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Risk for metabolic syndrome much higher in verified smokers
Men and women who smoke show an increased risk for metabolic syndrome, with the level of risk for some factors dependent on both the amount of smoking by as well as gender of the patient, according to research in Metabolic Syndrome and Related Disorders.
In a population-based, cross-sectional study of Korean adults, researchers showed that male smokers had an increased risk for high triglyceride and low HDL cholesterol levels and a decreased risk for high blood pressure, while female smokers had a higher risk for abdominal obesity and high triglycerides, compared with nonsmokers.
Ji-hun Kang, MD, MS, and Yun-Mi Song, MD, MPH, PhD, both of Sungkyunkwan University School of Medicine in Seoul, South Korea, analyzed data from 11,559 participants (6,201 women) from the Korean National Health and Nutrition Examination Surveys. Researchers conducted urinary nicotine tests; those with a cotinine level above 50 ng/mL were considered to be smokers.
Men who were smokers showed a 28.5% increased risk for metabolic syndrome (OR = 1.26; 95% CI, 1.04-1.53), while female smokers showed a 26.5% increase (OR = 1.32; 95% CI, 1.01-1.73) after adjusting for covariates.
In addition, self-reported smoking status differed from cotinine-verified smoking results, particularly for women, with only 344 women (5.5%) self-reporting as smokers but nicotine test results showing 744 female smokers (12.5%) in the group, according to researchers. There was a smaller disparity among men, with 2,354 men (43.9%) identifying as smokers but test results showing 2,602 male smokers (48.6%).
“Although the present study does not address the reason why women tend to conceal their smoking status, this finding suggests that information bias could be a significant problem in smoking-related studies of women when self-reported smoking status is relied upon,” the researchers wrote.
The study also showed a relationship between the amount of smoking and metabolic risk, with risk rising along with levels of urinary cotinine (men, P < .01; women, P = .02). Higher urinary cotinine levels were also associated with high triglycerides (P < .01 in both men and women), low HDL cholesterol (men, P < .01; women, P = .02) and increased abdominal obesity in women (P = .02).
No link was found between smoking and impaired fasting glucose, according to researchers.
Results based on urinary nicotine tests better clarify the link between smoking and metabolic syndrome, according to researchers.
“The extent of smoking is likely to be underestimated by self-reporters because smoking is often considered socially undesirable behavior, especially in adolescents and women in Asian countries,” the researchers wrote. “To estimate a participants smoking status accurately, it is necessary to use biochemical verification of smoking, such as measuring cotinine levels.”
—by Regina Schaffer
Disclosure: The authors report no relevant financial disclosures.