ABSTRACT
Introducción. Los carotenos y las vitaminas antioxidantes se asocian con un menor riesgo de aterosclerosis y enfermedad coronaria. Hay estudios que apoyan que el hábito tabáquico modifica el estado nutricional de estos micronutrientes. En este estudio se analizan las concentraciones plasmáticas de los carotenos y las vitaminas antioxidantes en varones y mujeres no fumadores, ex fumadores y fumadores. Pacientes y métodos. Se seleccionó aleatoriamente para participar en el estudio base (1988-1989) del proyecto SENECA (Survey in Europe on Nutrition and the Elderly, a Concerted Action), de la Unión Europea, a 2.200 habitantes de 19 ciudades europeas, Hamme (Bélgica), Roskilde (Dinamarca), Chateau Renault-Amboise, Haguenau y Romans (Francia), Markopoulo (Grecia), Anogia-Archanes (Creta), Monor (Hungría), Padua, Fara Sabina-Magliano y Sabina-Poggio Mirteto (Italia), Culemborg (Países Bajos), Elverum (Noruega), Vila Franca de Xila (Portugal), Betanzos (España), Yverdon-les-Bains, Burdorf y Bellinzona (Suiza), 1.091 varones y 1.109 mujeres, nacidos entre 1913 y 1918. El hábito tabáquico fue valorado usando un cuestionario estandarizado y categorizado en no fumadores, ex fumadores y fumadores. Se llevó a cabo una extracción de sangre y en laboratorios centrales determinaron los marcadores bioquímicos: concentraciones plasmáticas de carotenos, retinol y *-tocoferol con cromatografía líquida de alta presión (HPLC), y del ácido fólico mediante radioinmunoanálisis. El análisis estadístico de los datos se llevó a cabo con el programa R-SIGMA 2. Resultados. Los varones fumadores presentaron concentraciones (P50) más bajas de carotenos (0,34 µmol/l; p 30 µmol/l y cocientes de vitamina E/colesterol > 5,2 mmol/mol, con efectos protectores frente a enfermedades cardiovasculares según distintos estudios epidemiológicos entre los no fumadores que entre los fumadores. Conclusiones. A la vista de estos resultados la primera medida terapéutica debe ir dirigida al cese del consumo de tabaco. Los fumadores deberían consumir una dieta rica en frutas y vegetales con elevado contenido en vitaminas antioxidantes que les permitiera igualar el estado nutricional de estos micronutrientes al del grupo de los no fumadores
Introduction. Carotene and antioxidant vitamins are associated with lower arteriosclerotic risk and coronary disease. This association is supported by studies showing that smoking modifies the nutritional status of these micronutrients. Plasma levels of carotene and antioxidant vitamins in non-smokers, former smokers, and current smokers were analysed. Patients and methods. 2,200 elderly inhabitants 1,091 men, 1,109 women born between 1913 and 1918 of 19 European towns: Hamme (Belgium); Roskilde (Denmark); Chateau Renault-Amboise, Haguenau and Romans (France); Markopoulo (Greece); Anogia-Archanes (Crete); Monor (Hungary); Padua, Fara Sabina-Magliano Sabina-Poggio Mirteto (Italy); Culemborg (The Netherlands); Elverum (Norway); Vila Franca de Xila (Portugal); Betanzos (Spain); Yverdon-les-bains, Burdorf and Bellinzona (Switzerland) were randomly selected to participate in the baseline study (1988-1989) of the SENECA project (Survey in Europe on Nutrition and the Elderly, a Concerted Action) from the European Union. Smoking was assessed using a standardised questionnaire and categorised as-non, former and current smoker. Blood samples were collected and biochemical parameters: plasma levels of carotene, retinol and a-tocopherol by HPLC and folic acid by radioimmuno assay kits were measured at central laboratories, according to a strictly standardised methodology. Statistical analysis was perfomed out using the R-SIGMA 2 programme. Results. Male current smokers had levels (P50) of carotene (0.34 µmol/l; p < 0.001) and retinol (1.98 µmol/l; p < 0.01) lower than non-smokers (0.53; 2.0 µmol/l), respectively, whereas intermediate levels were observed in former smokers; carotene was the strongest parameter related to smoking consumption (r = -0.170; p < 0.006; Spearman). The marginal and deficient levels were less prevalent among non-smokers. a-tocopherol levels over 30 µmol/l or a-tocopherol/cholesterol ratios over 5.2 mmol/mol, with protective effects against cardiovascular disease, were more prevalent among non-smokers than current smokers. Conclusions. According to the results, smoking cessation would be the first measure advised. Current smokers, even former smokers, would require a diet rich in fruit and vegetables with a high antioxidant vitamin content, which would allow them to achieve the same nutritional status as non-smokers
