Hughes K, Choo M, Kuperan P, Ong C N, Aw T C
Department of Community, Occupational and Family Medicine, Faculty of Medicine, National University of Singapore, Singapore.
Atherosclerosis. 1998 Apr;137(2):253-8. doi: 10.1016/s0021-9150(97)00268-2.
To investigate how cigarette smoking increases the risk of cardiovascular disease, risk factors were compared between 166 cigarette smokers and 312 non-smokers, in a random sample of males (Chinese, Malays and Asian Indians) aged 30-69 years from the general population of Singapore. There was adjusted for age and ethnic group. The prevalence of hypertension was lower in cigarette smokers (15.2%) than non-smokers (21.9%), with the difference reduced by adjustment for body mass index (BMI). Smokers had: lower mean serum HDL-cholesterol (0.76 versus 0.81 mmol/l) and higher mean serum fasting triglyceride (1.92 versus 1.71 mmol/l), which will increase atherosclerosis; higher mean plasma fibrinogen (2.75 versus 2.67 g/l) and plasminogen activator inhibitor 1 [PAI-1] (24.9 versus 22.2 ng/ml), which will increase thrombosis; and lower mean plasma vitamin C (4.4 versus 6.4 mg/l) and serum selenium (118 versus 123 microg/l), which may increase atherosclerosis. Adjustment for BMI slightly increased the differences for HDL-cholesterol, fasting triglyceride, fibrinogen and PAI-1, indicating that less generalised obesity among smokers reduces their increased cardiovascular disease risk. Smoking was not found to be related to: diabetes mellitus; serum total cholesterol, LDL-cholesterol, apolipoproteins A1 and B and lipoprotein(a); plasma factor VIIc and prothrombin fragment 1 + 2; and plasma vitamins A and E and serum ferritin. There was no evidence of increased insulin resistance in smokers, as measured by mean fasting serum insulin.
为了研究吸烟如何增加心血管疾病风险，在一个从新加坡普通人群中随机抽取的30 - 69岁男性（华裔、马来裔和亚洲印度裔）样本中，对166名吸烟者和312名非吸烟者的风险因素进行了比较。研究对年龄和种族进行了校正。吸烟者的高血压患病率（15.2%）低于非吸烟者（21.9%），通过调整体重指数（BMI）后，差异有所减小。吸烟者有：较低的平均血清高密度脂蛋白胆固醇（0.76对0.81 mmol/l）和较高的平均血清空腹甘油三酯（1.92对1.71 mmol/l），这会增加动脉粥样硬化；较高的平均血浆纤维蛋白原（2.75对2.67 g/l）和纤溶酶原激活物抑制剂1 [PAI - 1]（24.9对22.2 ng/ml），这会增加血栓形成；以及较低的平均血浆维生素C（4.4对6.4 mg/l）和血清硒（118对123 μg/l），这可能会增加动脉粥样硬化。对BMI进行校正后，高密度脂蛋白胆固醇、空腹甘油三酯、纤维蛋白原和PAI - 1的差异略有增加，表明吸烟者中较少的全身性肥胖降低了他们增加的心血管疾病风险。未发现吸烟与以下因素有关：糖尿病；血清总胆固醇、低密度脂蛋白胆固醇、载脂蛋白A1和B以及脂蛋白(a)；血浆因子VIIc和凝血酶原片段1 + 2；以及血浆维生素A和E和血清铁蛋白。通过平均空腹血清胰岛素测量，没有证据表明吸烟者存在胰岛素抵抗增加的情况。
