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Smoking, C-reactive Protein, and the Metabolic Syndrome
Journal of the Korean Society for Research on Nicotine and Tobacco 2011; 2(2): 89-96
Published online July 15, 2011
© 2011 The Korean Society for Research on Nicotine and Tobacco.

Hyo-Jin Chon, Dong-Eun Lee, Hye-Rim Kwak, Yun-Jun Yang, Eon-Sook Lee, Jun-Hyung Lee, Yeong-Sook Yoon*

Department of Family Medicine, Ilsan Paik Hospital, College of Medicine, Inje University, Goyang, Korea
 Abstract
Background: Smoking is a major risk factor of cardiovascular disease including metabolic syndrome (MS). The low grade systemic inflammation might play a role in the relationship between smoking and MS. This study was performed to identify the role of systemic inflammation using high-sensitivity c-reactive protein (hs-CRP) affecting the association of smoking status, daily smoking amount, and pack-years with MS.
Methods: We analyzed 2184 men 20 years of age or older who participated in the health screening program of university hospital in Gyeonggi-do, Korea.
Results: Current smokers showed significant higher level of hs-CRP (0.120짹0.065mg/dl) than never smokers (0.095짹0.062 mg/dl) (P竊0.05). Daily smoking amount and total pack-years of smoking showed dose-dependent relationship with level of hs-CRP (P for trend 竊0.05). The adjusted odds ratio for the MS by daily smoking amount and total pack-years of smoking showed significant dose-dependent associations with MS (P for trend竊0.001). Compared with never smoker, subjects who smoked 돟30 cigarettes/day and 돟30 pack-year smokers showed significantly increased odds of MS [adjusted OR 2.31 (1.53-3.50), 1.95 (1.36-2.77)]. This significant positive association between Daily smoking amount and total pack-years of smoking and MS was remained after adjustment for hs-CRP [2.22 (1.46-3.36), 1.87 (1.31-2.66), respectively)].
Conclusion: This study showed that smoking was significantly associated with MS, but this association was not explained by hs-CRP. Therefore, more research is needed to elucidate potential mechanism by which smoking increases the risk of MS.
Keywords : Tobacco smoking; Metabolic syndrome; C-reactive protein
References
  1. Gray RS, Fabsitz RR, Cowan LD, Lee ET, Howard BV, Savage PJ. Risk factor clustering in the insulin resistance syndrome. The Strong Heart Study. Am J Epidemiol 1998; 148: 869-78.
    Pubmed CrossRef
  2. Nagasawa N, Tamakoshi K, Yatsuya H, Hori Y, Ishikawa M, Murata C et al. Association of white blood cell count and clustered components of metabolic syndrome in Japanese men. Circ J 2004; 68: 892-7.
    Pubmed CrossRef
  3. Ford ES. The metabolic syndrome and C-reactive protein, fibrinogen, and leukocyte count: findings from the Third National Health and Nutrition Examination Survey. Atherosclerosis 2003; 168: 351-8.
    CrossRef
  4. Cannon CP, McCabe CH, Wilcox RG, Bentley JH, Braunwald E. Association of white blood cell count with increased mortality in acute myocardial infarction and unstable angina pectoris. OPUS-TIMI 16 Investigators. Am J Cardiol 2001; 87: 636-9, A10.
  5. Stewart RA, White HD, Kirby AC, Heritier SR, Simes RJ, Nestel PJ et al. White blood cell count predicts reduction in coronary heart disease mortality with pravastatin. Circulation 2005; 111: 1756-62.
    Pubmed CrossRef
  6. Oh SW, Yoon YS, Lee ES, Kim WK, Park C, Lee S et al. Association between cigarette smoking and metabolic syndrome: the Korea National Health and Nutrition Examination Survey. Diabetes Care 2005; 28: 2064-6.
    CrossRef
  7. Hong AR, Lee KS, Lee SY, Yu JH. [Association of current and past smoking with metabolic syndrome in men]. J Prev Med Public Health 2009; 42: 160-4.
    Pubmed CrossRef
  8. Lee WY, Jung CH, Park JS, Rhee EJ, Kim SW. Effects of smoking, alcohol, exercise, education, and family history on the metabolic syndrome as defined by the ATP III. Diabetes Res Clin Pract 2005; 67: 70-7.
    Pubmed CrossRef
  9. Madsen C, Nafstad P, Eikvar L, Schwarze PE, Ronningen KS, Haaheim LL. Association between tobacco smoke exposure and levels of C-reactive protein in the Oslo II Study. Eur J Epidemiol 2007; 22: 311-7.
    Pubmed CrossRef
  10. Mascitelli L, Pezzetta F. Tobacco smoke, systemic inflammation and the risk of type 2 diabetes. J Intern Med 2006; 259: 332.
    Pubmed CrossRef
  11. Lowe GD, Yarnell JW, Rumley A, Bainton D, Sweetnam PM. C-reactive protein, fibrin D-dimer, and incident ischemic heart disease in the Speedwell study: are inflammation and fibrin turnover linked in pathogenesis? Arterioscler Thromb Vasc Biol 2001; 21: 603-10.
    Pubmed CrossRef
  12. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112: 2735-52.
    Pubmed CrossRef
  13. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract 2007; 75: 72-80.
    Pubmed CrossRef
  14. Koenig W, Sund M, Frohlich M, Fischer HG, Lowel H, Doring A et al. C-Reactive protein, a sensitive marker of inflammation, predicts future risk of coronary heart disease in initially healthy middle-aged men: results from the MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Augsburg Cohort Study, 1984 to 1992. Circulation. 1999; 99: 237-42.
    Pubmed CrossRef
  15. Frohlich M, Sund M, Lowel H, Imhof A, Hoffmeister A, Koenig W. Independent association of various smoking characteristics with markers of systemic inflammation in men. Results from a representative sample of the general population (MONICA Augsburg Survey 1994/95). Eur Heart J 2003; 24: 1365-72.
    CrossRef
  16. Tracy RP, Psaty BM, Macy E, Bovill EG, Cushman M, Cornell ES et al. Lifetime smoking exposure affects the association of C-reactive protein with cardiovascular disease risk factors and subclinical disease in healthy elderly subjects. Arterioscler Thromb Vasc Biol 1997; 17: 2167-76.
    Pubmed CrossRef
  17. Ohsawa M, Okayama A, Nakamura M, Onoda T, Kato K, Itai K et al. CRP levels are elevated in smokers but unrelated to the number of cigarettes and are decreased by long-term smoking cessation in male smokers. Prev Med 2005; 41: 651-6.
    Pubmed CrossRef
  18. Eliasson B, Mero N, Taskinen MR, Smith U. The insulin resistance syndrome and postprandial lipid intolerance in smokers. Atherosclerosis 1997; 129: 79-88.
    CrossRef
  19. Attvall S, Fowelin J, Lager I, Von Schenck H, Smith U. Smoking induces insulin resistance--a potential link with the insulin resistance syndrome. J Intern Med 1993; 233: 327-32.
    Pubmed CrossRef
  20. Goldbourt U, Medalie JH. Characteristics of smokers, nonsmokers and ex-smokers among 10,000 adult males in Israel. I. Distribution of selected sociodemographic and behavioral variables and the prevalence of disease. Isr J Med Sci 1975; 11: 1079-101.
    Pubmed
  21. Wu DM, Pai L, Sun PK, Hsu LL, Sun CA. Joint effects of alcohol consumption and cigarette smoking on atherogenic lipid and lipoprotein profiles: results from a study of Chinese male population in Taiwan. Eur J Epidemiol 2001; 17: 629-35.
    CrossRef
  22. van Eeden SF, Hogg JC. The response of human bone marrow to chronic cigarette smoking. Eur Respir J 2000; 15: 915-21.
    Pubmed CrossRef
  23. van Eeden SF, Yeung A, Quinlam K, Hogg JC. Systemic response to ambient particulate matter: relevance to chronic obstructive pulmonary disease. Proc Am Thorac Soc 2005; 2: 61-7.
    Pubmed CrossRef
  24. Casas JP, Shah T, Hingorani AD, Danesh J, Pepys MB. C-reactive protein and coronary heart disease: a critical review. J Intern Med 2008; 264: 295-314.
    Pubmed CrossRef
  25. Ishizaka N, Ishizaka Y, Toda E, Nagai R, Yamakado M. Association between cigarette smoking, white blood cell count, and metabolic syndrome as defined by the Japanese criteria. Intern Med 2007; 46: 1167-70.
    Pubmed CrossRef
  26. Ishizaka N, Ishizaka Y, Toda E, Nagai R, Koike K, Hashimoto H et al. Relationship between smoking, white blood cell count and metabolic syndrome in Japanese women. Diabetes Res Clin Pract 2007; 78: 72-6.
    Pubmed CrossRef
  27. Wada T, Urashima M, Fukumoto T. Risk of metabolic syndrome persists twenty years after the cessation of smoking. Intern Med 2007; 46: 1079-82.
    Pubmed CrossRef
  28. Ishizaka N, Ishizaka Y, Toda E, Hashimoto H, Nagai R, Yamakado M. Association between cigarette smoking, metabolic syndrome, and carotid arteriosclerosis in Japanese individuals. Atherosclerosis 2005; 181: 381-8.
    Pubmed CrossRef
  29. Wannamethee SG, Lowe GD, Shaper AG, Rumley A, Lennon L, Whincup PH. Associations between cigarette smoking, pipe/cigar smoking, and smoking cessation, and haemostatic and inflammatory markers for cardiovascular disease. Eur Heart J 2005; 26: 1765-73.
    Pubmed CrossRef