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Associations between smoking, components of metabolic syndrome and lipoprotein particle size.
BMC Med 2013; 11:195BM

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

Authors+Show Affiliations

Department of Endocrinology, University of Groningen, University Medical Center Groningen, HPC AA31, PO Box 30001, Groningen 9700 RB, The Netherlands. bwo@umcg.nl.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24228807

Citation

Slagter, Sandra N., et al. "Associations Between Smoking, Components of Metabolic Syndrome and Lipoprotein Particle Size." BMC Medicine, vol. 11, 2013, p. 195.
Slagter SN, van Vliet-Ostaptchouk JV, Vonk JM, et al. Associations between smoking, components of metabolic syndrome and lipoprotein particle size. BMC Med. 2013;11:195.
Slagter, S. N., van Vliet-Ostaptchouk, J. V., Vonk, J. M., Boezen, H. M., Dullaart, R. P., Kobold, A. C., ... Wolffenbuttel, B. H. (2013). Associations between smoking, components of metabolic syndrome and lipoprotein particle size. BMC Medicine, 11, p. 195. doi:10.1186/1741-7015-11-195.
Slagter SN, et al. Associations Between Smoking, Components of Metabolic Syndrome and Lipoprotein Particle Size. BMC Med. 2013 Sep 3;11:195. PubMed PMID: 24228807.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations between smoking, components of metabolic syndrome and lipoprotein particle size. AU - Slagter,Sandra N, AU - van Vliet-Ostaptchouk,Jana V, AU - Vonk,Judith M, AU - Boezen,H Marike, AU - Dullaart,Robin P F, AU - Kobold,Anneke C Muller, AU - Feskens,Edith J, AU - van Beek,André P, AU - van der Klauw,Melanie M, AU - Wolffenbuttel,Bruce H R, Y1 - 2013/09/03/ PY - 2013/05/04/received PY - 2013/07/24/accepted PY - 2013/11/16/entrez PY - 2013/11/16/pubmed PY - 2014/8/8/medline SP - 195 EP - 195 JF - BMC medicine JO - BMC Med VL - 11 N2 - BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSIONS: 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. SN - 1741-7015 UR - https://www.unboundmedicine.com/medline/citation/24228807/Associations_between_smoking_components_of_metabolic_syndrome_and_lipoprotein_particle_size_ L2 - https://bmcmedicine.biomedcentral.com/articles/10.1186/1741-7015-11-195 DB - PRIME DP - Unbound Medicine ER -