Smoking associates with visceral fat accumulation especially in women

Cumulative Cigarette Consumption is Associated with Cardio-Ankle Vascular Index (CAVI) Mediated by Abdominal Obesity Assessed by A Body Shape Index (ABSI): A Cross-Sectional Study

AIM

To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness.

METHODS

Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0.

RESULTS

Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (Rs: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (Rs: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks.

CONCLUSION

Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.

The effects of cigarette smoking and alcohol drinking on salty taste preferences based on Korean Community Health Survey data

BACKGROUND/OBJECTIVES

Excessive sodium intake, cigarette smoking, and alcohol consumption are risk factors for a wide range of diseases. This study aimed to determine whether smokers and drinkers are more likely to enjoy their food with more salt, and whether the combination of smoking and drinking is associated with salty taste preferences.

SUBJECTS/METHODS

This study analyzed the data of over 16 million Koreans from two four-year Korean Community Health Survey cycles (i.e., 2010 to 2013 and 2014 to 2017). The respondents' preferences for salty foods (i.e., their salt intake levels, whether they added salt or soy sauce to foods served on the table, and whether they dipped fried foods in salt or soy sauce), and the odds ratio (OR) of their preference were examined among smokers and drinkers when adjusted for sex, age, body mass index, educational level, household income, marital status, and cigarette smoking or alcohol consumption status.

RESULTS

Cigarette smoking and alcohol consumption were correlated with the consumption of salty food. Based on the adjusted model, cigarette smokers and alcohol drinkers preferred adding salt or soy sauce or dipping fried foods in soybean more than non-smokers and non-drinkers. In addition, people who smoked and consumed alcohol reported a more significant stacking effect regarding the salty taste preference.

CONCLUSION

This large population-based study found that both cigarette smoking and alcohol consumption were correlated with salty taste preferences, which may cause excessive sodium intake.

Association of the COVID-19 pandemic with changes in objectively measured sedentary behaviour and adiposity

BACKGROUND

Several studies have reported that the coronavirus disease (COVID-19) pandemic has increased sedentary behaviour and obesity; however, these analyses used self-reported data, and the association between sedentary behaviour and visceral fat and adipocytokines during the COVID-19 pandemic remains unclear. We aimed to investigate the association of the COVID-19 pandemic with objectively measured sedentary behaviour and these obesity-related factors.

METHODS

Longitudinal analysis was conducted on 257 Japanese participants who underwent health check-ups in 2018 before and in 2020 during the COVID-19 pandemic. For both time points, sedentary behaviour was measured using an accelerometer for at least 7 days, visceral fat area (VFA) was measured using abdominal bioelectrical impedance analysis, and blood adiponectin level was measured using latex agglutination turbidimetric immunoassay. Multiple linear regression was performed to determine the association between sedentary behaviour and these outcomes.

RESULTS

Compared with data in 2018, sedentary behaviour and VFA were significantly increased (P < 0.001, P = 0.006) whereas adiponectin level was significantly decreased (P < 0.001) in 2020. Increased sedentary behaviour was significantly associated with an increase in VFA (β = 3.85, 95% CI 1.22-6.49, P = 0.004) and a decrease in adiponectin level (β = -0.04, 95% CI -0.06 to -0.01, P = 0.005). However, the association of sedentary behaviour with adiponectin level was not significant after considering the effects of VFA.

CONCLUSIONS

The COVID-19 pandemic was associated with objectively measured sedentary behaviour and obesity-related factors in Japanese adults. Additionally, an increase in sedentary behaviour was associated with an increase in VFA, whereas the association of sedentary behaviour with adiponectin was partly mediated by VFA. These results suggest that avoiding increasing sedentary time is important to prevent visceral adiposity thereby ameliorating adiponectin, especially during behavioural limitations such as the COVID-19 pandemic.

Effects of Cigarette Smoking on Influenza Virus/Host Interplay

Cigarette smoking has been shown to increase the risk of respiratory infection, resulting in the exacerbation of infectious disease outcomes. Influenza viruses are a major respiratory viral pathogen, which are responsible for yearly epidemics that result in between 20,000 and 50,000 deaths in the US alone. However, there are limited general summaries on the impact of cigarette smoking on influenza pathogenic outcomes. Here, we will provide a systematic summarization of the current understanding of the interplay of smoking and influenza viral infection with a focus on examining how cigarette smoking affects innate and adaptive immune responses, inflammation levels, tissues that contribute to systemic chronic inflammation, and how this affects influenza A virus (IAV) disease outcomes. This summarization will: (1) help to clarify the conflict in the reports on viral pathogenicity; (2) fill knowledge gaps regarding critical anti-viral defenses such as antibody responses to IAV; and (3) provide an updated understanding of the underlying mechanism behind how cigarette smoking influences IAV pathogenicity.

The effect of age on the association between daily gait speed and abdominal obesity in Japanese adults

The aim of this work was to investigate the effect of age on the association between daily gait speed (DGS) and abdominal obesity defined by visceral fat area (VFA). A cross-sectional study was performed using data from an annual community-based health check-up. A total of 699 participants aged 20–88 years were enrolled in this analysis. DGS was assessed using tri-axial accelerometers worn for ≥ 7 days with at least 10 measuring hours each day. VFA was measured using a visceral fat meter. Since DGS differed significantly with age, the participants were divided into two groups: younger adults (YA), aged 20–49 years, and older adults (OA), aged 50–88 years. The association between DGS and VFA differed significantly with age (r = 0.099 for YA and r =  − 0.080 for OA; test for difference between correlation coefficients, P = 0.023). In OA, the adjusted odds ratio of abdominal obesity (VFA ≥ 100 cm²) was 0.40 (95% confidence interval 0.18, 0.88, P = 0.022) for the highest DGS quartile (DGS ≥ 1.37 m/s) compared to that for the lowest quartile (DGS < 1.11 m/s), whereas no significant association was found in YA. These data could aid in raising awareness of the self-management of obesity via DGS monitoring, especially in OA.

Polymethoxyflavone purified from Kaempferia parviflora reduces visceral fat in Japanese overweight individuals: a randomised, double-blind, placebo-controlled study

Visceral fat is a more important factor in obesity-associated disorders in Japanese individuals than in Caucasian individuals. The objective of this randomised, double-blind, placebo-controlled parallel group study, conducted in Japanese overweight adults, was to investigate the effects of polymethoxyflavone purified from Kaempferia parviflora on visceral fat. A total of 80 subjects (aged 20-64 years, 23.0 ≤ body mass index < 30 kg m-2) were randomly assigned in 1 : 1 ratio to either the active (polymethoxyflavone purified from K. parviflora) or placebo group. Over a 12-week period, each subject received two capsules containing polymethoxyflavone purified from K. parviflora (12 mg polymethoxyflavone per day) or placebo. The primary outcome was a reduction in visceral fat area (VFA), while the secondary outcome was a reduction in subcutaneous fat area (SFA) and total fat area (TFA). VFA was measured at 0, 8, and 12 weeks using computed tomography scanning. Results showed that VFA significantly reduced after 12 weeks in the active group and was significantly lower than in the placebo group at 8 and 12 weeks. A significant reduction was observed in SFA and TFA after 8 and 12 weeks in the active group; TFA was significantly lower than that in the placebo group at 8 and 12 weeks. No adverse events associated with the test supplements were observed in either group. Our study shows that administration of polymethoxyflavone purified from K. parviflora reduces visceral fat in Japanese overweight adults.

Association of smoking with abdominal adipose deposition and muscle composition in Coronary Artery Risk Development in Young Adults (CARDIA) participants at mid-life: A population-based cohort study

BACKGROUND

Smokers have lower risk of obesity, which some consider a "beneficial" side effect of smoking. However, some studies suggest that smoking is simultaneously associated with higher central adiposity and, more specifically, ectopic adipose deposition. Little is known about the association of smoking with intermuscular adipose tissue (IMAT), an ectopic adipose depot associated with cardiovascular disease (CVD) risk and a key determinant of muscle quality and function. We tested the hypothesis that smokers have higher abdominal IMAT and lower lean muscle quality than never smokers.

METHODS AND FINDINGS

We measured abdominal muscle total, lean, and adipose volumes (in cubic centimeters) and attenuation (in Hounsfield units [HU]) along with subcutaneous (SAT) and visceral adipose tissue (VAT) volumes using computed tomography (CT) in 3,020 middle-aged Coronary Artery Risk Development in Young Adults (CARDIA) participants (age 42-58, 56.3% women, 52.6% white race) at the year 25 (Y25) visit. The longitudinal CARDIA study was initiated in 1985 with the recruitment of young adult participants (aged 18-30 years) equally balanced by female and male sex and black and white race at 4 field centers located in Birmingham, AL, Chicago, IL, Minneapolis, MN, and Oakland, CA. Multivariable linear models included potential confounders such as physical activity and dietary habits along with traditional CVD risk factors. Current smokers had lower BMI than never smokers. Nevertheless, in the fully adjusted multivariable model with potential confounders, including BMI and CVD risk factors, adjusted mean (95% CI) IMAT volume was 2.66 (2.55-2.76) cm3 in current smokers (n = 524), 2.36 (2.29-2.43) cm3 in former smokers (n = 944), and 2.23 (2.18-2.29) cm3 in never smokers (n = 1,552) (p = 0.007 for comparison of former versus never smoker, and p < 0.001 for comparison of current smoker versus never and former smoker). Moreover, compared to participants who never smoked throughout life (41.6 [41.3-41.9] HU), current smokers (40.4 [39.9-40.9] HU) and former smokers (40.8 [40.5-41.2] HU) had lower lean muscle attenuation suggesting lower muscle quality in the fully adjusted model (p < 0.001 for comparison of never smokers with either of the other two strata). Among participants who had ever smoked, pack-years of smoking exposure were directly associated with IMAT volume (β [95% CI]: 0.017 [0.010-0.025]) (p < 0.001). Despite having less SAT, current smokers also had higher VAT/SAT ratio than never smokers. These findings must be viewed with caution as residual confounding and/or reverse causation may contribute to these associations.

CONCLUSIONS

We found that, compared to those who never smoked, current and former smokers had abdominal muscle composition that was higher in adipose tissue volume, a finding consistent with higher CVD risk and age-related physical deconditioning. These findings challenge the belief that smoking-associated weight loss or maintenance confers a health benefit.

Association of abdominal fat with metabolic syndrome components in overweight women: effect of menopausal status

BACKGROUND

The association between abdominal fat distribution and metabolic syndrome (MetSyn) components by menopausal status has yet to be explicated. The purpose of this study was to examine a cross-sectional association between abdominal fat compartments and MetSyn components in pre- and post-menopausal overweight Japanese women.

METHODS

Of 212 overweight Japanese women, 76 pre-menopausal overweight (BMI ≥ 25) women (PreM age, 42.1 ± 5.9 years) and 87 post-menopausal overweight women (PostM: age, 56.2 ± 4.5 years) were analyzed in this study. Measurements were taken for body mass index (BMI), abdominal compartments [visceral fat (VF), subcutaneous fat (SF), superficial subcutaneous fat (SSF), and deep subcutaneous fat (DSF)], serum high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol, triglycerides (TG), and fasting plasma glucose (FPG). Abdominal compartments were assessed using computed tomography.

RESULTS

No significant differences were found for BMI, SF, SSF, or DSF between the PreM and PostM. Despite this, the PreM had a significantly smaller VF area than that of the PostM. However, the difference in VF area disappeared when age was adjusted for. VFA significantly correlated with HDLC, TG, and FPG independently of menopause status.

CONCLUSIONS

These results suggest that the effect of menopause status on the association between VF and MetSyn components is negligible. Abdominal subcutaneous fat compartments were not associated with MetSyn components in overweight women regardless of menopausal status.

Prevalence of risk factors for cardiovascular diseases and their structure in healthy women. The main findings of the project “The three ages of a woman”

Aims and objectives. Identify the priority features of the formation of the most significant diseases in women with the focus on the determination of disease markers and their development triggers. Materials and methods. 408 healthy women from the students and employees of The Moscow State University of Medicine and Dentistry named after A.I. Yevdokimov took part in the research. All the women completed a questionnaire, which was elaborated by the researchers. The survey contained questions designed to identify major risk factors for cardiovascular diseases and explore dietary and physical activity habits, bad habits and diseases, gynaecological status. Results. All the participants were divided into 4 groups. The 1st group included 157 female subjects under the age of 24; the 2nd was represented by 113 women above the age of 25 who reported pregnancy and birth in their case history; the 3rd group was formed by non-parous 74 women of the same age and the 4th one consisted of 64 postmenopausal women. Complaints of dyspnea and unpleasant feelings in the region of the heart which were not caused by physical exercise were found, for the most part (р=0,001), in the women of the fourth group (73 % opposed to 36 % of cases in the 1st group). 18.4% of the interviewed smoked and were mainly found in the groups of reproductive-age women. Worth noting that lack of physical activity was reported in the groups. Inactivity was found predominantly (48 %, р=0,001) in the volunteers of the 4th group. A third of the women from that group noted the symptoms of physical activity intolerance represented by dyspnea and weakness. 41,4 % of the female subjects (n=169) had chronic conditions: most of them were gastrointestinal diseases with the prevalence of gastritis (36,5 %). The analysis of the gynaecological status of the interviewed allowed to discover ovarian dysfunction in 26,8 % of the interviewed women. 52 % of the women from the 1st group suffered from premenstrual syndrome. 14,7 % of the interviewed had a premature birth. 11,7 % of the women had undergone C-section. Pregnancy complications were reported in 15,4 % of the interviewed; 11,4 % of the cases were pregnancy losses. 28 % of the representatives of the 4th group reported surgical menopause. This group demonstrates the proven (р=0,001) increase of body mass index, high arterial pressure, hot flushes, insomnia. Conclusion. The conducted research allowed discovering significant negative impacts of smoking, low physical activity, unhealthy diet, especially, in the group of reproductive-age women. Hormonal disorders, pathology in pregnant women found in the groups of young subjects as well as high rate of somatic diseases in healthy women require an in-depth study of the identified risk groups.

Association between breath methane concentration and visceral fat area: a population-based cross-sectional study

High visceral fat area (VFA) is a stronger predictor of cardiovascular disease and overall mortality, compared with body mass index (BMI) and waist circumference (WC). Recent reports demonstrate that obesity is related to breath gas, which is produced by the intestinal microflora. However, these studies define obesity using BMI, not VFA. In this population-based cross-sectional study, we investigated the relationship between breath gases (methane and hydrogen) and both VFA and BMI. A total of 1033 participants (62% women; age [mean ± standard deviation] 54.4 ± 14.9 years) in the 2015 Iwaki Health Promotion Project in Japan were enrolled in the study. Breath samples were collected using a breath bag and analyzed by gas chromatography. VFA was measured using a visceral fat meter. The proportion of methanogenic bacteria to total intestinal microbiota was measured by polymerase chain reaction and 16S rRNA gene sequencing analysis. Our analysis revealed a significant association between high VFA and low breath methane, even after adjusting for confounding factors (B = -0.024 and P = 0.004). To identify the association between breath methane and VFA in participants with methane-producing bacteria in their intestinal microflora, participants were divided into two groups based on the presence or absence of methanogenic bacteria in their stool. The Methanogen + group was further divided into two subgroups with breath methane higher (Methane-UP) or lower (Methane-LO) than the median breath methane concentration. VFA was significantly lower in the Methane-UP group than in the Methane-LO group. In participants with methanogenic bacteria, breath methane concentration might be an independent biomarker of visceral fat accumulation.

Effect of present versus previous smoking on non-invasive haemodynamics

We examined cardiovascular function in 637 volunteers (19-72 years) without antihypertensive medication in never smokers (n = 365), present smokers (n = 81) and previous smokers (n = 191, median abstinence 10 years). Haemodynamics during passive head-up tilt were recorded using whole-body impedance cardiography and radial pulse wave analysis. Results were adjusted for age, sex, body mass index, LDL cholesterol and alcohol use. Systolic and diastolic blood pressure, heart rate, and pulse wave velocity were not different between the groups. Supine aortic reflection times did not differ, while upright values were shorter in present versus previous smokers (p = 0.04). Heart rate adjusted augmentation index was increased in the supine position in present smokers versus controls (p = 0.045), and in present (p < 0.001) and previous (p = 0.031) smokers versus controls in the upright position. Supine and upright cardiac output was higher (p ≤ 0.016) and systemic vascular resistance lower (p ≤ 0.001) in present versus previous smokers. In spite of the long abstinence, in the upright position previous smokers had lower cardiac output (p = 0.032) and higher systemic vascular resistance (p = 0.014) than never smokers. In the absence of differences in blood pressure and arterial stiffness, present smokers presented with hyperdynamic circulation and enhanced wave reflection compared with previous smokers.

An implication of Klotho-related molecules in different smoking-related health outcomes between men and women

BACKGROUND

Men and women react differently to some disease states, and women are reported to be more sensitive than men to the toxic effects of smoking. We examined the serum concentration of Klotho-related molecules, α-Klotho (αKl) and fibroblast growth factor (FGF)-21, and the influence of smoking on these molecules in both sexes.

METHODS

Subjects included 90 men and 140 women in good health who underwent a health examination.

RESULTS

Among male subjects, serum concentrations of FGF-21, soluble sαKl, and inflammation-related cytokine interleukin (IL)-6 were significantly higher in smokers than in never-smokers. In females, serum concentrations of FGF-21 and IL-6 were significantly higher in smokers than in never-smokers; however, sαKl concentrations were slightly lower in smokers than in never-smokers. Serum concentrations of sαKl were correlated with smoking status and IL-6 only in male subjects, suggesting an anti-inflammatory effect of sαKl only in men. Serum concentrations of FGF-21 were correlated with the concentrations of total cholesterol, triglycerides, and HbA1c, which are important factors of metabolic disorders in females, suggesting that metabolic disorders in female smokers may be more serious than that in male smokers.

CONCLUSIONS

Klotho-related molecules showed a differential association and response to smoking between men and women.

Resistin as an inflammatory marker in patients with schizophrenia treated with clozapine

BACKGROUND

Schizophrenia is associated with excess cardiovascular comorbidity and mortality related to lifestyle factors, such as lack of physical activity, poor diet, and smoking. The prevalence of metabolic syndrome is increased among patients with schizophrenia, with the highest rates among patients on clozapine treatment. Smoking, obesity, physical inactivity, airway inflammation and obstruction, and adipose tissue and inflammatory marker activation are related in systemic inflammation. Low-grade inflammation is also associated with schizophrenia. Adipokine resistin is a biomarker involving several acute and chronic inflammatory states. However, the inflammatory role of resistin is so far inconclusive and studies in schizophrenia are scanty.

AIMS

The aim of the present study was to explore the role of serum resistin as an inflammatory marker in patients with schizophrenia on clozapine treatment.

METHODS

Associations between serum levels of resistin and some other selected cytokines/adipokines (adiponectin, leptin, adipsin, IL-6, IL-1Ra, TNF-α, hs-CRP) and metabolic markers in 190 patients with schizophrenia on clozapine treatment were studied using a cross-sectional study design.

RESULTS

Among male patients especially, smokers had higher levels of resistin than non-smokers, and among smokers resistin levels were associated with IL-1Ra and hs-CRP levels. In the whole patient group levels of resistin associated with levels of IL-1Ra, and among male patients with low HDL-cholesterol.

CONCLUSIONS

Resistin is a biomarker of systemic inflammation associated with smoking among patients with schizophrenia on clozapine treatment. Resistin might have a role as a marker of cardiovascular comorbidity.

Risk for metabolic diseases in normal weight individuals with visceral fat accumulation: a cross-sectional study in Japan

OBJECTIVE

To investigate the association between visceral fat area (VFA) and metabolic syndrome (Mets) among normal weight Japanese.

DESIGN

A cross-sectional study.

SETTING

The health check-up centre of the Takeda Hospital group in Kyoto, Japan.

METHODS

This study involved 1674 men and 1448 women aged 30-74 years who underwent medical check-ups in 2012 in the health check-up centre. They were stratified by Body Mass Index (BMI cut-off for obesity is set at 23.0 kg/m² for Asians): normal weight 18.5-22.9 kg/m² or higher weight ≥23.0 kg/m². The age-adjusted ORs of the 2nd to 4th groups of sex-specific VFA quartiles compared with the 1st quartile for a Mets component clustering were estimated. The clustering was having two or more of the following factors: high blood pressure, high fasting blood glucose (FBG), low high-density lipoprotein cholesterol (HDL-C) and high triglycerides. Statistical analyses were conducted in 2016.

RESULTS

Participants in the 2nd to 4th VFA quartiles had significantly higher clustering risks; ORs were 3.4 (1.5 to 8.0), 6.3 (2.8 to 14.2) and 9.3 (4.2 to 20.7) for normal weight participants, and 1.7 (1.2 to 2.6), 2.6 (1.8 to 3.9) and 6.0 (4.1 to 8.8) for higher weight participants, respectively. The ORs of the 4th VFA quartile for Mets components were significantly higher; ORs for normal weight participants were 2.1 (1.5 to 3.0) (high blood pressure), 2.4 (1.4 to 4.2) (high FBG), 5.2 (2.1 to 12.9) (low HDL-C) and 12.0 (5.7 to 25.3) (high triglycerides), and higher weight participants were 3.9 (2.8 to 5.5), 4.1 (2.8 to 6.2), 3.9 (2.2 to 6.9) and 5.0 (3.4 to 7.4), respectively.

CONCLUSIONS

Among participants with normal weight, as well as those of higher weight, dose-dependent responses were observed between VFA and risk for Mets components and the clustering among Japanese adults. VFA may be useful information for interventions to improve metabolic risk factors in people with normal weight.

Association between N-terminal pro-brain natriuretic peptide and adiponectin in healthy Japanese men

BACKGROUND

The natriuretic peptides, brain natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP), are cardiac-derived hormones and can serve as biomarkers for ventricular dysfunction. BNP has cardio-protective effects and is known as a regulator of metabolism. In the present study, to evaluate the relationship between natriuretic peptides and metabolic disorders, we focused on the association between NT-proBNP and metabolic syndrome-related molecule adiponectin (APN).

METHODS

Forty-five apparently healthy men who underwent health examination at the Osaka University Health Care Center were enrolled for this study. Physical and biochemical parameters including serum APN and NT-proBNP concentrations were obtained from all the subjects.

RESULTS

The serum concentrations of NT-proBNP negatively correlated with metabolic disorder parameters, body mass index (BMI), waist circumferences, and fasting plasma glucose levels, but positively correlated with APN, suggesting that similar to APN, NT-proBNP is associated with metabolic disorders. Furthermore, increased serum concentrations of APN were found to be accompanied by increased serum concentrations of NT-proBNP and decreased BMI and mean intima-media thickness.

CONCLUSIONS

The serum concentrations of NT-proBNP are associated with APN concentrations and metabolic disorder parameters in healthy subjects.

Metabolic effects of smoking cessation

Smoking continues to be the leading cause of preventable death in the USA, despite the vast and widely publicized knowledge about the negative health effects of tobacco smoking. Data show that smoking cessation is often accompanied by weight gain and an improvement in insulin sensitivity over time. However, paradoxically, post-cessation-related obesity might contribute to insulin resistance. Furthermore, post-cessation weight gain is reportedly the number one reason why smokers, especially women, fail to initiate smoking cessation or relapse after initiating smoking cessation. In this Review, we discuss the metabolic effects of stopping smoking and highlight future considerations for smoking cessation programs and therapies to be designed with an emphasis on reducing post-cessation weight gain.

Klotho-related Molecules Upregulated by Smoking Habit in Apparently Healthy Men: A Cross-sectional Study

While aging is unavoidable, the aging mechanism is still unclear because of its complexity. Smoking causes premature death and is considered as an environmental aging accelerator. In the present study, we focused on the influence of smoking to the serum concentration of anti-aging protein α-klotho (αKl) and the β-klotho-associated protein fibroblast growth factor (FGF)-21 in men. Subjects consisted of apparently healthy men over 40 years of age who underwent health examination. Physical and biochemical parameters, including the levels of several cytokines and growth factors, were obtained from the subjects. Among middle-aged men (46.1 ± 5.1 years), serum levels of FGF-21, soluble αKl (sαKl), and inflammation-related cytokine interleukin (IL)-6 were significantly higher in smokers than in never-smokers. Serum levels of FGF-21 increased and correlated with alanine transaminase, γ guanosine-5′-triphosphate, and total cholesterol only in smokers, suggesting FGF-21 as a metabolic disorder-related factor in smokers. In aged men (60.3 ± 1.7 years), although the serum levels of sαKl in never-smokers were low, smokers showed highly increased serum levels of sαKl. Serum levels of sαKl was correlated with IL-6 in middle-aged never-smokers, suggesting sαKl regulates IL-6. However, this correlation was disrupted in smokers and aged men.

Impact of Metabolic Syndrome on Subclinical Atherosclerosis in Asymptomatic Individuals

BACKGROUND

Little is known about subclinical atherosclerosis on coronary computed tomographic angiography (CCTA) in asymptomatic individuals with metabolic syndrome (MetS).

METHODS AND RESULTS

We analyzed 5,213 asymptomatic individuals who underwent CCTA. A cardiac event was defined as a composite of all-cause death, myocardial infarction, unstable angina, or coronary revascularization. Of the study participants, 2,042 (39.2%) had MetS. MetS was an independent predictor of significant coronary artery disease (CAD) in at least 1 coronary artery (odds ratio [OR]=1.992, 95% confidence interval [CI]=1.623-2.445, P<0.001) and significant CAD in the left main (LM) or proximal left anterior descending (LAD) artery (OR=2.151, 95% CI=1.523-3.037, P<0.001). During the follow-up period (median 28.1 [interquartile range, 19.2-36.5] months), 111 individuals had 114 cardiac events. Individuals with MetS were significantly associated with more cardiac events than those without (RR [rate ratio]=1.67, 95% CI=1.15-2.43, P=0.007). In the MetS group, individuals with significant CAD had the majority of cardiac events (RR=64.33, 95% CI=29.17-141.88, P<0.001). Furthermore, in the MetS with significant CAD group, those with significant CAD in the LM or proximal LAD had more cardiac events (RR=2.63, 95% CI=1.51-4.59, P=0.001).

CONCLUSIONS

MetS was associated with subclinical atherosclerosis on CCTA with subsequent high risk for cardiac events. These findings suggest the importance of reducing unfavorable metabolic conditions in asymptomatic individuals.

Correlation of Lipid Parameters and Markers of Insulin Resistance: Does Smoking Make a Difference?

Insulin resistance associated with dyslipidemia enhances cardiovascular risk. Several atherogenic indexes have been suggested to give more precise information about the risk. The aim of our study was to estimate, which atherogenic index correlates better with parameters of insulin resistance. Furthermore, we compared the parameters of lipid metabolism and insulin resistance between smokers and non-smokers. In our cross-sectional study we enrolled 729 patients with dyslipidemia which were divided into two groups – non-smokers (586) and smokers (143). We measured lipid profile, parameters of insulin resistance (fasting glycemia, insulin, HOMA-IR, C-peptide, proinsulin) and calculated atherogenic indexes – atherogenic index of plasma (log (TAG/HDL-C), AIP), ApoB/ApoA1 index and nonHDL-C. AIP was found out to show stronger correlations with parameters of insulin resistance (p<0.001, correlation coefficients ranging between 0.457 and 0.243) than other indexes (ApoB/ApoA1 or nonHDL cholesterol). AIP correlated with parameters of insulin resistance both in smokers and non-smokers, but after adjustment (for age, body mass index, waist circumference) persisting only in non-smokers. Smokers had a wider waist circumference and a proatherogenic lipid profile. Smoking increases the risk of developing metabolic syndrome. AIP can be used in daily praxis for predicting insulin resistance in patients with dyslipidemia, predominantly in non-smokers.