Chatkin Raquel, Chatkin José Miguel, Spanemberg Lucas, Casagrande Daniela, Wagner Mario, Mottin Cláudio
Center of Obesity and Metabolic Syndrome, Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil; Post-Graduation Program in Medicine and Health Science, School of Medicine Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
Post-Graduation Program in Medicine and Health Science, School of Medicine Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil.
PLoS One. 2015 May 15;10(5):e0126146. doi: 10.1371/journal.pone.0126146. eCollection 2015.
While the association between cigarette smoking and abdominal fat has been well studied in normal and overweight patients, data regarding the influence of tobacco use in patients with morbid obesity remain scarce. The aim of this study is to evaluate body fat distribution in morbidly obese smokers.
We employed a cross-sectional study and grouped severely obese patients (body mass index [BMI] >40 kg/m2 or >35 kg/m2 with comorbidities) according to their smoking habits (smokers or non-smokers). We next compared the anthropometrical measurements and body composition data (measured by electric bioimpedance) of both groups. We analyzed the effect of smoking on body composition variables using univariate and multiple linear regression (MLR); differences are presented as regression coefficients (b) and their respective 95% confidence intervals.
We included 536 morbidly obese individuals, 453 (84.5%) non-smokers and 83 (15.5%) smokers. Male smokers had a higher BMI (b=3.28 kg/m2, p=0.036), larger waist circumference (b=6.07 cm, p=0.041) and higher percentage of body fat (b=2.33%, p=0.050) than non-smokers. These differences remained significant even after controlling for confounding factors. For females, the only significant finding in MLR was a greater muscle mass among smokers (b=1.34kg, p=0.028). No associations were found between tobacco load measured in pack-years and anthropometric measures or body composition.
Positive associations between smoking and BMI, and waist circumference and percentage of body fat, were found among male morbidly obese patients, but not among females. To the best of our knowledge, this study is the first investigation of these aspects in morbidly obese subjects. We speculate that our findings may indicate that the coexistence of morbid obesity and smoking helps to explain the more serious medical conditions, particularly cardiovascular diseases and neoplasms, seen in these patients.
虽然吸烟与腹部脂肪之间的关联在正常和超重患者中已得到充分研究，但关于吸烟对病态肥胖患者影响的数据仍然稀少。本研究的目的是评估病态肥胖吸烟者的体脂分布情况。
我们采用横断面研究，根据严重肥胖患者（体重指数[BMI]>40kg/m²或>35kg/m²且伴有合并症）的吸烟习惯（吸烟者或非吸烟者）进行分组。接下来，我们比较了两组的人体测量数据和身体成分数据（通过生物电阻抗测量）。我们使用单变量和多元线性回归（MLR）分析吸烟对身体成分变量的影响；差异以回归系数（b）及其各自的95%置信区间表示。
我们纳入了536名病态肥胖个体，453名（84.5%）非吸烟者和83名（15.5%）吸烟者。男性吸烟者的BMI（b=3.28kg/m²，p=0.036）、腰围（b=6.07cm，p=0.041）和体脂百分比（b=2.33%，p=0.050）均高于非吸烟者。即使在控制混杂因素后，这些差异仍然显著。对于女性，MLR中唯一显著的发现是吸烟者的肌肉量更大（b=1.34kg，p=0.028）。在以包年计算的吸烟量与人体测量指标或身体成分之间未发现关联。
在病态肥胖男性患者中发现吸烟与BMI、腰围和体脂百分比之间存在正相关，但在女性中未发现。据我们所知，本研究是对病态肥胖受试者这些方面的首次调查。我们推测，我们的发现可能表明病态肥胖与吸烟并存有助于解释这些患者中出现的更严重的疾病，特别是心血管疾病和肿瘤。
