Department of Internal Medicine, Nagayama Clinic.
Center of Diabetes, Endocrinology and Metabolism, Toho University, Sakura Medical Center.
J Atheroscler Thromb. 2023 Dec 1;30(12):1870-1881. doi: 10.5551/jat.64221. Epub 2023 May 18.
To elucidate the mechanism by which cigarette smoking causes vascular damage, we examined the relationship between cumulative cigarette consumption and abdominal obesity, and the possible mediating effect of smoking on arterial stiffness.
Cross-sectional data from 19499 never smokers and 5406 current smokers receiving health screening was analyzed. Abdominal obesity was assessed by ABSI, and arterial stiffness by CAVI. High CAVI was defined as CAVI ≥ 9.0.
Current smoker showed higher ABSI than never smokers after propensity score matching. Cumulative cigarette consumption expressed in pack-years correlated with ABSI (R: 0.312 in men, 0.252 in women), and was also extracted as an independent factor associated with ABSI by multiple regression analysis. A linear relationship between pack-year and CAVI was observed (R: 0.544 in men, 0.423 in women). Pack-year had almost equal discriminatory power in predicting high CAVI in both sexes (C-statistic: 0.774 in men, 0.747 in women), and the best cut-offs of pack-year for high CAVI were 24.5 in men and 14.7 in women. Bivariate logistic regression models revealed that the association between pack-year higher than cut-off and high CAVI was independent of traditional risks. A mediating effect of ABSI (mediation rate: 9.9% in men and 11.2% in women), but not waist circumference (WC), on the association of pack-year with CAVI was observed, after adjusting for traditional risks.
Cumulative cigarette smoking in pack-years was independently associated with ABSI. ABSI partially mediates the association between pack-year and CAVI, suggesting that abdominal obesity partially mediates smoking-related vascular dysfunction.
为了阐明吸烟导致血管损伤的机制，我们研究了累积吸烟量与腹型肥胖之间的关系，以及吸烟对动脉僵硬的可能中介作用。
分析了 19499 名从未吸烟者和 5406 名接受健康筛查的当前吸烟者的横断面数据。使用 ABSI 评估腹型肥胖，使用 CAVI 评估动脉僵硬。高 CAVI 定义为 CAVI≥9.0。
经过倾向评分匹配后，当前吸烟者的 ABSI 高于从不吸烟者。以包年表示的累积吸烟量与 ABSI 相关（男性 R：0.312，女性 R：0.252），并且通过多元回归分析也被提取为与 ABSI 相关的独立因素。包年与 CAVI 之间存在线性关系（男性 R：0.544，女性 R：0.423）。包年在预测两性高 CAVI 方面具有几乎相同的判别能力（男性 C 统计量：0.774，女性 C 统计量：0.747），高 CAVI 的最佳包年截断值为男性 24.5 包年和女性 14.7 包年。双变量逻辑回归模型显示，高于截断值的包年与高 CAVI 之间的关联独立于传统风险。在调整了传统风险因素后，观察到 ABSI（男性中介率：9.9%，女性中介率：11.2%）而不是腰围（WC）对包年与 CAVI 之间关联的中介作用。
以包年计的累积吸烟量与 ABSI 独立相关。ABSI 部分介导了包年与 CAVI 之间的关联，提示腹型肥胖部分介导了吸烟相关的血管功能障碍。
