University of Wisconsin School of Medicine and Public Health, Madison, 53792, USA.
Am Heart J. 2010 Sep;160(3):458-63. doi: 10.1016/j.ahj.2010.06.006.
Cigarette smoking has been associated with increases in C-reactive protein (CRP) and leukocyte counts (white blood cell [WBC]); however, the effects of smoking intensity and smoking cessation on inflammatory markers have not been evaluated prospectively in a large, modern cohort of current smokers.
White blood cell count and high-sensitivity CRP were measured in current smokers enrolled in a randomized, prospective clinical trial of 5 smoking cessation pharmacotherapies. Smoking intensity parameters included cigarettes per day, pack-years, Fagerström Test of Nicotine Dependence score, and carbon monoxide levels. C-reactive protein also was measured after 1 year with assessment of abstinence status.
The 1,504 current smokers (58% female) were (mean [SD]) 44.7 (11.1) years old, smoked 21.4 (8.9) cigarettes per day, and had a smoking burden of 29.4 (20.4) pack-years. Log(CRP) was not associated with any marker of smoking intensity, except for a weak correlation with pack-years (r = 0.05, P = .047). In contrast, statistically significant correlations were observed between all 4 markers of smoking intensity and WBC count (all P ≤ .011). In multivariable models, waist circumference (P < .001) and triglycerides (P < .05), but no markers of smoking intensity, were associated with log(CRP). However, pack-years (P = .002), cigarettes per day (P = .013), carbon monoxide (P < .001), and Fagerström Test of Nicotine Dependence (P < .001) were independently associated with WBC count. After 1 year, log(CRP) (P = .296) and changes in log(CRP) (P = .455) did not differ between abstainers and continuing smokers.
Smoking intensity is associated with increased WBC count, but not CRP levels. Smoking cessation does not reduce CRP. The relationship between CRP and smoking intensity may be masked by CRP's stronger relationship with adiposity.
吸烟与 C 反应蛋白（CRP）和白细胞计数（白细胞[WBC]）的增加有关；然而，吸烟强度和戒烟对炎症标志物的影响尚未在当前吸烟者的大型现代队列中进行前瞻性评估。
在一项针对 5 种戒烟药物治疗的随机、前瞻性临床试验中，对当前吸烟者进行了白细胞计数和高敏 CRP 测量。吸烟强度参数包括每天吸烟量、吸烟包年数、尼古丁依赖 Fagerström 测试评分和一氧化碳水平。在 1 年后还测量了 CRP，并评估了戒烟状态。
1504 名当前吸烟者（58%为女性）年龄（平均值[标准差]）为 44.7（11.1）岁，每天吸烟 21.4（8.9）支，吸烟负担为 29.4（20.4）包年。CRP 的对数与吸烟强度的任何标志物均无相关性，除了与吸烟包年数的弱相关性（r = 0.05，P =.047）。相比之下，所有 4 种吸烟强度标志物与白细胞计数之间均存在统计学显著相关性（所有 P ≤.011）。在多变量模型中，腰围（P <.001）和甘油三酯（P <.05），而不是吸烟强度标志物，与 CRP 的对数相关。然而，吸烟包年数（P =.002）、每天吸烟量（P =.013）、一氧化碳（P <.001）和尼古丁依赖 Fagerström 测试（P <.001）与白细胞计数独立相关。在 1 年后，戒烟者和继续吸烟者的 CRP 对数（P =.296）和 CRP 对数变化（P =.455）之间没有差异。
吸烟强度与白细胞计数增加有关，但与 CRP 水平无关。戒烟不会降低 CRP。CRP 与吸烟强度之间的关系可能被 CRP 与肥胖的更强关系所掩盖。
