Department of Preventive and Social Medicine, Medical University of Łódź, Łódź, Poland.
Menopause. 2012 Feb;19(2):194-201. doi: 10.1097/gme.0b013e3182273035.
Data on the relationship between tobacco use and metabolic risk among women with regard to their menopause status are scarce. This study assessed the prevalence of metabolic disorders in relation to smoking status in premenopausal and postmenopausal women.
A cross-sectional analysis of 7,462 randomly selected women aged 20 to 74 years who are participating in the WOBASZ (Polish National Multicentre Health Survey) was carried out. Lifestyle and menopause status details were collected via an interviewer-administered questionnaire. Weight, height, waist circumference, blood pressure, fasting plasma glucose, triglycerides, and high-density lipoprotein cholesterol (HDL-C) levels were measured by standard methods. Metabolic syndrome (MetS) was defined according to the International Diabetes Federation criteria.
The prevalence of MetS was 3.3-fold higher among postmenopausal than premenopausal women. Regardless of menopause status, the prevalence of central obesity was significantly higher among never and past smokers versus current smokers (P < 0.001). Past smoking was associated with a significantly higher probability of elevated blood pressure, fasting plasma glucose, and MetS (P < 0.05). However, premenopausal never and past smokers had a substantially lower prevalence of decreased HDL-C than did current smokers. Among postmenopausal nonsmoking women, high levels of leisure time and commuting physical activity were associated with a reduced likelihood of MetS (P < 0.01). Making an additional adjustment for calorie consumption did not substantially influence the results.
Except for HDL-C level, not smoking is associated with an unfavorable metabolic profile in women, regardless of menopause status. High level of physical activity may reduce the prevalence of MetS among never and past smokers after the menopausal transition.
关于女性绝经状态与吸烟与代谢风险之间的关系，相关数据较为缺乏。本研究评估了绝经前和绝经后女性中吸烟状况与代谢紊乱之间的相关性。
对参与 WOBASZ（波兰国家多中心健康调查）的 7462 名年龄在 20 至 74 岁之间的随机挑选的女性进行了横断面分析。通过访谈者管理的问卷收集了生活方式和绝经状态的详细信息。通过标准方法测量了体重、身高、腰围、血压、空腹血糖、甘油三酯和高密度脂蛋白胆固醇（HDL-C）水平。代谢综合征（MetS）根据国际糖尿病联合会的标准定义。
绝经后女性的 MetS 患病率比绝经前女性高 3.3 倍。无论绝经状态如何，从不吸烟和既往吸烟者的中心性肥胖患病率明显高于当前吸烟者（P < 0.001）。既往吸烟与血压升高、空腹血糖升高和 MetS 的发生概率显著增加相关（P < 0.05）。然而，绝经前从不吸烟和既往吸烟者的 HDL-C 水平降低的患病率明显低于当前吸烟者。在绝经后不吸烟的女性中，休闲时间和通勤身体活动水平较高与 MetS 的发生概率降低相关（P < 0.01）。对卡路里摄入量进行额外调整并未对结果产生重大影响。
除了 HDL-C 水平外，无论绝经状态如何，不吸烟与女性不良的代谢特征相关。高水平的身体活动可能会降低绝经后从不吸烟和既往吸烟者的 MetS 患病率。
