Jo Jaeseong, Kimm Heejin, Yun Ji Eun, Lee Kyu Jang, Jee Sun Ha
Institute for Health Promotion, Department of Epidemiology and Health Promotion, Yonsei University Graduate School of Public Health, Seoul, Korea.
J Prev Med Public Health. 2012 Mar;45(2):105-12. doi: 10.3961/jpmph.2012.45.2.105. Epub 2012 Mar 31.
Cigarette smoking is a modifiable risk factor for cardiovascular disease. Bilirubin is a potent antioxidant and its concentration decreases in smokers. However, studies about the association between cigarette smoking and bilirubin are scarce and most are limited to total bilirubin. Additionally, bilirubin is highly related to hemoglobin. Therefore, this study evaluates the association between bilirubin subtypes and cigarette smoking in healthy Korean men independently of hemoglobin.
This study included 48 040 Korean men aged 30 to 87 years who visited the Korea Medical Institute for routine health examinations from January to December, 2007. The association of smoking with total, direct, and indirect bilirubin was assessed by logistic regression analysis taking into consideration differences in subjects and smoking characteristics.
Current smokers had lower bilirubin concentrations than never-smokers and ex-smokers. Smoking amount and duration were inversely significantly associated with total, direct, and indirect bilirubin. In a multivariable adjusted model, compared to never-smokers, the odds ratios (ORs) and 95% confidence intervals (CIs) of current smokers with the highest number of pack-years were 1.7 (1.6 to 1.9) for total, 1.5 (1.4 to 1.6) for direct, and 1.7 (1.6 to 1.9) for indirect bilirubin. After further adjustment for hemoglobin, this association became stronger (OR [95% CI], 2.1 [1.9 to 2.2] for total; 1.9 [1.8 to 2.0] for direct; 2.0 [1.9 to 2.2] for indirect bilirubin).
In this study, bilirubin subtypes are inversely associated with smoking status, smoking amount, and smoking duration in healthy Korean men independently of hemoglobin. Further studies are needed to investigate this association in healthy Korean women.
吸烟是心血管疾病的一个可改变的风险因素。胆红素是一种强效抗氧化剂，吸烟者体内其浓度会降低。然而，关于吸烟与胆红素之间关联的研究较少，且大多数仅限于总胆红素。此外，胆红素与血红蛋白高度相关。因此，本研究独立于血红蛋白评估健康韩国男性中胆红素亚型与吸烟之间的关联。
本研究纳入了2007年1月至12月到韩国医学研究所进行常规健康检查的48040名30至87岁的韩国男性。考虑到受试者和吸烟特征的差异，通过逻辑回归分析评估吸烟与总胆红素、直接胆红素和间接胆红素之间的关联。
当前吸烟者的胆红素浓度低于从不吸烟者和既往吸烟者。吸烟量和吸烟时长与总胆红素、直接胆红素和间接胆红素均呈显著负相关。在多变量调整模型中，与从不吸烟者相比，吸烟包年数最多的当前吸烟者的总胆红素、直接胆红素和间接胆红素的比值比（OR）及95%置信区间（CI）分别为1.7（1.6至1.9）、1.5（1.4至1.6）和1.7（1.6至1.9）。在进一步调整血红蛋白后，这种关联变得更强（总胆红素的OR[95%CI]为2.1[1.9至2.2]；直接胆红素为1.9[1.8至2.0]；间接胆红素为2.0[1.9至2.2]）。
在本研究中，健康韩国男性的胆红素亚型与吸烟状态、吸烟量和吸烟时长呈负相关，且独立于血红蛋白。需要进一步研究以调查健康韩国女性中的这种关联。
