Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine.
Osaka Center for Cancer and Cardiovascular Disease Prevention.
J Atheroscler Thromb. 2018 Sep 1;25(9):836-845. doi: 10.5551/jat.42150. Epub 2018 Feb 8.
Smoking impairs endothelial function as an acute effect. However, few population-based studies have examined the association between smoking status and endothelial function or the dose-response and duration-response association of smoking with endothelial function. We examined whether smoking habits were associated with impaired endothelial function depending on smoking dose and duration.
We conducted a cross-sectional study of 910 men and women aged 30-79 years from 2013 to 2016. Statistical analyses of the data were conducted between 2016 and 2017. Endothelial function was assessed by brachial artery flow-mediated dilation (FMD) measurement. Low FMD was defined in two ways as the cutoff point based on the lowest quartile of %FMD (＜5.1%) and median of %FMD (＜6.8%), regarding as impaired endothelial function. We investigated the smoking status in terms of cigarettes consumed per day and the duration of smoking.
Heavy and chronic smokers were associated with a high prevalence of impaired endothelial function. Those associations did not change substantially after adjustment for other cardiovascular risk factors. Among all participants, the multivariable-adjusted ORs (95% CIs) of low FMD (＜5.1%) with reference to never smokers were 2.23 (1.00-5.14) for current heavy smokers of ≥ 30 cigarettes per day, 1.83 (1.04-3.20) for heavy smokers of ≥ 40 pack-years, and 2.16 (1.15-4.06) for chronic smokers of ≥ 40 years. For low FMD (＜6.8%) those values was 2.17 (1.01-5.05), 1.70 (1.01-2.86), and 1.98 (1.07-3.69), respectively.
Similar associations were observed among only men. Heavy or long-term tobacco smoking may induce impaired endothelial function.
吸烟会对内皮功能造成急性损害。然而，很少有基于人群的研究调查吸烟状况与内皮功能之间的关系，以及吸烟与内皮功能之间的剂量-反应和时间-反应关系。我们研究了吸烟习惯是否与内皮功能受损有关，具体取决于吸烟量和吸烟时间。
我们于 2013 年至 2016 年期间对 910 名年龄在 30-79 岁的男性和女性进行了横断面研究。数据的统计分析于 2016 年至 2017 年进行。通过肱动脉血流介导的扩张（FMD）测量评估内皮功能。低 FMD 通过两种方式定义：基于%FMD 的最低四分位数（＜5.1%）和%FMD 的中位数（＜6.8%）的截断点，即内皮功能受损。我们根据每天吸烟量和吸烟时间来研究吸烟状况。
重度和慢性吸烟者内皮功能受损的患病率较高。这些关联在调整其他心血管危险因素后并没有实质性改变。在所有参与者中，与从不吸烟者相比，当前每天吸烟≥30 支的重度吸烟者、吸烟≥40 包年的重度吸烟者和吸烟≥40 年的慢性吸烟者发生低 FMD（＜5.1%）的多变量调整比值比（95%置信区间）分别为 2.23（1.00-5.14）、1.83（1.04-3.20）和 2.16（1.15-4.06）。对于低 FMD（＜6.8%），这些值分别为 2.17（1.01-5.05）、1.70（1.01-2.86）和 1.98（1.07-3.69）。
仅在男性中观察到相似的关联。重度或长期吸烟可能会导致内皮功能受损。
