of endogenous lipid peroxidation and a tobacco smoke component, on the conformation and function of recombinant human apoE3-NT. Acrolein caused oxidative modification of apoE3-NT as detected by Western blot with acrolein-lysine-specific antibodies, and tertiary conformational alterations. Acrolein modification impairs the ability of apoE3-NT to interact with heparin and the LDL receptor. Furthermore, acrolein-modified apoE3-NT displayed a 5-fold decrease in its ability to interact with lipid surfaces. Our data indicate that acrolein disrupts the functional integrity of apoE3, which likely interferes with its role in regulating plasma cholesterol homeostasis. These observations have implications regarding the role of apoE in the pathogenesis of smoking- and oxidative stress-mediated cardiovascular and cerebrovascular diseases.

Influence of smoking on predictors of vascular disease

Beyond the already well-established strong causative relationship with cancer, smoking increases the risk for vascular disease. Smoking may act directly or adversely influence risk factors contributing to the development of vascular disease. Smoking causes endothelial dysfunction, dyslipidemia (decreased high-density lipoprotein cholesterol levels, hypertriglyceridemia and increased oxidation of low-density lipoprotein cholesterol) and platelet activation leading to a prothrombotic state. Smoking increases emerging risk factors (eg, fibrinogen, homocysteine, and high-sensitivity C-reactive protein) and increases insulin resistance and the risk of developing type 2 diabetes mellitus. The beneficial effects of statins and antioxidants (eg, vitamins C and E, beta-carotene) are counteracted by smoking. Smoking-induced alterations in growth factors, adhesion molecules, and even in genes can accelerate the progression of atherosclerosis. The aim of this review is to consider the adverse consequences of smoking on the factors predisposing to vascular disease and to emphasize the beneficial effects of smoking cessation.

Joint effects of alcohol consumption and cigarette smoking on atherogenic lipid and lipoprotein profiles: results from a study of Chinese male population in Taiwan

BACKGROUND

The present study examines the effect of joint exposure to cigarette smoking and alcohol intake on serum levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and triglyceride (TG) among Chinese male adults in Taiwan.

METHODS

A sample of 3311 men aged 20-59 years who reported having stable smoking and drinking behaviors during the period between January 1995 and December 1996 was selected from a periodic health checkup population. Serum lipids and lipoprotein cholesterol fractions were measured on fasting blood samples taken from participants. Statistical methods of analysis of variance and analysis of covariance were conducted to examine the associations of different smoking-drinking behavioral patterns with lipid and lipoprotein levels.

RESULTS

In the observed population, the percentages of men who had stable cigarette smoking and alcohol consumption behaviors were 39.5% (1,307/3,311) and 27.0% (895/3,311), respectively. Mean values of TC and TG increased significantly and monotonically with increasing levels of cigarette smoking and alcohol consumption. In addition, alcohol intake was significantly associated with increased HDL-C and reduced LDL-C levels in a dose-dependent manner. More interestingly, the effect of alcohol consumption on LDL-C (negative) and TG (positive) levels was substantially greater for heavy smoker (>20 cigarettes/day) than for light smokers (< or = 20 cigarettes/day) and non-smokers, while alcohol intake exerted a strong positive influence on HDL-C concentration regardless of levels of cigarette smoking.

CONCLUSIONS

In this Chinese male population, cigarette smoking and alcohol consumption were confirmed to have similar effects on lipid and lipoprotein levels as in Caucasians. More interestingly, a significance of joint exposure to smoking and drinking in predicting lipid and lipoprotein levels was evident. These data indicate the importance of multifactorial interventions to obtain more favorable lipid and lipoprotein levels in the population.

Development of a structural equation model for causal relationships among arteriosclerosis risk factors

The purpose of this study was to clarify the dynamic causal relationships among arteriosclerotic risk factors, including age, smoking, alcoholic consumption, exercise, hypercholesterolemia, hypertriglyceridemia, and hypertension. Data were collected from the medical records of 400 male clients who visited a university hospital located in Inchon, Korea, from May 1996 to December 1996 for physical examinations. The Lineal Structural Relationships 8 program was used to verify the fitness of the hypothetical model to data. All of the fit statistics, except the Chi-square value, showed that the hypothetical model was well fitted to the data. Seven percent of obesity was explained by the variables of age, smoking, alcohol consumption, and exercise. Sixty percent of hyperlipidemia could be explained by the variables of age, smoking, exercise, and obesity. And 22% of hypertension was explained by the variables of age, smoking, alcohol consumption, exercise, and hyperlipidemia. Our results showed that these risk factors were directly and indirectly interrelated, and lifestyle variables (smoking, alcohol consumption, and exercise) influence almost all of arteriosclerotic risk factors.

Cigarette smoking, blood pressure and serum lipids and lipoproteins in middle-aged women

The relationship of cigarette smoking with blood pressure and serum lipids and lipoproteins was studied in the 3934 middle-aged women aged 40 to 59 years. After adjusting age, body mass index (BMI), alcohol intake and physical activity scores, the mean systolic and diastolic blood pressures (SBP and DEP, respectively) did not indicate dose-dependent relationships. The largest significant mean differences in SBP (4.6 mmHg), DBP (3.9 mmHg), high density lipoprotein cholesterol (HDL-C) (9.6 mg/dL), ratio of total cholesterol to HDL-C (TC/HDL-C) (0.8), triglycerides (TG) (22.9 mg/dL) and the logarithmic transformation of TG (Log TG) (0.26) were found between the non-smokers and smokers. When age, BMI, alcohol intake and physical activity scores were included in the forward stepwise multiple regression analyses, there were negative relationships found for cigarette smoking and SBP, DBP and HDL-C and positive relationships for cigarette smoking and TC/HDL-C, TG, Log TG and low density lipoprotein cholesterol. Although the results are somewhat variable, the present study shows cigarette smoking is negatively associated with SBP and DBP and unfavorably associated with serum lipids and lipoproteins in middle-aged women.

Effect of smoking on lipid and thrombogenic factors two months after acute myocardial infarction

Cigarette smoking is linked to increased cardiac morbidity and mortality, and has been shown to affect both lipid profiles and thrombotic factors in healthy subjects. However, the influence of smoking on the atherothrombotic environment has not been studied in a large population of patients after acute myocardial infarction (AMI). Blood samples and medical history, including smoking status, were obtained from 1,045 patients at a 2-month visit after AMI. Smokers were asked to refrain 24 hours before the visit, but not all complied. Measurements included total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, apolipoprotein-B, apolipoprotein-A, triglycerides, factor VII, factor VIIa, von Willebrand factor, D-dimer, and plasminogen activator inhibitor. There were 247 current, 443 past, and 349 nonsmokers. After adjustment for clinical variables, current smokers had higher levels of total cholesterol and apolipoprotein-B than past and nonsmokers (p <0.01). High-density lipoprotein cholesterol and apolipoprotein-A levels were similar between groups. Fibrinogen was elevated in current (p = 0.001) and past (p = 0.029) smokers, compared with nonsmokers. Smokers who smoked within 24 hours of blood sampling had higher apolipoprotein-B (p = 0.005), total cholesterol (p = 0.001), and fibrinogen (p = 0.015) levels than those who refrained from smoking. In conclusion, postinfarction patients, who historically have higher levels of atherogenic lipids than healthy subjects, have increased levels of these lipids attributed to active smoking. After smoking cessation, lipid profiles approach nonsmoker levels, but fibrinogen remains elevated. Smoking within 24 hours of blood sampling was associated with further adverse prothrombotic and lipogenic effects.

Smoking influences the association between apolipoprotein E and lipids: the National Heart, Lung, and Blood Institute Family Heart Study

Apolipoprotein E allele 4 (apo epsilon4) and smoking each have been associated with an unfavorable lipid profile. We used data collected on 1,472 subjects in the National Heart, Lung, and Blood Institute Family Heart Study to assess whether smoking interacts with apo epsilon4 to influence the levels of plasma lipids. We dichotomized smoking and apo epsilon4 and used analysis of covariance to estimate the means of lipids. Smokers had lower body mass index, were younger, and consumed less fruits and vegetables. Among individuals without apo epsilon4, comparing nonsmokers with smokers, mean low density lipoprotein cholesterol (LDL) was 129.3 and 134.4 mg/dL, respectively, for women and 126.1 and 127.6 mg/dL, respectively, for men. Among subjects with an apo epsilon4 allele, corresponding means were 132.0, and 152.9 mg/dL, respectively, for women and 131.3 and 137.3 mg/dL, respectively, for men (Pfor interaction <0.001 for women and 0.11 for men). A similar interaction was observed for total cholesterol among women (P = 0.02). This study shows a statistically significant effect modification of the relation of apo epsilon4 to LDL and total cholesterol by smoking among women. Smoking may enhance genetic susceptibility to an unfavorable lipid profile among subjects with apo epsilon4.

Relationship of cigarette smoking with blood pressure, serum lipids and lipoproteins in young Japanese women

1. The relationship of cigarette smoking with blood pressure and serum lipids and lipoproteins was studied in 1062 young Japanese women aged 20-39 years of age. 2. After adjusting for age, body mass index (BMI), alcohol intake and physical activity scores, the mean systolic and diastolic blood pressures (SBP and DBP, respectively) did not indicate dose-dependent relationships with cigarette smoking. The largest significant mean differences in SBP (3.5%; P < 0.001), DBP (6.2%; P < 0.018), high-density lipoprotein-cholesterol (HDL-C; 13.2%; P < 0.005), ratio of total cholesterol to HDL-C (13.9%; P < 0.022), triglycerides (TG; 24.1%; P < 0.001) and the logarithmic transformation of TG (log TG; 5.6%; P < 0.001) were found between non-smokers and smokers. 3. When age, BMI, alcohol intake and physical activity scores were included in the forward step-wise multiple regression analysis, there were negative relationships found for cigarette smoking and SBP and DBP and positive relationships for cigarette smoking and TG and log TG. 4. Although the results are somewhat variable, the present study shows that cigarette smoking is negatively associated with SBP and DBP and that there is an association between cigarette smoking and serum lipids and lipoproteins and that smoking has an unfavourable effect on these parameters in young Japanese women.

Coronary risk factors: influences on the lipid profile

Risk factors for cardiovascular disease have been defined by various groups and experts for decades. Unfortunately, the lack of consensus among these groups and the periodic changes in risk factor listings have led to confusion among health care professionals. Because so many risk factors inter-relate, it is difficult to isolate the effect of a specific risk factor on the lipid profile. In an effort to eliminate some of the confusion, this article describes the known effects of physical inactivity, obesity, cigarette smoking, age, hypertension, and diabetes mellitus on lipids and lipoproteins. A summary of the known results is displayed in a table. Because of the complexity of the atherosclerotic disease process and the multifactorial influences on lipid metabolism, this remains an exciting and challenging area for research.

Smoking and lipid cardiovascular risk factors in Vietnamese refugees in Australia

BACKGROUND

The effects of smoking and sex on lipid risk factors for cardiovascular disease were examined among Vietnamese people newly arrived in Australia.

METHODS

Immigrants recruited through Refugee Screening had anthropometric data recorded and blood collected to measure total cholesterol (TC), high-density lipoprotein cholesterol (HDL), and triglyceride (TG) by Reflotron; apolipoprotein A-1 (apo A-1) and apolipoprotein B-100 (apo B) by immunoturbidimetric analyses (Turbitimer); and lipoprotein (a) (LP (a)) by ELISA. A questionnaire determined behavioral variables known to influence cardiovascular risk and Statview, Minitab, and SPSS were employed for data analysis.

RESULTS

Lipoprotein profiles of men (n = 242) and women (n = 159) were compared. Crude TC and apo B were similar; HDL, apo A-1, and LP (a) were higher in women, TG was higher in men. After adjustment (age, BMI, WHR, years of smoking, and drinks per week), only apo A-1 and LP (a), were higher in women. "At risk" levels of TC or apo B did not differ by gender; risk of low apo A-1 was higher among men. Smokers had a significant risk (crude and adjusted) of low HDL, low apo A-1, and high LP (a). The sex difference in HDL was removed by a single adjustment for smoking; male smokers had higher LP (a) than male nonsmokers.

CONCLUSION

Male and female Vietnamese immigrants had similar adjusted lipid profiles. Smoking had a marked detrimental effect on lipids.

Randomized controlled smoking cessation study: transient increase in plasma high density lipoprotein but no change in lipoprotein oxidation resistance

Low plasma levels of high density lipoprotein (HDL) and high levels of low density lipoprotein (LDL) as well as smoking are known risk factors in coronary heart disease. It has been suggested that oxidative modification renders LDL atherogenic. We investigated the influence of smoking cessation on plasma lipid and lipoprotein levels and on the ability of lipoproteins to resist oxidation in vitro (lag time). A total of 182 healthy smokers who smoked more than 15 cigarettes per day were randomized to stop smoking (smoking cessation group, n = 100) or to continue smoking for 4 weeks (control group, n = 82). The smoking cessation group was followed up after 26 weeks. After 4 weeks, the HDL level had increased from mean +/- SD 1.36 +/- 0.34 to 1.48 +/- 0.40 mmol l-1 (p < 0.001) in 62 successful quitters, while levels were unchanged in the control group (72 subjects in per-protocol analysis). However, after 26 weeks there was no change in HDL (1.34 +/- 0.36 vs. 1.36 +/- 0.35 mmol l-1) in 29 subjects from the smoking cessation group who fulfilled the study. Plasma levels of very low density lipoprotein (VLDL), LDL, total cholesterol, triglycerides and oxidation resistance of VLDL + LDL did not show significant changes any time during the study for either group. Thus, plasma levels of lipids and lipoproteins as well as oxidation resistance of lipoproteins seem unaffected by smoking cessation for 26 weeks.

Cholesterol efflux effect of high density lipoprotein is impaired by whole cigarette smoke extracts through lipid peroxidation

It has been reported that high density lipoprotein (HDL) plays an anti-atherogenic role by stimulating cholesterol efflux from the foam cells in the atheromatous lesion. In this study, we prepared a novel modified form of HDL (CS-HDL) by incubating HDL with whole cigarette smoke (CS) extracts containing both particulate matter and gas-phase smoke, and examined its effect on cholesterol efflux. CS-HDL showed a marked increase of conjugated dienes and denaturation of apoA-I, a major protein component of HDL. The cholesterol efflux effect of CS-HDL was remarkably reduced to the same level as that of oxidatively modified HDL induced by copper ion (Ox-HDL). Addition of 20 microg/ml superoxide dismutase (SOD) during the CS-modification of HDL caused retrieval of cholesterol efflux activity by 53% and a remarkable decrease in the conjugated dienes level. SOD, however, had no ameliorative effect on apoA-I denaturation. When HDL was incubated only with gas-phase smoke (gasCS-HDL), neither increase of conjugated dienes nor impairment of the cholesterol efflux effect was observed, whereas apoA-I was denaturated to the same extent as seen in CS-HDL. These results indicate that whole CS-extracts, but not gas-phase smoke, reduces cholesterol efflux effect of HDL and that lipid peroxidation associated with superoxide anion is involved in this functional impairment.

The association of cigarette smoking and alcohol consumption with other cardiovascular risk factors in men from Seoul, Korea

PURPOSE

To explore the effects of cigarette smoking and alcohol consumption on cardiovascular disease risk factors such as hypertension, dyslipidemia, and glucose intolerance in Korean men.

METHODS

In this cross-sectional study, we gathered the smoking and drinking history by self-administered questionnaire between June 1994 and May 1995 among 1053 men, age 20-77, who visited a prevention center for a multiphasic health check at St. Mary's Hospital, Seoul.

RESULTS

Cigarette smoking had a significant inverse association with systolic and diastolic blood pressure. Adjusted for age, body mass index (BMI), and alcohol consumption, the odds ratio of hypercho-lesterolemia (> or = 240 mg/dl) was 1.30 (95% confidence interval (CI) 1.09-1.55), lower high density lipoprotein (HDL) cholesterol (< 40 mg/dl) was 1.29 (95% CI 1.08-1.54), higher low density lipoprotein (LDL) cholesterol (> or = 160 mg/dl) was 1.30 (95% CI 1.07-1.56), and hypertriglyceridemia (> or = 200 mg/dl) was 1.40 (95% CI 1.16-1.68) among men who smoked 21-30 cigarettes per day compared with nonsmokers. Adjusted for age. BMI, and cigarette smoking in men who consumed 90-179 and 180-269 g/week of alcohol compared with nondrinkers, the odds ratio of hypertension was 1.73 (95% CI 1.01-3.00) and 1.48 (95% CI 1.01-2.17), respectively. Alcohol consumption had a significant protective effect (adjusted odds ratio: 0.60-0.78) against lower HDL cholesterol in all categories > or = 90 g of alcohol per week compared with nondrinkers. The adjusted odds ratio of hypertriglyceridemia was 1.17 (95% CI 1.04-1.31), and glucose intolerance (fasting blood sugar (FBS) > or = 120 mg/dl) was 1.27 (95% CI 1.11-1.14) among those who consumed > or = 360 g/week of alcohol compared with nondrinkers.

CONCLUSIONS

In this Korean population study, although alcohol consumption increased HDL cholesterol, which might have a protective effect on coronary heart disease, cigarette smoking was associated with decreased blood pressure, smoking was confirmed to have dyslipidemic effect such as increasing total cholesterol, LDL cholesterol, triglyceride and decreasing HDL cholesterol, and alcohol consumption was confirmed to be associated with hypertension, hypertriglyceridemia, and glucose intolerance as in Caucasian. Further prospective intervention studies are needed for evaluating cardiovascular effects after cessation of smoking and drinking.

Low and very low density lipoprotein composition and resistance to copper-induced oxidation are not notably modified in smokers

To study whether tobacco use was associated with oxidative phenomena affecting lipoproteins, we estimated susceptibility of LDL and VLDL to an in vitro copper-mediated oxidation, and measured serum autoantibody titers against oxidized LDL in 45 middle-age healthy nonsmokers, 35 smokers and 37 ex-smokers of both sexes, taking into account the detailed lipid composition of the lipoproteins. VLDL from female smokers had higher triglyceride, phospholipid, apolipoprotein E and alpha-tocopherol content and showed a higher rate of copper-induced oxidation in comparison with those from nonsmokers (P < or = 0.05) whereas the relative composition of these particles in saturated, mono- or poly-unsaturated fatty acids was not modified by tobacco consumption. After adjustment for triglyceride content, no statistically significant difference in oxidation rate was observed. Lipid, alpha-tocopherol and protein composition of LDL did not appear to be influenced by smoking; in accordance with these observations, no difference in indices of in vitro oxidizability of LDL was noticed between the different groups. Autoantibody titers against oxLDL were similar in smokers and nonsmokers. We conclude that, in supposed healthy individuals, smoking does not seem to be associated with notable variations in composition of VLDL and LDL or with an increase of oxidizability of these atherogenic lipoproteins.

Smoking is associated with higher cardiovascular risk in young women than in men: the Tecumseh Blood Pressure Study

BACKGROUND

Tobacco smoking is associated with a higher prevalence of atherosclerosis and respiratory disease.

OBJECTIVE

To investigate differences between hemodynamic and biochemical findings in smokers and nonsmokers in the two sexes separately in the Tecumseh population.

METHODS

We studied 851 subjects. They were divided according to smoking habits into group 1, nonsmokers (258 men and 234 women); and group 2, smokers (185 men and 174 women).

RESULTS

Unpaired Student's t-tests and nonparametric tests were performed to determine the between-group P-values. Only hematocrit differed significantly between smokers and nonsmokers in both sexes (43.9 +/- 0.2 and 44.6 +/- 9.3%, P < 0.05 in men; 39.2 +/- 0.3 and 40.3 +/- 0.3%, P = 0.007 in women, respectively in nonsmokers and smokers). Triglycerides (80.6 +/- 3.8 and 99.6 +/- 4.3 mg/dl, P < 0.001), left ventricular mass index (95.4 +/- 1.9 and 100.0 +/- 1.2 g/m2, P = 0.008), and posterior wall thickness (9.5 +/- 0.1 and 9.71 +/- 0.01 mm, P = 0.044) were elevated and high-density lipoproteins were decreased (48.7 +/- 0.8 and 44.5 +/- 0.9 mg/dl, P < 0.01) only in women smokers. After adjustment for home systolic blood pressure and body mass index the differences in women remained significant except for posterior wall thickness.

CONCLUSION

Tobacco smoking is deleterious to both sexes but it appears to be particularly harmful to women. Our data can, in part, explain why the relative risk of myocardial infarction is higher in women than it is in men.

Relationship of cigarette smoking to blood pressure and serum lipids and lipoproteins in men

1. The relationship of cigarette smoking to blood pressure and serum lipids and lipoproteins was studied in 7608 men, ranging from 40 to 59 years of age. Analyses were performed separately for non-drinkers and drinkers. 2. After adjusting age and body mass index (BMI) in non-drinkers and age, BMI and alcohol intake in drinkers in forward stepwise multiple regression analysis, there was a dose-dependent negative relationship between cigarette smoking and diastolic blood pressure (DBP) and high density lipoprotein cholesterol (HDL-C), regardless of drinking habit. There was a dose-dependent positive relationship between cigarette smoking and the ratio of total cholesterol (TC) to HDL-C (TC:HDL-C) in non-drinkers, but not in drinkers. There was a dose-dependent negative relationship between cigarette smoking and TC and a positive relationship between cigarette smoking and triglycerides (TG) in drinkers, but not in non-drinkers. 3. After matching age and BMI in non-drinkers, subjects who smoked more than 30 cigarettes/day had significantly lower mean values of systolic blood pressure (SBP; 4.3%; P < 0.05), DBP (3.0%; P < 0.01) and HDL-C (15.5%; P < 0.01) and higher mean values of TC:HDL-C (25.0%; P < 0.01), TG (46.8%; P < 0.01) and beta-lipoprotein (12.0%; P < 0.01) than non-smokers. In drinkers, after matching age, BMI, and alcohol intake, subjects who smoked more than 30 cigarettes/day had significantly lower mean values of SBP (2.8%; P < 0.05), DBP (4.8%; P < 0.01), HDL-C (17.3%; P < 0.01) and TC (4.4%; P < 0.01) and higher mean values of TC:HDL-C (15.4%; P < 0.01) and TG (45.1%; P < 0.01) than non-smokers. 4. Although the results are somewhat variable, the present study reveals that cigarette smoking is negatively associated with SBP and DBP and unfavourably associated with lipids and lipoproteins, regardless of drinking habit.