吸烟、体重指数对血清脂质谱影响的四向分解。
Four-way decomposition of effect of cigarette smoking and body mass index on serum lipid profiles.
机构信息
Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Institute for Medical Dataology, Shandong University, Jinan, China.
出版信息
PLoS One. 2022 Aug 18;17(8):e0270486. doi: 10.1371/journal.pone.0270486. eCollection 2022.
OBJECTIVE
Smoking and obesity are established risk factors of dyslipidemia, however, the interplay between them has not been well studied. This study aims to explore the joint effect of smoking and body mass index (BMI) on serum lipid profiles.
METHODS
The study consisted of 9846 Chinese adults (mean age = 49.9 years, 47.6% males, 31.2% ever smokers), based on the China Health and Nutrition Survey. Serum lipid profiles included total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein A (APO-A), and apolipoprotein B (Apo-B). The joint effect of smoking and BMI on serum lipids were examined by the four-way decomposition analysis and multivariate linear regression models.
RESULTS
The four-way decomposition showed that the interplay between smoking and BMI was complicated. There was only indirect effect (the mediated effect) between smoking and BMI on TC, LDL-C and APO-B. The pure indirect effect was -0.023 for TC, -0.018 for LDL-C, and -0.009 for APO-B. For TG, HDL-C and APO-A, the interaction effect was dominant. The reference interaction (the interactive effect when the mediator is left to what it would be in the absence of exposure) was 0.474 (P < 0.001) for TG, -0.245 (P = 0.002) for HDL-C, and -0.222 (P < 0.001) for APO-A, respectively. The effect of BMI on TG, HDL-C and APO-A were significantly higher in smokers than in nonsmokers (TG: 0.151 in smokers versus 0.097 in nonsmokers, HDL-C: -0.037 versus -0.027, APO-A: -0.019 versus -0.009, P for difference < 0.001 for all).
CONCLUSION
These findings illustrate the joint effects of smoking and BMI on serum lipid profiles. There were significant interaction effects of smoking and BMI on TG, HDL-C and APO-A, while BMI maybe a mediator for the association of smoking with TC, LDL-C and APO-B. The effects between them were rather complex. Smoking cessation is necessary, especially for those overweight.
目的
吸烟和肥胖是血脂异常的既定危险因素，但它们之间的相互作用尚未得到很好的研究。本研究旨在探讨吸烟和体重指数（BMI）对血清脂质谱的联合影响。
方法
本研究基于中国健康与营养调查，纳入了 9846 名中国成年人（平均年龄=49.9 岁，47.6%为男性，31.2%为曾经吸烟者）。血清脂质谱包括总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、载脂蛋白 A（APO-A）和载脂蛋白 B（Apo-B）。采用四向分解分析和多元线性回归模型探讨吸烟和 BMI 对血清脂质的联合影响。
结果
四向分解显示，吸烟和 BMI 之间的相互作用很复杂。吸烟和 BMI 对 TC、LDL-C 和 APO-B 仅有间接影响（中介效应）。TC 的纯间接效应为-0.023，LDL-C 为-0.018，APO-B 为-0.009。对于 TG、HDL-C 和 APO-A，交互作用占主导地位。参考交互作用（当暴露于中介物时，中介物的交互作用）分别为 0.474（P<0.001）、-0.245（P=0.002）和-0.222（P<0.001）。与不吸烟者相比，吸烟者 BMI 对 TG、HDL-C 和 APO-A 的影响更大（TG：吸烟者为 0.151，不吸烟者为 0.097；HDL-C：-0.037 对-0.027；APO-A：-0.019 对-0.009，差异 P 值均<0.001）。
结论
这些发现说明了吸烟和 BMI 对血清脂质谱的联合影响。吸烟和 BMI 对 TG、HDL-C 和 APO-A 有显著的交互作用，而 BMI 可能是吸烟与 TC、LDL-C 和 APO-B 之间关联的中介物。它们之间的影响相当复杂。戒烟是必要的，尤其是对那些超重的人。
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