Relationships between Smoking Status, Cardiovascular Risk Factors, and Lipoproteins in a Large Japanese Population

J Atheroscler Thromb. 2021 Sep 1;28(9):942-953. doi: 10.5551/jat.56838. Epub 2020 Oct 28.

Abstract

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.

Keywords: Cardiovascular disease risk; Dyslipidemia; Small dense LDL-C; Smoking; Smoking cessation.

MeSH terms

  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / etiology
  • Cholesterol, HDL / blood*
  • Cholesterol, LDL / blood*
  • Cigarette Smoking / adverse effects
  • Cigarette Smoking / blood*
  • Female
  • Heart Disease Risk Factors
  • Humans
  • Japan / epidemiology
  • Male
  • Middle Aged
  • Triglycerides / blood

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides