University of Helsinki, Department of Public Health, Helsinki, Finland.
J Womens Health (Larchmt). 2011 Jul;20(7):1051-64. doi: 10.1089/jwh.2010.2075. Epub 2011 Jun 15.
Several cardiovascular disease (CVD) biomarkers sensitive to tobacco exposure have been identified, but how tobacco use cessation impacts them is less clear. We sought to investigate the effects of a smoking cessation program with an exercise intervention on CVD biomarkers in sedentary women.
This is a cohort study on a subsample of a 2×2 factorial randomized controlled trial (RCT) (exercise setting: home vs. facility; level of exercise counseling: prescription only vs. prescription and adherence counseling) conducted January 2004 through December 2007. The analyses were completed in October 2010. In the greater Boston area, 130 sedentary female smokers aged 19-55 completed a 15-week program. All participants received nicotine replacement therapy (transdermal patch) and brief behavioral counseling for 12 weeks. They all received an exercise prescription on a moderate intensity level. All exercise interventions lasted for 15 weeks, from 3 weeks precessation until 12 weeks postcessation. Main outcome measures were selected CVD biomarkers hypothesized to be affected by smoking cessation or exercise measured at baseline and 12 weeks postcessation.
Independent of tobacco abstinence, improvement was seen in inflammation (white blood cells [WBC]), prothrombotic factor (red blood cells [RBC]), and cardiovascular fitness level (maximum oxygen consumption [Vo(2)max]). This suggests that even if complete abstinence is not achieved, reduction in tobacco exposure and increase in exercise can improve the cardiovascular risk profile. A significant decrease was seen for total cholesterol and the total cholesterol high-density lipoprotein cholesterol (HDL-C): ratio only among the abstainers. The heart rate was reduced among all participants, but this decrease was more profound among abstainers. A significant weight gain and body mass index (BMI) increase were observed among abstainers and those who relapsed. We also found an increase in hemoglobin A1c (Hb A1c), although significant only when the groups were combined.
A smoking cessation intervention including exercise reduced tobacco-induced cardiovascular damage selectively within 3 months.
已经发现了几种对烟草暴露敏感的心血管疾病(CVD)生物标志物,但戒烟对它们的影响尚不清楚。我们旨在研究一种包含运动干预的戒烟计划对久坐女性 CVD 生物标志物的影响。
这是一项针对 2×2 析因随机对照试验(RCT)的子样本的队列研究(运动环境:家庭与设施;运动咨询水平:仅处方与处方和依从性咨询),于 2004 年 1 月至 2007 年 12 月进行。分析于 2010 年 10 月完成。在大波士顿地区,130 名久坐的年轻女性吸烟者年龄在 19-55 岁之间,完成了为期 15 周的计划。所有参与者均接受尼古丁替代疗法(透皮贴剂)和为期 12 周的简短行为咨询。他们都接受了中等强度水平的运动处方。所有运动干预持续 15 周,从戒烟前 3 周持续到戒烟后 12 周。主要观察指标为假设因戒烟或运动而受影响的选定 CVD 生物标志物,在基线和戒烟后 12 周进行测量。
无论是否完全戒烟,炎症(白细胞[WBC])、促血栓形成因子(红细胞[RBC])和心血管健康水平(最大摄氧量[Vo(2)max])均有改善。这表明,即使无法完全戒烟,减少烟草暴露和增加运动也可以改善心血管风险状况。仅在戒烟者中,总胆固醇和总胆固醇高密度脂蛋白胆固醇(HDL-C):比值显著降低。所有参与者的心率均降低,但戒烟者的心率降低更为明显。戒烟者和复吸者的体重和体重指数(BMI)显著增加。我们还发现血红蛋白 A1c(Hb A1c)增加,尽管在将两组结合时才具有统计学意义。
包含运动的戒烟干预措施可在 3 个月内减少吸烟引起的心血管损害。