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Relationships between Smoking Status, Cardiovascular Risk Factors, and Lipoproteins in a Large Japanese Population
Marie Nakamura1, Yasushi Yamamoto2, Wataru Imaoka2
1Department of Insured Medical Care Management, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU).
Insights
Current smoking significantly elevates triglycerides (TG) and small dense LDL-C (sdLDL-C), while lowering HDL-C. These adverse lipid profile changes persist even after smoking cessation, underscoring the importance of quitting.
Area of Science:
- Cardiovascular Disease Research
- Lipid Metabolism Studies
- Public Health and Smoking Cessation
Background:
- Cardiovascular disease (CVD) is a leading cause of mortality, with smoking identified as a primary risk factor.
- Established CVD risk factors include age, hypertension, diabetes, and dyslipidemia (abnormal cholesterol levels).
- Understanding the specific impact of smoking on lipid profiles, including triglycerides (TG), HDL-C, and LDL-C subtypes, is crucial for risk assessment.
Purpose of the Study:
- To investigate the association between smoking status and key cardiovascular disease risk factors.
- To specifically examine the relationships between smoking and direct LDL-C, HDL-C, TG, and small dense LDL-C (sdLDL-C).
- To evaluate the persistence of smoking's effects on lipid profiles post-cessation.
Main Methods:
- Analysis of CVD risk factors in 34,497 Japanese men and women (mean age 51).
- Assessment of fasting serum lipids: total cholesterol, TG, HDL-C, sdLDL-C, and direct LDL-C.
- Statistical analyses including one-way ANOVA and multiple linear regression to determine smoking-related interrelationships.
Main Results:
- Current smokers exhibited significantly higher median TG and sdLDL-C levels and significantly lower HDL-C levels compared to non-smokers (p＜0.001).
- Smokers were more likely to present with elevated TG (>150 mg/dL), elevated sdLDL-C (>40.1 mg/dL), and low HDL-C (<40 mg/dL) (p＜0.05).
- Ex-smokers showed lipid profiles intermediate between current and non-smokers, with multivariate analysis confirming these associations.
Conclusions:
- Current cigarette smoking is strongly associated with adverse changes in lipid profiles: increased TG and sdLDL-C, and decreased HDL-C.
- The detrimental effects of smoking on lipid profiles appear to persist even after smoking cessation.
- These findings reinforce the critical need for smoking cessation interventions to mitigate cardiovascular disease risk.
Aims:
Smoking is a major risk factor for cardiovascular disease (CVD), a leading cause of death and disability. Other CVD risk factors include age, gender, hypertension, diabetes, increased low-density lipoprotein cholesterol (LDL-C) and decreased high-density lipoprotein cholesterol (HDL-C). Our goal was to assess relationships between smoking status and CVD risk factors, with a focus on direct LDL-C, HDL-C, triglycerides (TG) and small dense LDL-C (sdLDL-C).
Methods:
A total of 34,497 Japanese men and women, mean age 51 years, had their CVD risk factors including fasting serum total cholesterol, TG, HDL-C, sdLDL-C, and direct LDL-C assessed. One-way ANOVA and multiple linear regression analyses were carried to assess the interrelationships of these parameters with smoking.
Results:
In both men and women, current smokers had significantly (p＜0.001) higher median TG (+19.6%, +16.9%) and sdLDL-C levels (+12.7%, +4.2%) levels, and significantly (p＜0.001) lower HDL-C levels (-7.3%, -4.3%) than non-smokers. They were also significantly (p＜0.05) more likely to have TG values ＞150 mg/dL (+56.8%, +116.3%), sdLDL-C ＞40.1 mg/dL (+28.8%, +44.9%), and HDL-C ＜40 mg/dL (+89.8%, +114.3%). Ex-smokers generally had lipid values that were intermediate between non-smokers and current smokers. Multivariate analysis confirmed the significance of these relationships.
Conclusion:
Our data indicate that current cigarette smoking is associated with increased TG and sdLDL-C levels, as well as decreased HDL-C levels. Furthermore, smoking effect on lipid profiles remain after cessation. These data provide further justification for smoking cessation.
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