总血清胆红素水平作为抗动脉粥样硬化机制的介质，并考虑吸烟状况。

Total serum bilirubin levels as mediators of anti-atherosclerosis mechanisms with consideration of smoking status.

作者信息

Tani Shigemasa, Imatake Kazuhiro, Suzuki Yasuyuki, Yagi Tsukasa, Takahashi Atsuhiko

机构信息

Department of Health Planning Center, Nihon University Hospital, Tokyo, Japan.

Department of Cardiology, Nihon University Hospital, Tokyo, Japan.

出版信息

Tob Induc Dis. 2024 Nov 30;22. doi: 10.18332/tid/195378. eCollection 2024.

DOI:10.18332/tid/195378

PMID:39619739

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11607641/

Abstract

INTRODUCTION

Cigarette smoking is a significant risk factor for atherosclerotic cardiovascular diseases (ASCVDs). Mildly elevated total serum bilirubin (TSB) levels can exert anti-atherosclerotic effects and may regulate inflammation. We explore the relationship between TSB levels, smoking, and inflammation.

METHODS

This cross-sectional study evaluated health screening participants with no history of ASCVD between 1 April 2019 and 31 March 2020. TSB was compared between non-smokers and smokers using the Kruskal-Wallis test, and the influencing factors of TSB levels were identified using multivariable logistic regression with TSB levels above the 75th percentile set as the dependent variable. Mediation analysis was performed to determine whether TSB levels mediated the association between smoking and inflammation.

RESULTS

A total of 8337 participants (mean age: 46.6 ± 13.0 years; 58.9% men) were included. TSB levels were significantly lower in smokers (n=1353) than in non-smokers (n=6984) [median (IQR): 0.72 (0.56-0.92) vs 0.76 (0.60-0.97) mg/dL, p<0.0001]. Multivariable logistic regression analysis demonstrated that smoking was an independent determinant of lower TSB levels (adjusted odds ratio, AOR=0.81; 95% CI: 0.70-0.93, p=0.003). Leukocyte counts and C-reactive protein levels significantly decreased as TSB levels increased (p<0.0001). Moreover, the relationship between the duration of smoking cessation and TSB levels showed a positive correlation. Mediation analysis indicated that cigarette smoking had significant indirect effects on higher leukocyte counts and higher CRP levels (coefficient=0.014; 95% CI: 0.008-0.021; and coefficient=0.002; 95% CI: 0.001-0.003, respectively].

CONCLUSIONS

Lower TSB levels related to a smoking habit may be associated with higher inflammation, thereby increasing the ASCVD risk. TSB may regulate inflammation and exert antioxidant effects. Furthermore, smoking cessation may lead to higher TSB levels and lower inflammation.

摘要

引言

吸烟是动脉粥样硬化性心血管疾病（ASCVD）的一个重要危险因素。血清总胆红素（TSB）水平轻度升高可发挥抗动脉粥样硬化作用，并可能调节炎症。我们探讨TSB水平、吸烟与炎症之间的关系。

方法

这项横断面研究评估了2019年4月1日至2020年3月31日期间无ASCVD病史的健康筛查参与者。使用Kruskal-Wallis检验比较非吸烟者和吸烟者的TSB水平，并以TSB水平高于第75百分位数为因变量，采用多变量逻辑回归确定TSB水平的影响因素。进行中介分析以确定TSB水平是否介导吸烟与炎症之间的关联。

结果

共纳入8337名参与者（平均年龄：46.6±13.0岁；58.9%为男性）。吸烟者（n=1353）的TSB水平显著低于非吸烟者（n=6984）[中位数（IQR）：0.72（0.56-0.92） vs 0.76（0.60-0.97）mg/dL，p<0.0001]。多变量逻辑回归分析表明，吸烟是TSB水平降低的独立决定因素（调整后的优势比，AOR=0.81；95%CI：0.70-0.93，p=0.003）。随着TSB水平升高，白细胞计数和C反应蛋白水平显著降低（p<0.0001）。此外，戒烟持续时间与TSB水平之间的关系呈正相关。中介分析表明，吸烟对较高的白细胞计数和较高的CRP水平有显著的间接影响（系数分别为0.014；95%CI：0.008-0.021；以及系数为0.002；95%CI：0.001-0.003）。