Razay G, Heaton K W
University Department of Medicine, Bristol Royal Infirmary, UK.
QJM. 1995 Jul;88(7):503-8.
The incidence of coronary heart disease is increasing in women. Some of this may be related to increased smoking in women over the past decades. However, the mechanism mediating the smoking-coronary heart disease link is unclear. We therefore assessed the relationship of smoking habits to fasting plasma insulin, total and low-density lipoprotein (LDL) cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, including its subfractions HDL2 and HDL3, body mass index, and waist:hip circumference ratio in 1048 women aged 25-69 years. Compared with non-smokers, current smokers had higher plasma concentrations of LDL cholesterol by 0.2 mmol/l or 6%, total/HDL cholesterol ratio by 0.5 or 13%, triglyceride by 0.14 mmol/l or 13% and waist:hip ratio by 0.02 or 3%, but lower HDL cholesterol by 0.13 mmol/l or 9% and HDL2 cholesterol by 0.07 mmol/l or 13%, while ex-smokers had higher waist hip ratio by 0.01 or 1% but lower HDL cholesterol by 0.06 mmol/l or 4% and HDL2 cholesterol by 0.09 mmol/l or 16%. Ex-smokers for up to 5 years, compared with non-smokers, had higher plasma concentrations of total/HDL cholesterol ratio by 0.4 mmol/l or 11%, triglyceride by 0.22 mmol/l or 21% and waist hip ratio by 0.01 or 1%, but lower levels of HDL cholesterol by 0.12 mmol/l or 9% and HDL2 cholesterol by 0.14 mmol/l or 26%. Cigarette smoking is associated with adverse changes in lipoprotein levels; these changes decrease slowly after quitting.
冠心病在女性中的发病率正在上升。其中部分原因可能与过去几十年女性吸烟率上升有关。然而,介导吸烟与冠心病之间联系的机制尚不清楚。因此,我们评估了1048名年龄在25至69岁之间的女性的吸烟习惯与空腹血浆胰岛素、总胆固醇和低密度脂蛋白(LDL)胆固醇、甘油三酯、高密度脂蛋白(HDL)胆固醇(包括其亚组分HDL2和HDL3)、体重指数以及腰臀围比之间的关系。与不吸烟者相比,当前吸烟者的LDL胆固醇血浆浓度高0.2 mmol/l或6%,总胆固醇/HDL胆固醇比值高0.5或13%,甘油三酯高0.14 mmol/l或13%,腰臀比高0.02或3%,但HDL胆固醇低0.13 mmol/l或9%,HDL2胆固醇低0.07 mmol/l或13%,而曾经吸烟者的腰臀比高0.01或1%,但HDL胆固醇低0.06 mmol/l或4%,HDL2胆固醇低0.09 mmol/l或16%。与不吸烟者相比,戒烟达5年的曾经吸烟者的总胆固醇/HDL胆固醇比值血浆浓度高0.4 mmol/l或11%,甘油三酯高0.22 mmol/l或21%,腰臀比高0.01或1%,但HDL胆固醇水平低0.12 mmol/l或9%,HDL2胆固醇低0.14 mmol/l或26%。吸烟与脂蛋白水平的不良变化有关;戒烟后这些变化会缓慢下降。