Association between tobacco smoke exposure and levels of C-reactive protein in the Oslo II Study

Abstract

It is well known that tobacco smoke exposure is related to the risk of developing cardiovascular diseases and events. One mechanism could be that tobacco smoke acts on the cardiovascular system by altering the autonomic function and/or inducing inflammatory responses. We used data from 3 744 men aged 67-77 years from the city of Oslo that participated in the health screening for the Oslo II Health Study in 2000, to explore associations between C-reactive protein and environmental exposures including exposure to tobacco smoke products. Levels of C-reactive protein were higher in current smokers (2.05 mg/l, IQR, 1.11-4.17 mg/l), compared to former-smokers (1.58 mg/l, IQR, 0.83-3.03 mg/l) and non-smokers (1.26 mg/l, IQR, 0.65-2.40 mg/l). The risk of elevated C-reactive protein increased with both numbers of current cigarettes smoked per day and numbers of pack-years of smoking, when other factors were adjusted for (P < 0.001). We found a positive dose-response relationship between amount of current cigarette smoking and elevated C-reactive protein levels. These findings support the idea that the induction or exacerbation of inflammation could be a mechanism by which smoking promotes atherosclerotic cardiovascular diseases.

Associations of Cigarette Smoking With Subclinical Inflammation and Atherosclerosis: ELSA‐Brasil (The Brazilian Longitudinal Study of Adult Health)

“…In addition, hsCRP is associated with atherosclerotic processes40 and thus may also be directly involved in cardiovascular injury. The high sensitivity of this test, as indicated by significant differences via secondhand smoking exposure and consistent results for different indices of tobacco exposure in ELSA‐Brasil and across other studies,5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 41 highlights hsCRP as a favorable marker for monitoring hazardous health effects of tobacco exposure.…”

“…These studies have generally shown higher levels of hsCRP among current and former smokers compared with nonsmokers5, 6, 9, 10, 12, 13, 14, 15 and decreased levels after smoking cessation, albeit slower than systolic blood pressure and total cholesterol and LDL‐C 8, 11, 12. Calculating the probability of CAC onset following smoking exposure in the Heinz Nixdorf Recall study also demonstrated that onset of CAC was expedited by 10 years among current smokers and 5 years among former smokers compared with never smokers 16.…”

The association between smoking quantity and hypertension mediated by inflammation in Chinese current smokers

“…A few studies consistently reported that current smokers had a higher CRP level than ex-smokers and/or nonsmokers [12,13,[21][22][23] and several studies found a doseresponse relationship of pack-years of smoking and number of cigarettes smoked daily with elevated CRP levels [12,13,22]. Our study discovered that the number of cigarettes smoked per day was significantly related to elevated serum CRP levels after adjusting for potential confounders.…”

Mediation Role of C-Reactive Protein on the Association between Smoking Quantity and Type 2 Diabetes in Current Chinese Smokers

“…Some studies revealed a dose-response relationship between the smoking pack-year and the number of cigarettes smoked daily with elevated CRP levels [15, 16, 30]. Similarly, we found that the number of cigarettes smoked per day was significantly related to elevated serum CRP levels.…”

“…Studies on cigarette smoking and CRP in men have consistently shown that current smokers have a higher level of CRP than exsmokers and nonsmokers [15, 16, 30, 31]. Some studies revealed a dose-response relationship between the smoking pack-year and the number of cigarettes smoked daily with elevated CRP levels [15, 16, 30].…”