Relationship between smoking and antioxidant nutrient status

Transcriptional differences between smokers and non-smokers and variance by obesity as a risk factor for human sensitivity to environmental exposures

BACKGROUND

Obesity has been shown to alter response to air pollution and smoking but underlying biological mechanisms are largely unknown and few studies have explored mechanisms by which obesity increases human sensitivity to environmental exposures.

OBJECTIVE

Overall study goals were to investigate whole blood gene expression in smokers and non-smokers to examine associations between cigarette smoke and changes in gene expression by obesity status and test for effect modification.

METHODS

Relative fold-change in mRNA expression levels of 84 genes were analyzed using a Toxicity and Stress PCR array among 50 21-54 year old adults. Data on smoking status was confirmed using urinary cotinine levels. Adjusted models included age, gender, white blood cell count and body-mass index.

RESULTS

Models comparing gene expression of smokers vs. non-smokers identified six differentially expressed genes associated with smoking after adjustments for covariates. Obesity was associated with 29 genes differentially expressed compared to non-obese. We also identified 9 genes with significant smoking/obesity interactions influencing mRNA levels in adjusted models comparing expression between smokers vs non-smokers for four DNA damage related genes (GADD45A, DDB2, RAD51 and P53), two oxidative stress genes (FTH1, TXN), two hypoxia response genes (BN1P3lL, ARNT), and one gene associated with unfolded protein response (ATF6B).

CONCLUSIONS

Findings suggest that obesity alters human sensitivity to smoke exposures through several biological pathways by modifying gene expression. Additional studies are needed to fully understand the clinical impact of these effects, but risk assessments should consider underlying phenotypes, such as obesity, that may modulate sensitivity of vulnerable populations to environmental exposures.

Differences in Dietary Patterns of Nonsmoking Adults Married to Smokers vs. Nonsmokers

Purpose.

To compare dietary intakes of nonsmoking adults married to smokers or non-smokers.

Design.

Respondents to the U.S. Department of Agriculture's Continuing Survey of Food Intakes by Individuals (CSFII), 1994 to 1996 (response rate = 76.1% for 2 days of dietary intake). Nonsmoking adults aged 18 and older were grouped according to the smoking status of their spouse.

Setting.

In-home interviews in all 50 states and Washington, D.C.

Subjects.

The selected sample included 757 men and 754 women who were married to nonsmokers, and 197 men and 262 women who were married to smokers.

Measures.

Selected demographic variables, food group servings, food energy, and densities of selected nutrients were compared using χ2 and analysis of covariance.

Results.

Men and women married to smokers had greater (p ⩽ .025) energy-adjusted intakes of total and saturated fat but significantly lower (p ⩽ .05) energy-adjusted intakes of fiber and vitamin A. Men married to smokers consumed significantly more (p < .025) energy-adjusted cholesterol and ethanol but significantly less calcium (p = .026); women married to smokers consumed significantly less (p = .014) energy-adjusted folate. Men married to smokers consumed significantly more (p ⩽ .05) alcoholic beverages, coffee, and soft drinks; women married to smokers consumed significantly less water (p = .014) but more cheese and table sweeteners (p ⩽ .05).

Conclusions.

Nonsmoking men and women who were married to smokers had compromised dietary intakes. Nonsmoking men whose wives smoked, in particular, had unhealthy diets due to elevated intakes of fat and cholesterol and low intakes of vitamin A, calcium, and fiber. Health professionals should continue to provide tobacco cessation instruction and dietary guidance, but also be aware of at-risk patients' immediate family members who likely share an increased risk of disease because of poor diet quality and exposure to environmental tobacco smoke.

An Official American Thoracic Society Research Statement: Current Understanding and Future Research Needs in Tobacco Control and Treatment

INTRODUCTION

Since the mid-20th century, the scientific community has substantially improved its understanding of the worldwide tobacco epidemic. Although significant progress has been made, the sheer enormity and scope of the global problem put it on track to take a billion lives this century. Curbing the epidemic will require maximizing the impact of proven tools as well as the development of new, breakthrough methods to help interrupt the spread of nicotine addiction and reduce the downstream morbidity.

METHODS

Members of the Tobacco Action Committee of the American Thoracic Society queried bibliographic databases, including Medline, Embase, and the Cochrane Collaborative, to identify primary sources and reviews relevant to the epidemic. Exploded search terms were used to identify evidence, including tobacco, addiction, smoking, cigarettes, nicotine, and smoking cessation. Evidence was consolidated into three thematic areas: (1) determinants of risk, (2) maternal-fetal exposure, and (3) current tobacco users. Expert panel consensus regarding current gaps in understanding and recommendations for future research priorities was generated through iterative discussion.

RESULTS

Although much has been accomplished, significant gaps in understanding remain. Implementation often lags well behind insight. This report identifies a number of investigative opportunities for significantly reducing the toll of tobacco use, including: (1) the need for novel, nonlinear models of population-based disease control; (2) refinement of "real-world" models of clinical intervention in trial design; and (3) understanding of mechanisms by which intrauterine smoke exposure may lead to persistent, tobacco-related chronic disease.

DISCUSSION

In the coming era of tobacco research, pooled talent from multiple disciplines will be required to further illuminate the complex social, environmental and biological codeterminants of tobacco dependence.

Anti-oxidant effect of heme oxygenase-1 on cigarette smoke-induced vascular injury

Cigarette smoking, a major independent risk factor of atherosclerosis, can cause oxidative and inflammatory damage of vascular tissue. Heme oxygenase-1 (HO-1) is an endogenous cytoprotective enzyme with an anti-oxidant role in cells. The aim of the present study was to investigate whether HO-1 was able to protect vascular and endothelial cells from the oxidative damage induced by cigarette smoking. It was observed that cigarette smoking was able to induce the generation of the reactive oxygen species (ROS) in carotid arteries of rats. Hemin, a widely used HO-1 inducer, was able to reduce the generation of ROS. In addition, when human umbilical vein endothelial cells (HUVECs) were cultured in the serum of smoking rats, this was able to increase ROS, and the protective effect of hemin was also observed in this system. In conclusion, the present study demonstrated that cigarette smoking causes oxidative damage of vascular cells and HUVECs by inducing the generation of ROS, while HO-1 has an anti-oxidant effect in this course. This also implied that hemin, an inducer of HO-1, may have potential therapeutic applicability in the prevention of vascular diseases caused by cigarette smoking.

Pathophysiological Mechanisms of Tobacco-Related CVD

Cigarette smoking is a leading preventable risk factor for the development and progression of cardiovascular diseases (CVDs). Epidemiologic studies conclusively prove that both active smoking and secondhand smoke contribute significantly to morbidity and mortality related to CVD. Cigarette smoke is a mixture of several toxic chemicals, of which nicotine, carbon monoxide, and oxidant chemicals are most commonly implicated in the pathogenesis of cardiovascular disease. Tobacco causes endothelial dysfunction, inflammation, insulin resistance, alteration of lipid profile, hemodynamic alterations, and a hypercoagulable state. All of these act synergistically as pathobiologic mechanisms of atherothrombosis in tobacco users.

Could a vegetarian diet reduce exercise-induced oxidative stress? A review of the literature

Oxidative stress is a natural physiological process that describes an imbalance between free radical production and the ability of the antioxidant defence system of the body to neutralize free radicals. Free radicals can be beneficial as they may promote wound healing and contribute to a healthy immune response. However, free radicals can have a detrimental impact when they interfere with the regulation of apoptosis and thus play a role in the promotion of some cancers and conditions such as cardiovascular disease. Antioxidants are molecules that reduce the damage associated with oxidative stress by counteracting free radicals. Regular exercise is a vital component of a healthy lifestyle, although it can increase oxidative stress. As a typical vegetarian diet comprises a wide range of antioxidant-rich foods, it is plausible that the consumption of these foods will result in an enhanced antioxidant system capable of reducing exercise-induced oxidative stress. In addition, a relationship between a vegetarian diet and lower risks of cardiovascular disease and some cancers has been established. This review explores the current available evidence linking exercise, vegetarians, antioxidants, and oxidative stress.

Assessment of zinc concentration in random samples of the adult population in shiraz, iran

BACKGROUND

Zinc is an essential micronutrient for human health. However, little is known about concentration of this mineral among Iranian population. This study was carried out to determine the current zinc status, evaluate the impact of certain factors like age, sex and Body Mass Index (BMI), and to verify the prevalence of zinc deficiency among Iranian adult population in Shiraz, southern Iran.

METHODS

Serum samples from 374 randomly selected healthy individuals living in Shiraz, Iran, aged 19-82 years (143 males, 231 females) were collected and the serum zinc concentration was measured by Flame-Atomic Absorption Spectrometry. We considered the subjects with serum zinc concentration less than 100 μg/dl as zinc deficient.

RESULTS

The serum zinc levels in females were lower than those of males with no statistically significant difference. Serum zinc concentrations were unrelated to age and BMI. It also did not change among different ages and BMI intervals.

CONCLUSION

About 42.5% of our cases had serum zinc concentration below the cut off value of 100 μg/dl in the serum. Designing appropriate strategies for overcoming this public health problem is necessary.

8-oxo-7,8-dihydro-2'-deoxyguanosine as a biomarker of oxidative damage in oesophageal cancer patients: lack of association with antioxidant vitamins and polymorphism of hOGG1 and GST

Background

The present report was designed to investigate the origins of elevated oxidative stress measured in cancer patients in our previous work related to a case-control study (17 cases, 43 controls) on oesophageal cancers. The aim was to characterize the relationship between the levels of 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), antioxidant vitamins and genetic susceptibility.

Methods

8-oxodG was analysed in peripheral blood mononuclear cells (PBMCs) by High Performance Liquid Chromatography with Electrochemical Detection (HPLC-ED). Analysis of gene polymorphisms in GSTM1 and GSTT1 was performed by multiplex PCR and in GSTP1 and hOGG1 by a PCR-RFLP method. Reversed-phase HPLC with UV detection at 294 nm was used to measure vitamins A and E in serum from the same blood samples.

Results

We observed that in our combined population (cases and control, n = 60), there was no statistically significant correlation between the levels of 8-oxodG and (i) the serum concentration of antioxidant vitamins, vitamin A (P = 0.290) or vitamin E (P = 0.813), or (ii) the incidence of the Ser326Cys polymorphic variant (P = 0.637) of the hOGG1 gene. Also, the levels of 8-oxodG were not significantly associated with polymorphisms in metabolite-detoxifying genes, such as GSTs, except for the positive correlation with Val/Val GST P1 allele (P < 0.0001).

Conclusions

The weakness of our cohort size notwithstanding, vitamins levels in serum and genetic polymorphisms in the hOGG1 or GST genes do not appear to be important modulators of 8-oxodG levels.

Determinants of serum zinc concentrations in a population of French middle-age subjects (SU.VI.MAX cohort)

BACKGROUND/OBJECTIVES

Few studies have been conducted on determinants of serum zinc concentration, especially in France. The aim of this study was to investigate the relationships between serum zinc concentrations, and age, education, living area and life style in a large sample cohort of French adults.

SUBJECTS/METHODS

Blood samples were collected after 12-h fasting in French adults (7448 women, 35-65 years old and 4926 men, 45-65 years old) participating to the SUpplementation in AntioXidant VItamins and Minerals cohort at enrolment. Serum zinc was determined by flame atomic absorption.

RESULTS

Serum zinc concentration was lower in women (mean: 12.9 μmol/l, 95% confidence interval: 9.2-16.6 μmol/l) compared with men (mean: 13.4 μmol/l, 95% confidence interval: 9.7-17.1 μmol/l, P<0.0001). In total, 10% of the women showed serum zinc values <10.7 μmol/l and 10% of the men showed serum zinc values <11.3 μmol/l. Age was negatively associated with serum zinc only in men (P=0.001). In women, a positive association between smoking and serum zinc concentration (P=0.0003), and a negative relationship between highest education level and serum zinc concentration (P=0.01) were observed. With regard to geographical areas, the highest serum zinc concentrations were found in the Center, and the lowest in the Southwest of France for both men and women. The association between serum zinc concentrations and food categories or macronutrient intake disappeared after stratifying by gender.

CONCLUSIONS

Age, gender and geographic area seem the main determinants of serum zinc concentrations in this study.

Factors contributing to gender differences in serum retinol and alpha-tocopherol in infertile couples

Oxidative stress is detrimental to fertility potential. Retinol and alpha-tocopherol are natural antioxidants that inhibit lipid peroxidation and protect against cell damage induced by oxidative stress. This study evaluated whether gender-related differences in antioxidant status exist among couples with infertility and, if so, to evaluate relevant factors that may contribute to such differences. Retinol and alpha-tocopherol in the sera of 40 couples and in the semen of 40 men were measured using high performance liquid chromatography. Serum retinol and alpha-tocopherol in women were significantly higher than in men (both P < 0.001). There was an inverse relationship between body mass index and serum retinol and alpha-tocopherol in both men and women. Heavy smokers (>or=20 cigarettes/day), compared with nonsmokers, had lower serum concentrations of retinol and alpha-tocopherol. Serum concentrations of retinol and alpha-tocopherol in men with normal sperm parameters were significantly higher than in those with oligozoospermia and asthenozoospermia (both P < 0.001). Lower serum retinol and alpha-tocopherol in men compared with their female partners could be related to their older age, higher body mass index and smoking habits. Low concentrations of these natural antioxidants were associated with abnormal semen parameters in men and anovulation in women.

Hábito alimentar, níveis de lipídios sangüíneos e o status antioxidante de adultos jovens fumantes e não fumantes

OBJETIVO: Avaliar o hábito alimentar, os níveis dos lipídios sangüíneos e o status antioxidante de jovens fumantes e não fumantes. MÉTODOS: Trata-se de um estudo transversal em que 68 indivíduos, de 18 a 26 anos, emparelhados por sexo e idade, foram divididos em dois grupos: fumantes (n=34) e não fumantes (n=34). Os voluntários selecionados em instituições de ensino, em Viçosa (MG) foram questionados quanto a: hábito de fumar, consumo de bebidas alcoólicas e atividade física; também foi estimada a dependência nicotínica. O hábito alimentar foi avaliado por questionário de freqüência de consumo. Quantificaram-se níveis séricos de lipídios, nível plasmático de malondialdeído, vitamina E e vitamina C. RESULTADOS: Os jovens começaram a fumar precocemente, independentemente do sexo. O hábito de fumar foi estratificado e encontrou-se 58,8% de fumantes leves e 41,2% de fumantes pesados. Os fumantes apresentaram hábitos alimentares inadequados e consumo freqüente de bebida alcoólica. De acordo com a recomendação do International Physical Activity Questionnaire 69% dos fumantes eram ativos e 27,6% eram muito ativos. Não se observou diferença significante na concentração sérica de lipídios entre fumantes e não fumantes. No grupo de fumantes mulheres, verificou-se correlação positiva entre o número de cigarros fumados por dia e os triglicerídeos séricos (r=0,824 e p=0,0001) e também entre o tempo que fumavam em anos e o nível de colesterol total (r=0,523 e p=0,031). Os fumantes apresentaram concentração inferior de vitaminas E e C (p=0,002 e p=<0,001, respectivamente) e a concentração de malondialdeído plasmático correlacionou-se ao tempo de tabagismo em anos (r=0,352 e p=0,041). CONCLUSÃO: O grupo de fumantes apresentou hábito alimentar inadequado, principalmente para alimentos gordurosos, e consumo freqüente de bebida alcoólica. Os valores para malondialdeído plasmático apresentaram correlação positiva com o tempo de tabagismo, mas não com o número de cigarros fumados por dia.

Evaluation of arsenic, cobalt, copper and manganese in biological Samples of Steel mill workers by electrothermal atomic absorption Spectrometry

The determination of trace and toxic elements in biological samples (blood, urine and scalp hair samples) of human beings is an important clinical test. The aim of our present study was to determine the concentration of arsenic (As), copper (Cu), cobalt (Co) and manganese (Mn), in biological samples of male production workers (PW) and quality control workers (QW) of steel mill, with aged 25–55 years, to assess the possible influence of environmental exposure. For comparison purpose, the same biological samples of unexposed healthy males of same age group were collected as control subjects. The determination of all elements in biological samples was carried out by electrothermal atomic absorption spectrometry, prior to microwave assisted acid digestion. The accuracy of the As, Cu, Co and Mn measurements was tested by simultaneously analyzing certified reference materials (CRMs) and for comparative purposes conventional wet acid digestion method was used on the same CRMs. No significant differences were observed between the analytical results and the certified values, using both methods (paired t-test at P > 0.05). The results indicate that concentrations of As, Cu, Co and Mn in all three biological samples of the exposed workers (QW and PW) were significantly higher than those of the controls. The possible correlation of these elements with the etiology of different physiological disorders is discussed. The results were also demonstrated the need of attention for improvements in workplace, ventilation and industrial hygiene practices.

An overview of interactions between micronutrients and of micronutrients with drugs, genes and immune mechanisms

The objective of the present review is to examine critically the consequences of interactions that micronutrients undergo with nutrients and non-nutrients (mainly prescribed medicines) in diets and lifestyle factors (smoking, tea and alcohol consumption). In addition, the review describes recent work on interactions between nutrients and genes, the influence of gene polymorphisms on micronutrients, the impact of immune responses on micronutrients and specific interactions of antioxidant micronutrients in disease processes to minimise potential pro-oxidant damage.

Is plasma vitamin C an appropriate biomarker of vitamin C intake? A systematic review and meta-analysis

Background

As the primary source of dietary vitamin C is fruit and to some extent vegetables, the plasma level of vitamin C has been considered a good surrogate or predictor of vitamin C intake by fruit and vegetable consumption. The purpose of this systematic review was to investigate the relationship between dietary vitamin C intakes measured by different dietary methods and plasma levels of vitamin C.

Method

We searched the literature up to May 2006 through the OVID interface: MEDLINE (from 1960) and EMBASE (from 1988). We also reviewed the reference lists in the articles, reviews, and textbooks retrieved. A total of 26 studies were selected and their results were combined using meta-analytic techniques with random-effect model approach.

Results

The overall result of this study showed a positive correlation coefficient between Food Frequency Questionnaire (FFQ) and biomarker (r = 0.35 for "both" genders, 0.39 for females, and 0.46 for males). Also the correlation between Dietary Recalls (DR)/diary and biomarker was 0.46 for "both" genders, 0.44 for females, and 0.36 for males. An overall correlation of 0.39 was found when using the weight record method. Adjusting for energy intake improved the observed correlation for FFQ from 0.31 to 0.41. In addition, we compared the correlation for smokers and non-smokers for both genders (FFQ: for non-smoker r = 0.45, adjusted for smoking r = 0.33).

Conclusion

Our findings show that FFQ and DR/diary have a moderate relationship with plasma vitamin C. The correlation may be affected/influenced by the presence of external factors such as vitamin bioavailability, absorption condition, stress and food processing and storage time, or by error in reporting vitamin C intake.

The prevalence of inflammatory periodontitis is negatively associated with serum antioxidant concentrations

Chronic periodontitis is an inflammatory disease that affects the supporting tissues of the teeth. It is initiated by specific bacteria within the plaque biofilm and progresses due to an abnormal inflammatory-immune response to those bacteria. Periodontitis is the major cause of tooth loss and is also significantly associated with an increased risk of stroke, type-2 diabetes and atheromatous heart disease. Oxidative stress is reported in periodontitis both locally and peripherally (serum), providing potential mechanistic links between periodontitis and systemic inflammatory diseases. It is therefore important to examine serum antioxidant concentrations in periodontal health/disease, both at an individual species and total antioxidant (TAOC) level. To determine whether serum antioxidant concentrations were associated with altered relative risk for periodontitis, we used multiple logistic regression for dual case definitions (both mild and severe disease) of periodontitis in an analysis of 11,480 NHANES III adult participants (>20 y of age). Serum concentrations of vitamin C, bilirubin, and TAOC were inversely associated with periodontitis, the association being stronger in severe disease. Vitamin C and TAOC remained protective in never-smokers. Higher serum antioxidant concentrations were associated with lower odds ratios for severe periodontitis of 0.53 (CI, 0.42,0.68) for vitamin C, 0.65 (0.49,0.93) for bilirubin, and 0.63 (0.47,0.85) for TAOC. In the subpopulation of never-smokers, the protective effect was more pronounced: 0.38 (0.26,0.63, vitamin C) and 0.55 (0.33,0.93, TAOC). Increased serum antioxidant concentrations are associated with a reduced relative risk of periodontitis even in never-smokers.

Transdermal nicotine patch enhances type I collagen synthesis in abstinent smokers

Cigarette smokers deposit less collagen, expressed as hydroxyproline, in granulation tissue than nonsmokers. We studied the effect of abstinence from smoking and transdermal nicotine patches on deposition of hydroxyproline, proline, type I procollagen, and total proteins. Fifty-four healthy smokers were studied during 10 days of smoking and again from days 10 to 20 following smoking cessation. After the first 10 days of abstinence they were randomized to double-blind treatment with transdermal nicotine patches of 25 mg/day or placebo for a period of 10 days. During this period and during smoking, an expanded polytetrafluoroethylene tube was implanted into the subcutis. Following removal of the implant, total amino acids and peptides were extracted. Hydroxyproline and proline were analyzed by high-pressure liquid chromatography, type I procollagen was analyzed by enzyme-linked immunoassay, and total proteins were determined colorimetrically. In the 39 subjects who complied with the study protocol, abstinence from smoking did not affect the deposition of hydroxyproline, proline, type I procollagen, or total protein in the implants. During abstinence, the type I procollagen level increased by 18% in the transdermal nicotine patches group and decreased by 10% in the placebo group (p<0.05). We conclude that 20 days of abstinence from smoking does not affect collagen deposition in granulation tissue. However, in abstinent smokers, transdermal nicotine patches appears to increase type I collagen synthesis.

Evaluating associations between Mediterranean diet adherence indexes and biomarkers of diet and disease

Objective

We examined associations between two Mediterranean diet (MD) adherence indexes (the MD index, MDI, and the MD score, MDS) and several blood biomarkers of diet and disease.

Subjects

We studied 328 individuals from Catalonia (Northeastern Spain), ages 18–75, who provided fasting blood samples, a subset of the 2346 individuals as part of a larger representative and random sample from the 1992–1993 Catalan Nutritional Survey.

Design and method

Diet was measured using 24-h recalls. Biomarkers studied were plasma levels of β-carotene, α-tocopherol, retinol, vitamins B12, C and folates as well as serum total cholesterol, HDL cholesterol, LDL cholesterol and triglycerides. Multivariate linear regression was used to analyse associations of the nutrient biomarkers with the dietary pattern indexes, adjusting for potential confounders.

Results and conclusions

Subjects with higher MD adherence, as measured by the two dietary indexes, had significantly higher plasma concentrations of β-carotene, folates, vitamin C, α-tocopherol and HDL cholesterol. The most highly significant relationship was that between folates and the adherence to the MD Pattern, as determined by both indexes.

These research findings suggest the potential usefulness of biomarkers as complementary tools for assessing adherence to a dietary pattern. This type of data not only informs the development of robust dietary adherence indexes, but it also provides specific clues about the potential physiological mechanisms that explain the beneficial effects of the MD pattern on chronic disease risk.

Monitoring micronutrients in cigarette smokers

Smoking is associated with oxidative stress and increased risks of many chronic diseases that both shorten life and impair its quality. Low concentrations of several micronutrients, especially the antioxidants vitamin C and beta-carotene, are also associated with smoking, and there has been much interest in determining whether deficiencies in micronutrients are involved etiologically in smoking-related diseases. The objective of this review was to bring together reports on dietary intakes, biochemical indicators of micronutrient status, and results of some intervention studies on micronutrients where authors had compared outcomes in smokers and non-smokers. The micronutrients discussed are vitamins A, E, and C; the carotenoids; some of the B-vitamin group; and the minerals selenium, zinc, copper, and iron. The data were then examined to determine whether effects on the biochemical markers of micronutrient status were due to differences in dietary intakes between smokers and non-smokers or to the consequences of inflammatory changes caused by the oxidative stress of smoking. It was concluded that although smoking is associated with reduced dietary intake of vitamin C and carotenoid-containing foods, inflammatory changes increase turnover of these micronutrients so that blood concentrations are still lower in smokers than non-smokers even when there is control for dietary differences. In the case of vitamin E, there is some evidence for increased turnover of this nutrient in smokers, but this has little to no influence on blood concentrations, and there are no differences in dietary intake of vitamin E between smokers and non-smokers. Serum concentrations of vitamin A, folate, and vitamin B12 and B6 markers do not appear to be influenced by smoking, although there is some influence of dietary intake on concentrations of these nutrients in the body. In the case of the minerals examined, the main effects on biochemical markers of mineral status were attributed to inflammation and were therefore greater in heavy or long-term smokers. Serum concentrations of selenium and erythrocyte GPx activity were lower in smokers. Erythrocyte CuZn-SOD activity and serum ceruloplasmin concentrations were elevated, while serum zinc concentrations were depressed only in heavy smokers. Lastly, smoking appears to affect iron homeostasis mainly by changing hemoglobin concentrations, which were in general increased. Serum iron, TfR, and ferritin were mostly unaffected by smoking, except in pregnancy where there is evidence of increased erythropoiesis causing lower saturation of plasma transferrin and some evidence of lowering of iron stores.

Ascorbate is a pro-oxidant in chromium-treated human lung cells

The human A549 lung cell line is used in this study as a model to evaluate chromium toxicity and mutagenesis since inhalation exposure of this metal gives rise to an epidemiology that indicates the lung as a target organ of chromium toxicity. Hexavalent chromium is considered the carcinogenic form of chromium, however it must be reductively activated following uptake into cells in order to react with intracellular constituents. We have previously established that the fluorescent dyes, dichlorofluorescein (DCF) and dihydrorhodamine, are effective indicators of the reductive activation of chromium and are sensitive measures of the formation of highly reactive chromium species (RCS) intracellularly. In order to examine the role of the two common intracellular reductants, glutathione and ascorbic acid (Vitamin C) in generating RCS intracellularly, we manipulated their intracellular levels through the use of buthionine sulfoximine (BSO) or by the addition of ascorbate into the culture media. We found that the high levels of glutathione in this cancer cell line lowered endogenous oxidation levels markedly, and that, by decreasing intracellular glutathione, BSO not only generated a higher background level of endogenous intracellular oxidation but the chromium-stimulated oxidation also increased markedly. Contrary to it appellation as an anti-oxidant, ascorbic acid stimulated a strong pro-oxidant response upon chromium treatment and this pro-oxidant response was evident regardless of the levels of glutathione in the cells. Based on these results, we conclude that ascorbic acid acts as a pro-oxidant in chromium-treated cells.

Vitamin E biokinetics, oxidative stress and cigarette smoking

Vitamin E is comprised of four tocopherols and four tocotrienols, and functions as a lipophilic chain-breaking antioxidant that prevents lipid peroxidation. Although it is well recognized that cigarette smoke is source of oxidative stress, relatively little is known regarding how oxidative stress alters vitamin E utilization in humans. Therefore, this review will highlight the recent knowledge regarding how cigarette smoking alters vitamin E (as alpha- and gamma-tocopherols) utilization in humans. Specifically, we will discuss the mechanisms by which cigarette smoking increases the turnover of plasma vitamin E, decreases the P450-mediated metabolism of vitamin E, and increases the nitration of gamma-tocopherol to result in the formation of 5-nitro-gamma-tocopherol. In addition, the interrelationship between oxidative stress and vitamin C will also be emphasized as it relates to vitamin E utilization.

Cigarette smokers differ in their handling of natural (RRR) and synthetic (all rac) alpha-tocopherol: a biokinetic study in apoE4 male subjects

We have compared the biokinetics of deuterated natural (RRR) and synthetic (all rac) alpha-tocopherol in male apoE4-carrying smokers and nonsmokers. In a randomized, crossover study subjects underwent two 4-week treatments (400 mg/day) with undeuterated RRR- and all rac-alpha-tocopheryl acetate around a 12-week washout. Before and after each supplementation period subjects underwent a biokinetic protocol (48 h) with 150 mg deuterated RRR- or all rac-alpha-tocopheryl acetate. During the biokinetic protocols, the elimination of endogenous plasma alpha-tocopherol was significantly faster in smokers (P < 0.05). However, smokers had a lower uptake of deuterated RRR than nonsmokers, but there was no difference in uptake of deuterated all rac. The supplementation regimes significantly raised plasma alpha-tocopherol (P < 0.001) with no differences in response between smokers and nonsmokers or between alpha-tocopherol forms. Smokers had significantly lower excretion of alpha-carboxyethyl-hydroxychroman than nonsmokers following supplementation (P < 0.05). Nonsmokers excreted more alpha-carboxyethyl-hydroxychroman following RRR than all rac; however, smokers did not differ in excretion between forms. At baseline, smokers had significantly lower ascorbate (P < 0.01) and higher F(2)-isoprostanes (P < 0.05). F(2)-isoprostanes in smokers remained unchanged during the study, but increased in nonsmokers following alpha-tocopherol supplementation. These data suggest that apoE4-carrying smokers and nonsmokers differ in their handling of natural and synthetic alpha-tocopherol.

Cigarette smokers have decreased lymphocyte and platelet alpha-tocopherol levels and increased excretion of the gamma-tocopherol metabolite gamma-carboxyethyl-hydroxychroman (gamma-CEHC)

Cigarette smoking is associated with increased oxidative stress and increased risk of degenerative disease. As the major lipophilic antioxidant, requirements for vitamin E may be higher in smokers due to increased utilisation. In this observational study we have compared vitamin E status in smokers and non-smokers using a holistic approach by measuring plasma, erythrocyte, lymphocyte and platelet alpha- and gamma-tocopherol, as well as the specific urinary vitamin E metabolites alpha- and gamma-carboxyethyl-hydroxychroman (CEHC). Fifteen smokers (average age 27 years, smoking time 7.5 years) and non-smokers of comparable age, gender and body mass index (BMI) were recruited. Subjects completed a 7-day food diary and on the final day they provided a 24 h urine collection and a 20 ml blood sample for measurement of urinary vitamin E metabolites and total vitamin E in blood components, respectively. No significant differences were found between plasma and erythrocyte alpha- and gamma-tocopherol in smokers and non-smokers. However, smokers had significantly lower alpha-tocopherol (mean+/-SD, 1.34+/-0.31 micromol/g protein compared with 1.94+/-0.54, P = 0.001) and gamma-tocopherol (0.19+/-0.04 micromol/g protein compared with 0.26+/-0.08, P = 0.026) levels in their lymphocytes, as well as significantly lower alpha-tocopherol levels in platelets (1.09+/-0.49 micromol/g protein compared with 1.60+/-0.55, P = 0.014; gamma-tocopherol levels were similar). Interestingly smokers also had significantly higher excretion of the urinary gamma-tocopherol metabolite, gamma-CEHC (0.49+/-0.25mg/g creatinine compared with 0.32+/-0.16, P = 0.036) compared to non-smokers, while their alpha-CEHC (metabolite of alpha-tocopherol) levels were similar. There was no significant difference between plasma ascorbate, urate and F2-isoprostane levels. Therefore in this population of cigarette smokers (mean age 27 years, mean smoking duration 7.5 years), alterations to vitamin E status can be observed even without the more characteristic changes to ascorbate and F2-isoprostanes. We suggest that the measurement of lymphocyte and platelet vitamin E may represent a valuable biomarker of vitamin E status in relation to oxidative stress conditions.

Antioxidant Vitamin Supplementation Reduces Benzo(a)pyrene-DNA Adducts and Potential Cancer Risk in Female Smokers

Background: Elevated benzo(a)pyrene [B(a)P]-DNA adducts have been associated with 3-fold increased risk of lung cancer in current smokers. We assessed the chemopreventive effects of antioxidant supplementation using B(a)P-DNA adducts in leukocytes as an intermediate cancer risk marker.

Methods: Subjects were randomized to a double-blinded placebo-controlled clinical trial of antioxidant vitamin supplementation [500 mg vitamin C and 400 IU vitamin E (dl-α-tocopherol) daily] or placebo. Smokers with ≥10 cigarettes per day and serum cotinine ≥25 ng/mL were eligible for the study. B(a)P-DNA adduct level was the outcome. The randomization was stratified by gender and cigarettes per day (≤20 or &gt;20). Smoking habits and blood samples were collected every 3 months during the 15-month treatment period. Samples were analyzed for B(a)P-DNA adducts (high-performance liquid chromatography), plasma cotinine, vitamin levels, and GSTM1 genotype. The intent-to-treat model adjusted for B(a)P-DNA and cotinine at randomization.

Results: Overall and among men, there was no effect of treatment on B(a)P-DNA adduct levels. Among treated women, B(a)P-DNA adducts decreased by 31% compared with women on placebo (P = 0.03). Among treated women with the GSTM1 genotype, there was a 43% decrease in adducts (P = 0.04).

Conclusion: Our primary hypothesis that the mean level of smoking-related B(a)P-DNA adducts would be lower in all subjects in the vitamin treatment group compared with all placebo-treated subjects was not substantiated. However, oursecondary gender-specific analysis found a significant reduction in B(a)P-DNA adducts in women with vitamin treatment, suggesting that antioxidant supplementation maymitigate some of the procarcinogenic effects of exposuretoB(a)P. The effect in GSTM1-null women suggeststhat certain subgroups may derive more benefit fromsupplementation. Although the results of this trial showthe potential chemopreventive role of antioxidants, thebest way for smokers to reduce their cancer risk remains smoking cessation.

{alpha}-Tocopherol disappearance is faster in cigarette smokers and is inversely related to their ascorbic acid status

BACKGROUND

Cigarette smokers have enhanced oxidative stress from cigarette smoke exposure and from their increased inflammatory responses.

OBJECTIVE

The objective of this study was to determine whether cigarette smoking increases plasma alpha-tocopherol disappearance in otherwise healthy humans.

DESIGN

Smokers and nonsmokers (n = 10/group) were supplemented with deuterium-labeled alpha-tocopheryl acetates (75 mg each of d(3)-RRR-alpha-tocopheryl acetate and d(6)-all-rac-alpha-tocopherols acetate) for 6 evenings (days -6 to -1). Plasma alpha-tocopherols, ascorbic acid, uric acid, and F(2alpha)-isoprostanes were measured in blood samples collected on days -6 through 17. The urinary alpha-tocopherol metabolite, alpha-carboxy-ethyl-hydroxy-chroman (alpha-CEHC), was measured on days -6, 0, and 17 in 24-h urine samples.

RESULTS

F(2alpha)-isoprostanes were, on average, approximately 40% higher in smokers than in nonsmokers. On day 0, plasma labeled and unlabeled alpha-tocopherol concentrations were not significantly different between groups. Smoking resulted in faster fractional disappearance of plasma alpha-tocopherol (0.215 +/- 0.011 compared with 0.191 +/- 0.009 pools/d; P < 0.05). Fractional disappearance rates of alpha-tocopherol correlated with plasma ascorbic acid concentrations in smokers (P = 0.021) but not in nonsmokers despite plasma ascorbic acid concentrations that were not significantly different between groups. By day 17, cigarette smoking resulted in lower plasma alpha-tocopherol concentrations and urinary excretion of labeled and unlabeled alpha-CEHC (P < 0.05).

CONCLUSIONS

Cigarette smoking increased alpha-tocopherol disappearance. Greater rates of alpha-tocopherol disappearance in smokers appear to be related to increased oxidative stress accompanied by lower plasma ascorbic acid concentrations. Thus, smokers have an increased requirement for both alpha-tocopherol and ascorbic acid.

Vitamin C deficiency and depletion in the United States: the Third National Health and Nutrition Examination Survey, 1988 to 1994

OBJECTIVES

We sought to determine prevalence rates of vitamin C deficiency and depletion in the United States.

METHODS

We used data from the Third National Health and Nutrition Examination Survey to assess intake of dietary, supplemental, and serum vitamin C.

RESULTS

Mean intakes and serum levels of vitamin C were normal; however, vitamin C deficiency and depletion were common (occurring among 5%-17% and 13%-23% of respondents, respectively). Smokers, those who did not use supplements, and non-Hispanic Black males had elevated risks of vitamin C deficiency, while Mexican Americans had lower risks.

CONCLUSIONS

Health professionals should recommend consumption of vegetables and fruits rich in vitamin C and should recommend supplementation for individuals at risk of vitamin C deficiency.

The complex relationship between smoking in pregnancy and very preterm delivery. Results of the Epipage study

OBJECTIVE

To assess the relationship between cigarette smoking during pregnancy and very preterm births, according to the main mechanisms of preterm birth.

DESIGN

Case-control study (the French Epipage study).

SETTING

Regionally defined population of births in France.

POPULATION

Eight hundred and sixty-four very preterm live-born singletons (between 27 and 32 completed weeks of gestation) and 567 unmatched full-term controls.

METHODS

Data from the French Epipage study were analysed using a polytomous logistic regression model to control for social and demographic characteristics, pre-pregnancy body mass index and obstetric history. The main mechanisms of preterm delivery were classified as gestational hypertension, antepartum haemorrhage, premature rupture of membranes, spontaneous preterm labour and other miscellaneous mechanisms.

MAIN OUTCOME MEASURES

Odds ratios for very preterm birth for low to moderate (1-9 cigarettes/day) and heavy (>/=10 cigarettes/day) maternal smoking in pregnancy, estimated according to the main mechanisms leading to preterm birth.

RESULTS

Smokers were more likely to give birth to very preterm infants than non-smokers [adjusted odds ratio (aOR) 1.7, 95% confidence interval (CI) 1.3-2.2]. Heavy smoking significantly reduced the risk of very preterm birth due to gestational hypertension (aOR 0.5, 95% CI 0.3-1.0), whereas both low to moderate and heavy smoking increased the risk of very preterm birth due to all other mechanisms (aOR between 1.6 and 2.8).

CONCLUSION

These data from the Epipage study show that maternal smoking during pregnancy is a risk factor for very preterm birth. The impact of maternal smoking on very preterm birth appears to be complex: it lowers the risk of very preterm birth due to gestational hypertension, but increases the risk of very preterm birth due to other mechanisms. These findings might explain why maternal smoking is more closely related to preterm birth among multiparous women than among nulliparous women.

Dietary intake in male and female smokers, ex-smokers, and never smokers: the INTERMAP study

This report examines dietary intakes in smokers, ex-smokers, and never smokers in INTERMAP. The 4680 participants aged 40-59 years-from 17 population samples in four countries (China, Japan, UK, USA)-provided four 24-h recalls to assess nutrient intakes and two 24-h urine collections to assess excretion of urea, sodium (Na), potassium (K), etc. Compared to never smokers, current smokers generally consumed more energy from alcohol and saturated fats (SFA), less energy from vegetable protein and carbohydrates, less dietary fibre, vitamin E, beta carotene, vitamin C, thiamine, riboflavin, folate, vitamin B6, calcium, iron, phosphorus, magnesium (Mg), and K per 1000 kcal, excreted less K and urea (marker of dietary protein), had a lower ratio of polyunsaturated fat (PFA) to SFA intake, higher Keys dietary lipid score, and higher dietary and urinary Na/K. There were few differences between smokers and never smokers for total energy intake, energy from total and animal protein, monounsaturated fats, PFA, omega 3 and omega 6 PFA, dietary cholesterol, total vitamin A, retinol, vitamin D, vitamin B12, and urinary and dietary Na. Compared to ex-smokers, smokers generally consumed less energy from vegetable protein, omega 3 PFA, carbohydrates, less dietary fibre, beta carotene, vitamin E, vitamin C, thiamine, riboflavin, folate, vitamin B6, iron, phosphorus, Mg, had lower PFA/SFA, and excreted less urea and K. In conclusion, INTERMAP results are consistent with other reports indicating that smokers have less healthful diets than nonsmokers. Public health interventions in smokers should focus not only on helping them to quit smoking but also on improving their diets to further reduce cancer and cardiovascular disease risks.

Serum concentrations of macro and trace elements in heroin addicts of the Canary Islands

Na, K, Ca, Mg, P, Fe, Cu, Zn and Se concentrations were determined in the serum of 106 heroin addicts and were compared with the concentrations obtained in a control group formed of 186 apparently healthy individuals. Heroin addicts displayed K and Se mean concentrations lower (p < 0.05), and Na, Mg, P mean concentrations and a Cu/Zn ratio higher (p < 0.05) than those mean values observed in the control group. The Mg and P concentrations in the serum of heroin addicts tended to normalize when age increased. The heroin addicts included in the methadone maintenance treatment program had higher serum mean concentrations of K and Mg than the heroin addicts in the detoxification process. The Na, K and Mg concentrations displayed highly significant correlations, with a different behavior for the heroin addicts group and the control group. When applying factor analysis and representing the scores of the first and second factors, the heroin addicts tended to differentiation from the control group. However, methadone substitution treatment was not able to normalize these concentrations.

Environmental factors and membrane polyunsaturated fatty acids in schizophrenia

There is accumulating evidence of reductions in red blood cell membrane essential fatty acids in patients with schizophrenia. The mechanisms that may underlie these reductions have yet to be determined. It is possible that the observed membrane fatty acid deficits are associated with the development of schizophrenia. Alternatively, the membrane fatty acid deficits may be due to environmental factors, such as smoking and variations in diet, which may not be associated specifically with the pathophysiology of schizophrenia. Patients with schizophrenia smoke cigarettes at very high rates. Cigarette smoke contains many pro-oxidants that contribute directly to oxidative stress. Polyunsaturated fatty acids (PUFAs) are very susceptible to oxidative effects of free radicals. Thus, smoke-induced oxidative stress could plausibly account for reductions in membrane fatty acid in schizophrenia. Recent studies provide conflicting evidence for smoking effects on membrane fatty acid deficits. Likewise, the effects of diet on membrane PUFAs in schizophrenia are not entirely clear. Essential PUFAs need to be consumed in diet. Thus, differences in membrane PUFAs observed between patients and control subjects may be due to dietary variation. Few studies that have examined dietary effects differ in their interpretation of the effects of diet on membrane PUFAs. Thus, the jury is still out whether smoking or dietary effects are the primary causes of membrane PUFA deficits in patients with schizophrenia. Future studies will need to systematically examine the potential effects of smoking and diet, as well as other environmental factors such exercise, to definitively establish whether or not PUFA abnormalities are inherent to schizophrenia.

Effects of beta-carotene, vitamin C and E on antioxidant status in hyperlipidemic smokers

Smoking can accelerate the consumption of the stored antioxidant vitamins and increase the oxidative stress in the hyperlipidemic patients. The study investigated the effects of combined beta-carotene, vitamin C, and vitamin E on plasma antioxidant levels, erythrocyte antioxidative enzyme activities, and LDL lipid peroxides. Male hyperlipidemic smokers (35-78 years old) were randomly divided into two antioxidant supplemented groups: intervention 1 (I1, n = 22) (15 mg beta-carotene/day, 500 mg vitamin C/day, and 400 mg alpha-tocopherol equivalent/day) and intervention 2 (I2, n = 20) (30 mg beta-carotene/day, 1000 mg vitamin C/day, and 800 mg alpha-tocopherol equivalent/day). After 6-week supplementation, plasma beta-carotene, vitamin C, vitamin E, and erythrocyte glutathione levels increased significantly by 200%, 98%, 129%, and 39%, respectively, in the I1 group, and by 209%, 216%, 197%, and 32%, respectively, in the I2 group. Plasma Fe(+2) concentrations and Fe(+2)/Fe(+3) decreased significantly in both groups. Except erythrocyte glutathione peroxidase activity in the I1 group, erythrocyte catalase, glutathione peroxidase, and superoxide dismutase activities increased significantly in both groups. Lipid peroxides in LDL decreased significantly by 56% and 72% in the I1 and I2 groups, respectively. However, the levels of plasma iron, erythrocyte glutathione, and LDL lipid peroxides, and the activities of erythrocyte antioxidative enzymes did not differ between two groups. In conclusion, combined antioxidant supplements increased plasma antioxidant levels and antioxidative enzyme activities, and lowered LDL lipid peroxides in male hyperlipidemic smokers. Higher dosage of the supplements did not have an additive effect.

[Distribution of the serum concentration of vitamin C, folic acid and vitamin B12 in a representative sample of the adult population of Catalonia (Spain)]

BACKGROUND

The subclinical deficiency of certain micronutrients (vitamin C, folic acid, vitamin B12) has been associated with disorders as cardiovascular diseases, cancer, cataracts, immunodepression and fetal neural tube defects. The purpose of this study was to determine the serum concentration of vitamin C, folic acid and vitamin B12 in the Catalan population and to examine the prevalence of deficits of these micronutrients.

SUBJECTS AND METHOD

We studied a subsample of individuals (n = 378) from a representative sample of people aged 18 to 75 years who had participated in the study of the Nutritional Status of the Catalan Population (1992-93). Serum concentrations of vitamin C, folic acid and vitamin B12 were determined.

RESULTS

The serum concentration of vitamin C was lower in men than in women. 4.6 and 0.5% subjects were found to have marginal and severe deficits of vitamin C, respectively. 4 and 1.6% subjects had marginal and severe deficits of folic acid, respectively. Folic acid deficit involved up to 12.9% women aged 18-34 years and up to 9.1% men within the same age group. Subjects who had a severe deficit of folic acid consumed more than 20 g/day of alcohol. The serum concentration of vitamin B12 was greater in women than in men. 1.9% individuals had a marginal deficit of this vitamin.

CONCLUSION

The sample of individuals studied were found to have a correct nutritional status with regard to vitamin C, folic acid and vitamin B12. This may explain the lower incidence of cancer and ischemic heart disease associated with the Mediterranean diet.

Serum copper and zinc concentrations in a representative sample of the Canarian population

Serum copper (Cu) and zinc (Zn) concentrations of 395 individuals (187 males + 208 females) living in Canary Islands were determined by flame atomic absorption spectrometry. The mean copper and zinc concentrations were 1.10 +/- 0.25 mg/L and 1.16 +/- 0.52 mg/L respectively. Our data were similar to other data published in other Spanish regions. Individuals from Lanzarote presented a mean Cu and Zn concentrations higher (p < 0.05) than individuals from the rest of islands; Individuals from EL Hierro showed the lowest (p < 0.05) mean Zn concentration. These differences could be attributed a differences in Cu and Zn contents of soil and/or differences in dietary habits of the populations. The mean serum Cu concentration in females was higher (p < 0.05) than in males, however serum Zn concentration did not vary with the sex of the subjects. No relation to socio-economic status and educational level were found with respect to the serum Cu and Zn concentrations. The serum Cu concentration varied with age of individuals, observing the highest (p < 0.05) Cu concentration in the 20-30 year old interval. A higher serum Cu concentration in females within 20-30 year old interval was observed. This could be due to a higher use of oral contraceptives or to the higher number of pregnancies. Boys (younger than 15) showed a decrease (p < 0.05) of the serum Cu concentration with age. The mean Zn concentrations in serum did not change (p > 0.05) among the different age intervals. No clear trends in the serum Cu and Zn concentrations were observed when drinking and smoking habits were considered. The increase of physical exercise reduced (p < 0.05) the serum Cu concentrations.

Vitamin E kinetics in smokers and nonsmokers

Does cigarette smoking increase vitamin E utilization in vivo? A trial was carried out in 6 smokers and 5 nonsmokers of comparable ages and serum lipids. Subjects consumed 75 mg each d(3)-RRR and d(6)-all rac-alpha-tocopheryl acetates (natural and synthetic vitamin E, respectively) daily for 7 d with a standardized breakfast. Fasting blood samples were drawn on days -7, -6, -5, -4, -3, -2, -1, 0, 1, 2, 3, 4, 5, 6, 7, 9, 14, 21 (negative days indicate supplementation). In both groups, plasma d(3)-alpha-tocopherol concentrations were approximately double of d(6)-alpha-tocopherol. At day 0, the %d(3) alpha-tocopherols (d(3)-alpha-tocopherol/total-alpha-tocopherol x 100) were similar in both smokers and nonsmokers. Subsequently, there was a trend toward a faster exponential disappearance of the plasma %d(3) alpha-tocopherol in smokers compared with nonsmokers (0.30 +/- 0.04 compared with 0.24 +/- 0.05, p =.0565). The calculated %d(3) half-lives were 55.6 +/- 7.4 h in smokers and 72.1 +/- 17.3 h in nonsmokers (p =.0630). By day 21, the %d(3) in smokers had decreased to 1.4% +/- 0.3% while it was 2.2% +/- 0.7% (p =.0418) in the nonsmokers. These data suggest that smoking increases plasma vitamin E disappearance, but further studies are needed to confirm this finding and to assess its cause.

Effects of tobacco smoking on plasma selenium, zinc, copper and iron concentrations and related antioxidative enzyme activities

OBJECTIVES

The aim of the study was to investigate whether alterations in antioxidative enzyme activities are dependent on their cofactor concentrations in tobacco smokers.

DESIGN AND METHODS

Plasma selenium, copper, zinc and iron concentrations, and the activities of related erythrocyte antioxidative enzymes copper-zinc superoxide dismutase (Cu-Zn SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) were measured in tobacco smokers and compared with those of nonsmokers. Plasma thiocyanate levels were measured as an index of smoking status.

RESULTS

While plasma copper concentration and erythrocyte Cu-Zn SOD activity were significantly higher, plasma selenium concentration and erythrocyte GSH-Px activities were significantly lower in tobacco smokers than in nonsmokers. There was no significant difference in plasma iron and zinc concentrations or erythrocyte CAT activity between the two groups. There were significant positive correlations between erythrocyte GSH-Px and plasma selenium levels, between Cu-Zn SOD and copper levels, and between CAT and iron levels, and a negative correlation between plasma thiocyanate and selenium content in tobacco smokers.

CONCLUSIONS

These findings suggest that antioxidative enzyme activities change depending on their cofactor concentrations in tobacco smokers.

Placental abruption and perinatal death

Studies of risk factors for abruptio placentae (AP) are partly conflicting and studies of risk factors for perinatal death in these pregnancies are scarce. Using the population-based Swedish Birth Registry from 1987 to 1993, we were able to study these risks in 795,459 singleton pregnancies. Logistic regression analysis was used to estimate odds ratios (OR) for risk of AP and risk of perinatal death in pregnancies with and without AP. Risk factors for AP were: age, primiparity, high parity, not cohabiting with infant's father, low education, smoking, infertility, pregestational diabetes, essential hypertension, pregnancy-induced hypertensive diseases, preterm premature rupture of membranes, preterm birth and small-for-gestational-age (SGA) births. Risk factors for perinatal death in pregnancies with placental abruption were smoking (1--9 and > or =10 cigarettes/day; OR 1.4 and 1.7 respectively), severe pre-eclampsia (OR 2.0) and SGA (OR 1.9), whereas in pregnancies without abruption, risks were also increased in maternal age > or =35 years, primiparity, infertility, essential hypertension and pregestational diabetes. These findings support the theory that, in cases of AP, a general impairment of the placenta and/or a defect placentation may be fatal.

Tobacco smoking and vitamin C concentration in gastric juice in healthy subjects and patients with Helicobacter pylori infection

Low gastric juice total vitamin C concentration in the presence of Helicobacter pylori infection probably plays a role in gastric carcinogenesis. Vitamin C plays a role in the neutralization of various pathogenic factors connected with H. pylori infection, including the destruction of free radicals, which damage tissues and cell DNA, and inhibition of the formation of N-nitroso compounds, which have a strong carcinogenic activity. The aim of the study was to determine whether tobacco smoking had any effect on gastric juice vitamin C concentration in healthy subjects and in patients infected with H. pylori. Eighty-six patients with dyspeptic symptoms undergoing routine endoscopy entered the study after giving informed consent. In all patients plasma and gastric juice total vitamin C levels were measured by a spectrophotometric method. They were entered into four groups: group I (controls) - H. pylori-negative non-smokers (n = 17), group II - H. pylori-negative smokers (n = 16), group III - non-smokers with H. pylori infection (n = 21), and group IV - H. pylori-infected smokers (n = 32). In the control group (I) the mean gastric juice total vitamin C concentration was 17.1 microg/ml (range 5.3-40.0 microg/ml), which was significantly higher (P < 0.05) than in group II (12.6 microg/ml, range 5.1-21.0 microg/ml), group III (5.8 microg/ml range 2.1-13.7 microg/ml) and group IV (3.9 microg/ml, range 1.1-10.6 microg/ml) (P < 0.001). Statistically significant differences also were noted between groups II and III (P < 0.01) and groups II and IV (P < 0.001) and between groups III and IV (P < 0.05). These results demonstrate that the concentration of vitamin C in gastric juice is significantly lower in smokers than in non-smokers. This was observed in healthy subjects as well as H. pylori-infected patients. This phenomenon may be one of the mechanisms whereby smoking contributes to the production of gastric lesions, impairs healing of peptic ulcers and also increases the recurrence rate of peptic ulcers in cases with H. pylori infection.

Differences and trends in antioxidant dietary intake in smokers and non-smokers, 1980-1992: the Minnesota Heart Survey

PURPOSE

Differences and secular trends in dietary antioxidant vitamin intake (vitamins E, C, and beta-carotene) in current non-smokers, light smokers, and heavy smokers were examined as part of the Minnesota Heart Survey.

METHODS

Three cross-sectional surveys were conducted in adults ages 25-74 years in 1980-82 (N = 1682), 1985-87 (N = 2326), and 1990-92 (N = 2487). Dietary information was obtained from a 24-hour dietary recall. Smoking was assessed through self-report. Intakes were adjusted for age, energy intake, body mass index, education level, and exercise level (vitamins E, C and beta-carotene).

RESULTS

Antioxidant vitamin intakes were significantly higher in non-smokers than in light (1-20 cig/day) and heavy smokers (>20 cig/day) when all three survey periods were combined. In men, mean vitamin E intake was 9.2 mg, 8.6 mg, and 7.8 mg for non-smokers, light smokers, and heavy smokers, respectively. Results were similar in men for beta-carotene (non-smokers 1408 microg, light smokers 1287 microg, and heavy smokers 1064 microg), and vitamin C (non-smokers 81 mg, light smokers 67 mg, and heavy smokers 56 mg). Women had results of similar magnitude and direction. From 1980-92, secular trends in men showed non-significant increases from 1980-82 to 1990-92 in beta-carotene (+6.1%), while decreases were observed in vitamins E (-1.1%) and C (-2.6%). In contrast, women had large decreases in all antioxidant vitamin intakes: vitamin E (-13%), vitamin C (-18.6%), and beta-carotene (-16.2%).

CONCLUSIONS

Light and heavy smokers had a significantly lower overall mean dietary antioxidant vitamin intake than non-smokers. Over the decade, antioxidant dietary intake remained relatively stable in men and decreased in women in Minneapolis-St. Paul, despite improvements in access to antioxidant rich fruits and vegetables.

Comparative study of the effects of vitamin C and bleomycin on smokers' and non-smokers' lymphocytes in clastogenicity assays

Free radicals are products of metabolic reactions and of external factors that can injure different biological molecules. However, different antioxidant agents can prevent the action of these reactive species and the damage they cause. Vitamin C (VC) is an important micronutrient found in the diet, which presents defense mechanisms against the free radicals that challenge the cells of the organism. The objective of the present study was to investigate the effect of VC as a modulator of the damage induced in DNA by bleomycin (BLM) in lymphocytes from smokers and non-smokers. The difference in response to the mutagenic potential of BLM between smokers and non-smokers was also investigated. Peripheral blood lymphocyte cultures were treated simultaneously with BLM (20 microg/ml) and/or VC (100, 200, and 400 microg/ml) in the G2 phase of the cell cycle. The results obtained did not demonstrate a statistically significant difference in the response to the antitumor agent BLM between smokers and non-smokers. The data also showed that VC had no significant modulating effect on the frequency of chromosome aberrations induced by BLM in the cells of smokers and non-smokers under the experimental conditions used.