Effects of smoking and smoking cessation on lipids and lipoproteins: Outcomes from a randomized clinical trial

Abstract

Background The effects of smoking and smoking cessation on lipoproteins have not been studied in a large contemporary group of smokers. This study was designed to determine the effects of smoking cessation on lipoproteins. Methods One-year, prospective, double-blind, randomized, placebo-controlled clinical trial of the effects of 5 smoking cessation pharmacotherapies. Fasting nuclear magnetic resonance spectroscopy lipoprotein profiles were obtained before and 1-year after the target smoking cessation date. The effects of smoking cessation and predictors of changes in lipoproteins after one year were identified by multivariable regression. Results The 1,504 current smokers were mean (standard deviation) 45.4 (11.3) years old and smoked 21.4 (8.9) cigarettes/day at baseline. Of the 923 adult smokers who returned at 1 year, 334 (36.2%) had quit smoking. Despite gaining more weight (4.6 kg [5.7] vs. 0.7 kg [5.1], p<0.001], abstainers had increases in high-density lipoprotein cholesterol (HDL-C) (2.4 [8.3] vs. 0.1 [8.8] mg/dL, p<0.001], total HDL (1.0 [4.6] vs. −0.3 mcmol/L [5.0], p<0.001) and large HDL (0.6 [2.2] vs. 0.1 [2.1] mcmol/L, p=0.003) particles, compared with continuing smokers. Significant changes in low-density lipoprotein (LDL) cholesterol and particles were not observed. After adjustment, abstinence from smoking (p<0.001) was independently associated with increases in HDL-C and total HDL particles. These effects were stronger in women. Conclusions Despite weight gain, smoking cessation improved HDL-C, total HDL and large HDL particles, especially in women. Smoking cessation did not affect LDL or LDL size. Increases in HDL may mediate part of the reduced cardiovascular disease risk observed after smoking cessation.

Effect of Cigarette Smoking on Serum Lipid Profile in Male Population of Udaipur

“…Smoking is associated with a more atherogenic lipid profile [3][4][5]. It increases the concentration of serum total Cholesterol, triglycerides, LDLCholesterol, VLDL-Cholesterol and decreases the level of good Cholesterol i.e., HDL-Cholesterol [6][7][8][9][10]. Thus, smoking is a major risk factor for atherosclerosis and coronary artery disease [11,12].…”

Impact of Smoking on Coronary Microcirculatory Resistance in Patients With Coronary Artery Disease

“…Smoking cessation has been known to result in an improvement in lipid profile, as reflected in enhanced levels of HDL, 31) and a rapid decline in cardiovascular risk. 32) Following smoking cessation, coronary endothelial vasomotor abnormality recovers in healthy young smokers, 33) although not in middle-aged smokers or long-term smokers.…”

“…Impact of smoking on coronary physiology: The finding that among patients with CAD, smokers had greater IMR than nonsmokers, suggests that smoking adversely affects coronary microcirculatory resistance. Smoking is associated with coronary endothelial dysfunction, 23) coronary vascular smooth muscle relaxation, 24) dyslipidemia, 25,26) progression of coronary atherosclerosis, 27) and cardiovascular events. 28) Although the mechanisms of CMVD associated specifically with smoking have not been fully established, CMVD with CAD is caused in general by two mechanisms: inappropriate subepicardial prearteriolar dilatation in the presence of increased myocardial oxygen consumption, and prearteriolar and arteriolar constriction.…”

Association of smoking with prevalence of common diseases and metabolic abnormalities in community-dwelling Japanese individuals

“…In addition, the current study indicated that past smoking is associated with dyslipidemia and hypertriglyceridemia in men. Cessation of smoking is reported to have relatively limited effects on lipid profiles (24,25). A meta-analysis showed that smoking cessation led to increased serum concentration of HDL-cholesterol, but no significant improvement in serum triglycerides and LDL-cholesterol (25).…”