ABSTRACT
BACKGROUND: Smoking is a major risk factor for cardiovascular disease. Also, inflammatory activation and metabolic disorder are the mediators of smoking-induced atherosclerotic progression. The aim of the present study was to investigate whether current smoking and smoking cessation alter inflammatory or metabolic status and affect subclinical atherosclerosis in apparently healthy men. METHODS AND RESULTS: Classical risk factors and smoking habit were evaluated in 354 men who completed health examinations annually without any current medications. Carotid intima-media thickness (IMT) was followed for 27.1±4.5 months. At baseline, both maximum and mean IMT significantly changed during 2-year follow-up. They tended to increase along with progression of smoking habit, with significantly greater maximum IMT in current smokers compared with never smokers. Both maximum and mean IMT significantly changed during 2-year follow-up, and tended to increase with progression of smoking habit, with maximum IMT being greatest for current smokers. Past smokers tended to have greater IMT increase than never smokers. Among smoking habit and some atherosclerotic risk markers that showed significant correlation with maximum IMT increase, stepwise regression showed that smoking habit and serum low-density lipoprotein-cholesterol (LDL-C) level were the only independent predictors. CONCLUSIONS: Significant 2-year progression of subclinical atherosclerosis was associated with continuous smoking and LDL-C. This was only partly moderated in past smokers despite complete reversal of inflammatory activation, suggesting another crucial factor for inhibiting accelerated progression of subclinical atherosclerosis in men.
Subject(s)
Carotid Artery Diseases/diagnostic imaging , Carotid Intima-Media Thickness , Smoking/adverse effects , Adiponectin/blood , Adult , Analysis of Variance , Asymptomatic Diseases , Biomarkers/blood , C-Reactive Protein/analysis , Carotid Artery Diseases/blood , Carotid Artery Diseases/etiology , Cholesterol, LDL/blood , Disease Progression , Follow-Up Studies , Humans , Interleukin-6/blood , Male , Middle Aged , Predictive Value of Tests , Regression Analysis , Risk Factors , Smoking Cessation , Smoking Prevention , Surveys and Questionnaires , Time FactorsABSTRACT
BACKGROUND: Inflammation has been implicated in the pathogenesis of cardiovascular disease. Since there have been few studies elucidating gender-specific effect of inflammation and metabolic syndrome (MetS) on subclinical atherosclerosis, we evaluated the relative contribution of these factors in healthy subjects. METHODS: MetS components, carotid intima-media thickness (IMT) and pulse wave velocity (PWV) were evaluated in apparently healthy 714 men and 364 women (40-59 y). Serum levels of high sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6) and adiponectin were also examined. RESULTS: Increase in number of clustering MetS components was more clearly associated with worsening of IMT and PWV in women than in men. Serum IL-6 level was positively correlated with IMT and PWV, and adiponectin level was negatively correlated with IMT in men but not in women. The subjects either with a "high" IL-6 or hs-CRP, or a "low" adiponectin were associated with increase in IMT in the presence of MetS, though there was no significant effect of MetS in those with low inflammation. CONCLUSIONS: While IL-6 and adiponectin are the important risk factors for early arterial alterations in men, components of MetS present profound effects on subclinical atherosclerosis in women rather than in men.
