Changes in Serum Lipid Profiles in Patients with Familial Hypercholesterolemia Who Smoke: A Pilot Study

Familial hypercholesterolemia (FH) is an autosomal codominant disease, and lipid abnormalities are a major risk factor for atherosclerotic cardiovascular disease (ASCVD).

We aimed to elucidate the lipid indicators that are significantly different between smokers and non-smokers and attempt to analyze their clinical implications in the risk of ASCVD in pedigrees of FH.

We screened 39 males aged 18-80 years with FH from the Chinese "National High Technology Research and Development Program" ("863 Project") after questionnaire survey, physical examination, and serum lipid test.

The apoA1/apoB ratio and apoA1 were significantly correlated with the daily amount of cigarettes and smoking years, respectively (p<0.05). The serum apoB level was higher in smokers who smoke at least one stick per day than in non-smokers (p<0.05). Importantly, there was a significant difference in the apoA1/apoB ratio when the daily smoking amount exceeded one pack (p<0.05), and there was a significant difference in the apoA1 ratio when the smoking years exceeded 20 (p<0.05).

The serum lipid profiles of apoA1 and apoB in smokers of FH pedigrees were significantly changed. With the increase of the smoking level, apoA1 decreased and apoB increased. Moreover, the ratio of apoA1 to apoB reflects the imbalance of cholesterol transport in blood vessels and might imply a higher risk of ASCVD in FH smokers.