Associations between smoking, components of metabolic syndrome and lipoprotein particle size.
Associations between smoking, components of metabolic syndrome and lipoprotein particle size.
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DOI：
10.1186/1741-7015-11-195
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发表时间：
2013-09-03
期刊：
影响因子：
9.3
通讯作者：
Wolffenbuttel BH
中科院分区：
文献类型：
--
作者：
Slagter SN;van Vliet-Ostaptchouk JV;Vonk JM;Boezen HM;Dullaart RP;Kobold AC;Feskens EJ;van Beek AP;van der Klauw MM;Wolffenbuttel BH
代谢和心血管危险因素的聚集被称为代谢综合征（MetS）。患有 MetS 的风险与肥胖增加密切相关，并且可以通过吸烟行为进一步改变。与低密度脂蛋白胆固醇 (LDL-C) 和高密度脂蛋白胆固醇 (HDL-C) 相关的载脂蛋白 (apo) 可能在 MetS 中发生改变。本研究旨在探讨吸烟与以下参数之间的关联：MetS 及其成分、载脂蛋白水平和估计脂蛋白颗粒大小，分别针对男性和女性，以及不同的体重指数 (BMI) 类别。我们纳入了 2006 年 12 月至 2012 年 1 月期间参加生命线队列研究的 24,389 名男性和 35,078 名年龄在 18 岁至 80 岁之间的女性；目前有 5,685 名男性和 6,989 名女性吸烟。参与者被分为三个不同的体重指数 (BMI) 类别（BMI <25；BMI 25 至 30；BMI ≥30 kg/m2）。 MetS 是根据国家胆固醇教育计划的成人治疗小组 III (NCEP:ATPIII) 标准定义的。血压、人体测量和血脂测量均经过严格标准化，大样本量能够对定量变化进行有力的估计。通过线性回归测试吸烟与各个 MetS 成分以及 apoA1 和 apoB 之间的关联。使用逻辑回归来检验吸烟和每日吸烟对代谢综合征风险的影响。所有模型均经过年龄调整并按性别和 BMI 等级进行分层。 MetS 的患病率随着 BMI 水平的升高而增加。共有 64% 的肥胖男性和 42% 的肥胖女性患有 MetS。目前吸烟与男女和所有 BMI 类别的 MetS 风险较高相关（男性比值比为 1.7 至 2.4，女性比值比为 1.8 至 2.3，所有 P 值均<0.001）。目前吸烟者的 HDL 胆固醇和 apoA1 水平较低，甘油三酯和 apoB 水平较高，腰围高于不吸烟者（均 P <0.001）。吸烟与血压或空腹血糖没有一致的关联。在所有 BMI 类别中，我们发现每日吸烟量与 MetS 患病率以及较低水平的 HDL 胆固醇、较高的甘油三酯水平和较低的 HDL 胆固醇/apoA1 比率以及较低的 HDL 胆固醇/apoA1 比率以及低密度脂蛋白胆固醇/apoB 比率（仅在 BMI <30 的人群中）之间存在剂量依赖性关联（所有 P <0.001）。吸烟与 MetS 患病率增加相关，与性别和 BMI 等级无关。这种风险增加主要与高密度脂蛋白胆固醇降低、甘油三酯和腰围升高有关。此外，吸烟与 apoA1 和 apoB 以及脂蛋白颗粒大小的不利变化有关。请参阅相关评论：http://www.biomedcentral.com/1741-7015/11/196。
The clustering of metabolic and cardiovascular risk factors is known as metabolic syndrome (MetS). The risk of having MetS is strongly associated with increased adiposity and can be further modified by smoking behavior. Apolipoproteins (apo) associated with low-density lipoprotein-cholesterol (LDL-C) and high-density lipoprotein-cholesterol (HDL-C) may be altered in MetS. This study aimed to examine the association between smoking and the following parameters: MetS and its components, levels of apolipoproteins and estimated lipoprotein particle size, separately for men and women, and in different body mass index (BMI) classes. We included 24,389 men and 35,078 women aged between 18 and 80 years who participated in the LifeLines Cohort Study between December 2006 and January 2012; 5,685 men and 6,989 women were current smokers. Participants were categorized into three different body mass index (BMI) classes (BMI <25; BMI 25 to 30; BMI ≥30 kg/m2). MetS was defined according to the National Cholesterol Education Program’s Adult Treatment Panel III (NCEP:ATPIII) criteria. Blood pressure, anthropometric and lipid measurements were rigorously standardized, and the large sample size enabled a powerful estimate of quantitative changes. The association between smoking and the individual MetS components, and apoA1 and apoB, was tested with linear regression. Logistic regression was used to examine the effect of smoking and daily tobacco smoked on risk of having MetS. All models were age adjusted and stratified by sex and BMI class. Prevalence of MetS increased with higher BMI levels. A total of 64% of obese men and 42% of obese women had MetS. Current smoking was associated with a higher risk of MetS in both sexes and all BMI classes (odds ratio 1.7 to 2.4 for men, 1.8 to 2.3 for women, all P values <0.001). Current smokers had lower levels of HDL cholesterol and apoA1, higher levels of triglycerides and apoB, and higher waist circumference than non-smokers (all P <0.001). Smoking had no consistent association with blood pressure or fasting blood glucose. In all BMI classes, we found a dose-dependent association of daily tobacco consumption with MetS prevalence as well as with lower levels of HDL cholesterol, higher triglyceride levels and lower ratios of HDL cholesterol/apoA1 and, only in those with BMI <30, LDL cholesterol/apoB (all P <0.001). Smoking is associated with an increased prevalence of MetS, independent of sex and BMI class. This increased risk is mainly related to lower HDL cholesterol, and higher triglycerides and waist circumference. In addition, smoking was associated with unfavorable changes in apoA1 and apoB, and in lipoprotein particle size. Please see related commentary: http://www.biomedcentral.com/1741-7015/11/196.
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