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Smoking and Serum Triglycerides
Published in Journal of the Medical Association of the State of Alabama, October 1975.
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Introduction
Blood lipids, cholesterol, triglycerides and phospholipids are transported as a complex with alpha and beta lipoproteins. Increased concentrations of these complexes are grouped into six types of hyperlipoproteinemia [Types I, IIa, IIb, III, IV and V]. Types IIa, IIb, III and IV are clearly associated with cardiovascular disease. Elevated serum triglycerides are a feature of Types IIb, III and IV. Thus, hypertriglyceridemia predisposes to the development of atherosclerosis and is regarded as an important risk factor.1,2
Although serum chemistry tests have been compared in smokers and nonsmokers,3-6 our cursory review of the literature has failed to identify a publication showing a significant effect of smoking upon serum triglycerides. Concerning serum cholesterol, the general consensus is that the mean level is higher in smokers.3,4,6
Method
On the basis of a health questionnaire, biochemical analysis and an electrocardiogram, each subject was judged to be in a reasonably good state of health.
The daily cigarette smoking habits of 1101 doctors and their wives were determined by a questionnaire and divided into three categories: 0-10 cigarettes per day versus 11+, 0-20 versus 21+ and 0-10 versus 21+.
Following a twelve-hour fast, each participant’s blood was analyzed to determine the serum triglycerides.7
Results
The effect of smoking upon serum triglycerides is shown in the accompanying table.
Relationship Between Serum Triglycerides and Daily Cigarette Consumption
It is readily apparent that the heavier smokers have higher serum triglyceride levels. In each category, the upper limit of the laboratory normal range [150 mg. per cent] was exceeded by the heavier smokers.
Those smoking 11 or more cigarettes daily had a mean serum triglyceride level [174.95 mg. per cent] that was significantly higher [P<0.25] than the level in the group smoking 0-10 cigarettes daily [145.25 mg. per cent].
Statistical analysis for the mean serum triglyceride difference between those smoking 0-20 cigarettes per day versus 21+ and 0-10 cigarettes versus 21+ just escaped the five per cent confidence level of statistical significance [P>0.050].
Discussion
The finding of a higher serum triglyceride level in the heavier smokers is a risk factor in their cardiovascular disease prognosis. Additionally, smoking has been found to increase serum cholesterol and serum glucose.3,4,6 These are also considered to be cardiovascular risk factors. Therefore, the elevation of serum triglycerides observed in this report is consistent with the body of data which links smoking to ischemic heart disease and other cardiovascular disorders.
References Cited:
- Kreisberg, R. A. “Hyperlipoproteinemia and ischemic heart disease.” Alabama J. Med. Sci. 11: No. 2, 111-114, April 1974.
- Frommeyer, W. B., Jr. “The diagnosis and treatment of the hyperlipoproteinemias: emphasis on types Ila, Ilb, and IV.” Alabama J. Med. Sci. 11: No. 3, 207-214, July 1974.
- Brackenridge, C. J. and Bloch, S. “Smoking in medical students.” Psychoso. Res. 16: No. 1, 35-40, February 1972.
- Dales, L. C., Freidman, G. D., Siegelaub, A. B., and Seltzer, C. C. “Cigarette smoking and serum chemistry tests.” Chron. Dis. 27: No. 6, 293-307, August 1974.
- Murchison, L. E. and Fyfe, T. “Effects of cigarette smoking on serum lipids, blood glucose, and platelet stickiness.” Lancet 2: No. 7456, 182-184, 23 July 1966.
- Kershbaum, A. and Bellet, S. “Cigarette smoking and blood lipids.” A.M.A. 187: No. 1, 32-34, 4 January 1964.
- McLellan, G. H. “Automated colorimetric method for estimating serum triglycerides.” Clin. Chem. 17: No. 6, 535-537, June 1971.