ABSTRACT
Background: The acute effects of cigarette smoking in smokers include dyslipidemia and impaired insulin action that leads to abnormal glucose metabolism. Both dyslipidemia and insulin resistance are well-established major risk factor for cardiovascular disease. Aims & Objective: To ascertain the prevalence of several degrees of glucose abnormalities in smokers and to assess the impact of active tobacco smoking on lipids profile in adult male population. Material and Methods: A cross-sectional study was conducted with one hundred and fifty two active adult male smokers defined by persons smoking cigarettes over 2 pack years and fifty age and Body Mass Index (BMI) matched healthy control. Smokers were classified into mild to moderate (Group I) and severe (Group II) based on the number of pack years as 2 – 10 and more than 10 respectively. Glucose tolerance was assessed according to American Diabetes Association (ADA) guidelines and standard methods were adopted to check the lipid levels. Data analyses were performed with the SPSS 15.0 statistical software. Results: An abnormal glucose metabolism was diagnosed in 66% (95% confidence interval [CI], 61.4%-71.6%) of the smokers. The mean HOMA-IR (Homeostasis model assessment-insulin resistance) in smokers was 6.8 + 3.1. Decreasing glucose tolerance was associated with insulin resistance i.e. from normal glucose tolerance condition through IGT, IFG to diabetic, the HOMA IR progressively increased (4.9 + 2.1, 6.7 + 4.2, 7.4 + 3.1 and 8.9 + 3.7 respectively). Atherogenic index as indicated by total cholesterol/HDL cholesterol and LDL cholesterol/HDL cholesterol ratio was significantly elevated in both the smoker groups as compared to non-smokers. According to the Adult Treatment Program III criteria, the metabolic syndrome was diagnosed in 44.07% (95% CI, 35.9%-47.3%) of the smokers. In fact only 10 participants (6%, 95% CI, 5.4% - 7.1%) showed good control of cardiovascular risk factors. Conclusion: Abnormalities in lipid profile and glucose tolerance are directly correlated with smoking pack years in this study. Intense education program about adverse health events of smoking should be under taken through all means.