Kim Eun Ha, Lee Hyejin, Shin Dong Wook, Yun Jae Moon, Shin Jung-Hyun, Lim Yoo Kyoung, Koo Hye Yeon, Jang Miso
Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.
Korean J Fam Med. 2017 May;38(3):122-129. doi: 10.4082/kjfm.2017.38.3.122. Epub 2017 May 23.
Cigarette smoking is a risk factor for cardiovascular disease (CVD) and has both beneficial and harmful effects in CVD. We hypothesized that weight gain following smoking cessation does not attenuate the CVD mortality of smoking cessation in the general Korean population.
Study subjects comprised 2.2% randomly selected patients from the Korean National Health Insurance Corporation, between 2002 and 2013. We identified 61,055 subjects who were classified as current smokers in 2003-2004. After excluding 21,956 subjects for missing data, we studied 30,004 subjects. We divided the 9,095 ex-smokers into two groups: those who gained over 2 kg (2,714), and those who did not gain over 2 kg (6,381, including weight loss), after smoking cessation. Cox proportional hazards regression models were used to estimate the association between weight gain following smoking cessation and CVD mortality.
In the primary analysis, the hazard ratios of all-cause deaths and CVD deaths were assessed in the three groups. The CVD risk factors and Charlson comorbidity index adjusted hazard ratios (aHRs) for CVD deaths were 0.80 (95% confidence interval [CI], 0.37 to 1.75) for ex-smokers with weight gain and 0.80 (95% CI, 0.50 to 1.27) for ex-smokers with no weight gain, compared to one for sustained smokers. The associations were stronger for events other than mortality. The aHRs for CVD events were 0.69 (95% CI, 0.54 to 0.88) and 0.81 (95% CI, 0.70 to 0.94) for the ex-smokers with and without weight gain, respectively.
Although smoking cessation leads to weight gain, it does not increase the risk of CVD death.
吸烟是心血管疾病（CVD）的一个危险因素，并且在心血管疾病中既有有益影响也有有害影响。我们假设在韩国普通人群中，戒烟后体重增加并不会削弱戒烟对心血管疾病死亡率的影响。
研究对象包括2002年至2013年间从韩国国民健康保险公社随机抽取的2.2%的患者。我们确定了在2003年至2004年被归类为当前吸烟者的61055名受试者。在排除21956名因数据缺失的受试者后，我们对30004名受试者进行了研究。我们将9095名戒烟者分为两组：戒烟后体重增加超过2千克的（2714名）和体重增加未超过2千克的（6381名，包括体重减轻者）。采用Cox比例风险回归模型来估计戒烟后体重增加与心血管疾病死亡率之间的关联。
在初步分析中，对三组的全因死亡和心血管疾病死亡的风险比进行了评估。与持续吸烟者相比，体重增加的戒烟者心血管疾病死亡的心血管疾病风险因素和Charlson合并症指数调整风险比（aHRs）为0.80（95%置信区间[CI]，0.37至1.75），体重未增加的戒烟者为0.80（95%CI，0.50至1.27）。对于非死亡事件，这种关联更强。体重增加和未增加的戒烟者心血管疾病事件的aHRs分别为0.69（95%CI，0.54至0.88）和0.81（95%CI，0.70至0.94）。
虽然戒烟会导致体重增加，但它不会增加心血管疾病死亡风险。
