Relationship Between Smoking Status and Serum Lipids in a Hyperlipidemic Population and Analysis of Possible Confounding Factors

Abstract

The aim of our study was to estimate the potential relationship between smoking behavior and other coronary heart disease risk factors in 250 hyperlipidemic patients. We present data obtained through self-reporting of the number of cigarettes smoked per day, measurements of three tobacco markers, and data on dietary habits and lipid variables. We measured cotinine (by HPLC) and thiocyanate and used a recent colorimetric assay for the indirect evaluation of the nicotine metabolites in a single urine specimen. Mean values of nicotine metabolites, expressed as cotinine equivalents, were 6.7, 39.9, and 79.4 mumol/L, respectively, for nonsmokers, light smokers (7.7 cigarettes per day), and heavy smokers (25.8 cigarettes per day). We found that light smokers have higher concentrations of cotinine and nicotine metabolites in proportion to the number of cigarettes smoked per day than do heavy smokers. Thus, the simple colorimetric assay can accurately evaluate smoking status. Hyperlipidemia and smoking are linked by an intricate network of multiple relations. The concentration of high-density lipoprotein (HDL) cholesterol is lower in heavy smokers, and the concentrations of triglycerides and cholesterol are higher. The 0.11 mmol/L difference in HDL cholesterol between light and heavy smokers is close to the results of previous papers; however, when gender, dietary habits (including alcohol intake), and data on body mass index are included in a multiple regression analysis, there is no longer an association between HDL cholesterol concentrations and smoking status. Therefore, these different dietary habits may be confounding factors that partly explain the pattern of lipid variables.

Biomarkers Derived from Nicotine and its Metabolites: A Review

“…However, a correlation and discrimination between light and heavy smokers is not apparent in all studies (129,130). The results obtained by colorimetric assays for "cotinine equivalents" in urine correlate well with the results obtained for determination of cotinine concentrations by radioimmunoassay (RIA) (119,131,134), GC (61,136), and HPLC (57,58,130). However, in all cases, colorimetric assay results for "cotinine equivalents" are consistently and quantitatively 3-to 4-fold higher than the corresponding results for cotinine concentrations in urine determination by RIA, GC or HPLC methods.…”

“…In addition, the instability of the chromophores may result in a falsenegative response (130)(131)(132)(133). A number of rapid screening tests have been developed to evaluate current smoking status using colorimetric assays (57,58,(134)(135)(136). HPLC using either diode array detection (DAD) or ultraviolet (UV) detection has been used to quantify individual nicotine metabolite chromophores formed by barbituric acid (57,130) and DETBA (132,133,137,138).…”

“…The sensitivity of the DETBA assay can be further enhanced by using the 1,3-dibutyl-2-thiobarbituric acid (DBTBA) analogue and extraction of the chromophores into ethyl acetate prior to HPLC-UV analysis (139). Despite the unspecific nature of colorimetric assays, urinary "cotinine equivalents" correlate well with daily cigarette consumption (57,58,61,136). However, a correlation and discrimination between light and heavy smokers is not apparent in all studies (129,130).…”

The axial distribution of nicotine content along hair shaft as an indicator of changes in smoking behaviour: evaluation in a smoking‐ cessation programme with or without the aid of nicotine chewing gum.

“…and cotinine in blood or urine, thiocyanate in blood Many smokers give up smoking without any special and carbon monoxide (CO) in expired air have been help or treatment, but others have great difficulty. shown to provide some indication of smoking status The value of nicotine replacement in the treatment [7]. However, since smoking-cessation programmes of dependent smokers is now established.…”

Features of the Lipid Profile in Patients with Arterial Hypertension and Cardiovascular Diseases According to Smoking Status

“…The effect of total cholesterol (TCH) and low-density lipoprotein cholesterol (LDL-C) levels on carotid intimamedia thickness was studied in previous works and the differences in the dependence on smoking status were confirmed [3]. It was expected that different mechanisms were involved in atherogenesis in LDL according to smoking status [4,5].…”