Kato Toru, Umeda Akira, Miyagawa Kazuya, Takeda Hiroshi, Adachi Taichi, Toyoda Shigeru, Taguchi Isao, Inoue Teruo, Node Koichi
1] Department of Clinical Research, National Hospital Organization Tochigi Medical Center, Tochigi, Japan [2] Department of Cardiovascular Medicine, Dokkyo Medical University, Tochigi, Japan.
Department of Respiratory Medicine, International University of Health and Welfare Shioya Hospital, Tochigi, Japan.
Hypertens Res. 2014 Jul;37(7):655-8. doi: 10.1038/hr.2014.52. Epub 2014 Mar 20.
Smoking cessation decreases oxidative stress and restores vascular endothelial function. However, a recent meta-analysis suggests that the use of varenicline, a α4β2 nicotinic acetylcholine receptor partial agonist, increases the risk of cardiovascular events. This study was designed to determine the effect of varenicline-assisted smoking cessation on vascular endothelial function. Study subjects were 11 healthy Japanese males (mean age, 54.4 years) without evidence of cardiovascular disease who were eager to quit smoking. Each subject was treated with varenicline titrated up to 1.0 mg twice daily. We evaluated serum derivatives of reactive oxygen metabolites (d-ROMs) as a marker of oxidative stress, and flow-mediated dilation (FMD) of the brachial artery as a marker of vascular endothelial function. Both measurements were performed before and 3 months after completing smoking cessation. All subjects gained weight (average, 1.7 kg) after smoking cessation. However, there were no significant differences in the following parameters before and after smoking cessation: systolic blood pressure, diastolic blood pressure, heart rate, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, glucose and hemoglobin A1c. Serum d-ROM levels significantly decreased from 340.7±70.4 to 300.0±43.2 U.CARR (P=0.012), and FMD significantly increased from 3.36±1.26 to 5.25±1.33% (P=0.00067) after smoking cessation. There was an inverse correlation between FMD and serum d-ROM levels (R=-0.377; P=0.043). Our observations suggest that varenicline-assisted smoking cessation restores vascular endothelial function, and this is associated with decreased oxidative stress, despite an increase in body weight. As varenicline-assisted smoking cessation possibly has beneficial effects on vascular endothelial function, it might also reduce cardiovascular risk.
戒烟可降低氧化应激并恢复血管内皮功能。然而，最近的一项荟萃分析表明，使用伐尼克兰（一种α4β2烟碱型乙酰胆碱受体部分激动剂）会增加心血管事件的风险。本研究旨在确定伐尼克兰辅助戒烟对血管内皮功能的影响。研究对象为11名无心血管疾病证据且渴望戒烟的健康日本男性（平均年龄54.4岁）。每位受试者接受伐尼克兰治疗，剂量逐渐增加至每日两次，每次1.0毫克。我们评估了血清活性氧代谢产物衍生物（d-ROMs）作为氧化应激的标志物，以及肱动脉血流介导的舒张功能（FMD）作为血管内皮功能的标志物。这两项测量均在戒烟前和戒烟完成后3个月进行。所有受试者戒烟后体重均增加（平均增加1.7千克）。然而，戒烟前后以下参数无显著差异：收缩压、舒张压、心率、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血糖和糖化血红蛋白A1c。戒烟后血清d-ROM水平从340.7±70.4显著降至300.0±43.2 U.CARR（P = 0.012），FMD从3.36±1.26显著增加至5.25±1.33%（P = 0.00067）。FMD与血清d-ROM水平呈负相关（R = -0.377；P = 0.043）。我们的观察结果表明，伐尼克兰辅助戒烟可恢复血管内皮功能，且这与氧化应激降低有关，尽管体重有所增加。由于伐尼克兰辅助戒烟可能对血管内皮功能有有益影响，它也可能降低心血管风险。
