Department Primary Care & Population Health, UCL Medical School, Rowland Hill St, NW3 2PF, London, UK.
Atherosclerosis. 2010 Feb;208(2):550-6. doi: 10.1016/j.atherosclerosis.2009.07.044. Epub 2009 Jul 30.
Secondhand smoke (SHS) exposure is associated with elevated CHD risks. Yet the pathways through which this may operate have not been investigated in epidemiologic studies with objective SHS exposure measures and a wide range of CHD risk factors associated with active smoking. Therefore we investigate associations between SHS exposure and CHD risk factors, to clarify how SHS exposure may raise risk of CHD.
Cross-sectional population-based study of 5029 men and women aged 59-80 years from primary care practices in Great Britain. Smoking, behavioural and demographic information was reported in questionnaires; nurses made physical measurements and took blood samples for analysis of serum cotinine and markers of inflammation, hemostasis and endothelial dysfunction.
Active cigarette smokers had lower albumin and higher triglycerides, CRP, IL-6, white cell count, fibrinogen, blood viscosity, factor VIII, VWF and t-PA than non-smokers. Among non-smokers, serum cotinine levels were independently positively associated with CRP, fibrinogen, factor VIII, VWF and t-PA and inversely associated with albumin, after adjustment for age, gender, social and behavioural factors. The differences in CRP, fibrinogen and albumin between cotinine < or =0.05 and >0.7 ng/ml were one-third to one half the size of differences between cotinine < or =0.05 ng/ml and current smokers, but were of similar magnitude for VWF and t-PA.
Endothelial, inflammatory and haemostatic markers related to CHD risk showed independent associations with SHS exposure in the same direction as those for active smoking. Results aid understanding of the associations between SHS exposure and elevated CHD risks.
二手烟(SHS)暴露与冠心病(CHD)风险增加有关。然而,在具有客观 SHS 暴露测量和与主动吸烟相关的广泛 CHD 风险因素的流行病学研究中,尚未研究这些途径。因此,我们调查了 SHS 暴露与 CHD 风险因素之间的关联,以阐明 SHS 暴露如何增加 CHD 的风险。
这是一项来自英国初级保健机构的 5029 名 59-80 岁男性和女性的横断面人群研究。问卷调查报告了吸烟、行为和人口统计学信息;护士进行了身体测量并采集了血液样本,用于分析血清可替宁和炎症、止血和血管内皮功能障碍标志物。
与不吸烟者相比,主动吸烟者的白蛋白水平较低,而甘油三酯、CRP、IL-6、白细胞计数、纤维蛋白原、血液黏度、VIII 因子、vWF 和 t-PA 水平较高。在不吸烟者中,在校正年龄、性别、社会和行为因素后,血清可替宁水平与 CRP、纤维蛋白原、VIII 因子、vWF 和 t-PA 呈独立正相关,与白蛋白呈负相关。在 cotinine < or =0.05 和 >0.7 ng/ml 之间,CRP、纤维蛋白原和白蛋白的差异为 cotinine < or =0.05 ng/ml 和当前吸烟者之间差异的三分之一到一半,但 vWF 和 t-PA 的差异则相似。
与 CHD 风险相关的内皮、炎症和止血标志物与 SHS 暴露呈独立关联,与主动吸烟的方向相同。研究结果有助于理解 SHS 暴露与升高的 CHD 风险之间的关联。