Longevity-associated mitochondrial DNA 5178 A/C polymorphism and blood pressure in the Japanese population

It has been reported that the mitochondrial DNA 5178 adenine/cytosine (mt5178 A/C) polymorphism, also called NADH dehydrogenase subunit 2-237 methionine/leucine (ND2-237 Met/Leu) polymorphism, may be associated with longevity in Japanese individuals, and that the mt5178A genotype may have an antiatherogenic influence. To determine whether mt5178 A/C polymorphism influences blood pressure, we genotyped 412 healthy Japanese individuals and performed a cross-sectional study investigating the relationship between genotype and blood pressure. In women with mt5178A, the mean diastolic blood pressure was higher than in those with mt5178C by 3.2 mmHg (P=0.040). In men, no statistically significant difference in systolic or diastolic blood pressure was observed between mt5178 A/C genotypes. However, a significant correlation between mt5178 A/C genotypes and the effects of habitual drinking on blood pressure was found. After adjustment for several factors, in men carrying mt5178C, both systolic and diastolic blood pressure were significantly higher in daily drinkers than in occasional (P=0.002 and 0.002, respectively) as well as nondrinkers (P<0.001 and 0.001, respectively), whereas in men carrying mt5178A, no significant differences in blood pressure were detected, irrespective of alcohol consumption. These results suggest that mt5178 A/C (=ND2-237 Met/Leu) polymorphism may influence both diastolic blood pressure in Japanese women and the blood-pressure-increasing effect of drinking in Japanese men.     

Longevity-associated mitochondrial DNA 5178 A/C polymorphism modulates effects of daily drinking and cigarette consumption on serum triglyceride levels in middle-aged Japanese men

Mitochondrial DNA 5178 adenine/cytosine (mt5178 A/C) polymorphism is one of the longevity-associated mitochondrial DNA polymorphisms. The frequency of the mt5178A genotype is significantly higher in Japanese centenarians than in the general population. We previously reported that serum high-density lipoprotein cholesterol levels were significantly higher in men with mt5178A than in those with mt5178C. However, this significant difference disappeared after adjusting for drinking frequency. To investigate the interaction between mt5178 A/C polymorphism and habitual drinking on serum lipid levels, we performed an association study in 321 healthy middle-aged Japanese men. Interaction between mt5178 A/C polymorphism and daily drinking on serum triglyceride (TG) levels was observed (P=0.019). Moreover, interaction between mt5178 A/C polymorphism and cigarette consumption on serum TG levels was also observed (P=0.022). Multiple regression analysis showed that, in men with mt5178A, daily drinking decreased TG levels (P=0.025), and cigarette consumption increased TG levels (P<0.001), while in men with mt5178C, the effects of daily drinking and cigarette consumption on TG levels were unclear. No interaction was observed on other lipid levels. Longevity-associated mitochondrial DNA 5178 A/C polymorphism thus influences the effects of daily drinking and cigarette consumption on TG levels in middle-aged Japanese men.     

Association of the longevity-associated mitochondrial DNA 5178 A/C polymorphism with serum protein fraction levels in healthy Japanese women

Mitochondrial DNA 5178 adenine/cytosine (mt5178 A/C) polymorphism was reported to be associated with longevity and susceptibility to adult-onset diseases in Japanese. To examine whether mt5178 A/C genotypes are associated with serum protein fraction profiles, we genotyped 461 healthy Japanese individuals, and studied the relationship of mt5178 A/C genotypes to both proportion and levels of serum protein fraction. The mt5178 A/C was genotyped using polymerase chain reaction-restriction fragment length polymorphism method. The alpha-1, alpha-2, and beta globulin proportions in females carrying mt5178A were significantly higher than those in females carrying mt5178C (P=0.002, 0.006, and 0.008, respectively). Moreover, the alpha-1, alpha-2, and beta globulin levels in females carrying mt5178A were significantly higher than those in females carrying mt5178C (P=0.001, 0.002, 0.018, respectively). This difference in globulin fraction level between the two genotypes was more evident in premenopausal females than in postmenopausal females. However, no such difference was found in males. These results provide the first evidence that the mt5178 A/C polymorphism may influence the serum protein fraction levels of the healthy Japanese women.     

Association of the mitochondrial DNA 5178A/C polymorphism with maternal inheritance and onset of type 2 diabetes in Japanese patients.

The mitochondrial DNA 5178A/C (mt5178A/C) polymorphism is associated with longevity and adult onset diseases. We investigated an association of the mt5178A/C polymorphism with the occurrence and clinical features of type 2 diabetes. Two hundred and seventy Japanese patients with type 2 diabetes (181 men and 89 women) and 254 control subjects without diabetes were studied. Patients with mutations at position 3243 in the mitochondrial DNA were excluded. Genotype was determined by the polymerase chain reaction-restriction fragment length polymorphism method. Various clinical features including age at disease onset were compared between the patients with the mt5178A and mt5178C alleles. Mt5178C was observed more frequently in patients with type 2 diabetes than in control subjects (65.9% vs 57.9%, P = 0.058). Clear information about the maternal history of diabetes was obtained from 233 diabetic patients. Patients with a maternal history of diabetes carried the mt5178C allele (58/75, 77.3%) more frequently than did patients without a maternal history of diabetes (100/158, 63.3%; P = 0.032) and control subjects (57.9%; P = 0.002). The mean age at onset of diabetes was significantly lower in patients with mt5178C (47.6 +/- 11.4 years) than in patients with mt5178A (51.5 +/- 10.0 years; P = 0.0073). The mt5178A/C polymorphism may be associated with maternal inheritance of type 2 diabetes and may influence the age at onset through deterioration of mitochondrial function.     

Effects of tobacco smoking on alpha-2-macroglobulin and some biochemical parameters in Thai males

This cross-sectional study was carried out among smokers and nonsmokers from suburban and urban residential areas in Bangkok, Thailand. One hundred eighty-six smokers and 102 nonsmokers, who voluntarily participated in the study, were investigated. The levels of alpha-2-macroglobulin (A2M), albumin, total protein, and other biochemical and hematological parameters as well as body mass index (BMI) measurements were taken. The levels of A2M, BUN and WBC counts were significantly higher in smokers than nonsmokers. Total protein and albumin concentrations were significantly lower in smokers than nonsmokers, but the levels of other biochemical parameters did not differ between the two groups. The relationship between BMI and median A2M levels in the smoker and nonsmoker groups showed the higher the BMI, the lower the serum A2M levels. Smokers had a higher percentage of hyperalpha-2-macroglobulinemia than nonsmokers. A2M concentrations correlated inversely with BMI, BUN, albumin, total cholesterol, triglycerides, and the quantity of cigarettes smoked for the total period of smoking (cigarette pack-years). Multiple regression analysis revealed that albumin and cigarette pack-years were the most closely related variables to A2M concentrations among smokers. These findings suggest cigarette smoking affects inflammation markers, increasing A2M and WBC and decreasing albumin. This effect may be the mechanism responsible for the development of chronic disease states associated with smoking since cigarette smoke contains many toxic compounds harmful to health.     

Correlations between changes in hematological indices of mothers with preeclampsia and umbilical cord blood of newborns

Preeclampsia is a condition that might severely impact the health of mothers and their newborns. The aim of this investigation is to examine hematological parameters in mothers with preeclampsia and umbilical cord blood. Eighty preecalmptic mothers were recruited in the study. In addition, eighty normal pregnant mothers served as controls. Hematological parameters that include hemoglobin (Hb), red blood cell count (RBC), red cell distribution width (RDW), packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell counts (WBC), platelet counts, mean platelet volume (MPV) and Platelet large cell ratio (PLCR) were examined. Results showed a strong association between preeclampsia and low birth weight, premature/cesarean delivery and proteinuria (P < 0.001). Hb and neutrophils were significantly lower (P < 0.01), whereas RDW, PCV, MCV, MCH, MCHC and lymphocytes were significantly higher than normal ones (P < 0.01). When cord blood of preeclamptic mothers were compared with that of normal ones, similar findings were observed. In addition, results showed significant and positive correlations between preeclamptic mothers and their newborn in Hb (r2 = 0.075, P < 0.05), PCV (r2 = 0.084, P < 0.01), MCV (r2 = 0.077, P < 0.05), MCHC (r2 = 0.115, P < 0.01), RBC (r2 = 0.086, P < 0.01) and retics (r2 = 0.306, P < 0.01). In conclusion, changes in several hematological parameters associated with preeclampsia were correlated in affected mothers and their newborns. Such biomarkers can be used to predict pregnancy outcomes in women with preeclampsia.     

Effects of the Interaction between Interleukin-6 -634C/G Polymorphism and Smoking on Serum C-Reactive Protein Concentrations.

Smoking and interleukin-6 (IL-6) are major factors in inflammation. The aim of this study was to investigate whether or not the IL6 -634C/G polymorphism (rs1800796) and its interaction with smoking influence serum C-reactive protein (CRP) concentrations. The subjects were 347 Japanese male employees of a transit company. CRP and conventional cardiovascular risk factors were evaluated. IL6 -634C/G polymorphisms were genotyped by allelic discrimination using fluorogenic probes and the 5' nuclease assay. The mean values of CRP were significantly higher in current smokers than in nonsmokers after adjustment for age, body mass index (BMI), systolic blood pressure, total cholesterol, log triglycerides, high-density lipoprotein cholesterol (HDL-C), fasting glucose, and drinking habit (p=0.011). Comparison of three genotypes revealed significant interaction between smoking and the IL6 -634C/G genotype manifested by CRP concentrations (p=0.007) after the adjustments cited above. After stratification by smoking status, CRP differed significantly among IL6 -634C/G genotypes groups in nonsmokers (p=0.010, p for trend=0.007), whereas no significant difference was found in current smokers. Comparison between -634C/C and C/G+G/G groups revealed also a significant interaction between smoking and the IL6 -634C/G genotype (p=0.007). These findings suggest that the impact of the -634G allele on CRP elevation is greater in nonsmokers than in current smokers. Since gene-environment interactions have been insufficiently examined, further studies are required to clarify their effect on inflammation, including CRP elevation.     

Association between smoking and blood pressure: evidence from the health survey for England

Cigarette smoking causes acute blood pressure (BP) elevation, although some studies have found similar or lower BPs in smokers compared with nonsmokers. Cross-sectional data from 3 years (1994 to 1996) of the annual Health Survey for England were used to investigate any difference in BP between smokers and nonsmokers in a nationally representative sample of adults (>/=16 years old). Randomly selected adults (33 860; 47% men) with valid body mass index (BMI) and BP measurements provided data on smoking status (never, past, or current) and were stratified into younger (16 to 44 years old) and older (>/=45 years old) age groups. Analyses provided between 89% and 94% power to detect a difference of 2 mm Hg systolic BP between smokers and nonsmokers in the 4 age/gender strata (alpha=0.05). Older male smokers had higher systolic BP adjusted for age, BMI, social class, and alcohol intake than did nonsmoking men. No such differences were seen among younger men or for diastolic blood pressure in either age group. Among women, light smokers (1 to 9 cigarettes/d) tended to have lower BPs than heavier smokers and never smokers, significantly so for diastolic BP. Among men, a significant interaction between BMI and the BP-smoking association was observed. In women, BP differences between nonsmokers and light smokers were most marked in those who did not drink alcohol. These data show that any independent chronic effect of smoking on BP is small. Differences between men and women in this association are likely to be due to complex interrelations among smoking, alcohol intake, and BMI.     

Relationships between cigarette smoking, body size and body shape

OBJECTIVE: To define relationships between smoking status, body mass index (BMI), waist and hip circumferences (WC, HC) and waist to hip ratio (WHR). DESIGN: Further analysis of the cross-sectional Scottish Health Survey 1998 data. SUBJECTS: Nationally representative sample of 9047 adults aged 16-74 y. RESULTS: Body mass index (BMI) was lower in current smokers and higher in ex-smokers (P<0.001) when compared with nonsmokers in the survey population as a whole. After adjustment for confounding factors (age, social class, physical activity and alcohol intake), these differences still remained. However, examination of age categories showed no such differences in BMI between current smokers and nonsmokers in men aged 16-24 y or women aged below 55 y. In the age category 16-24 y, prevalence of cigarette smoking was highest at 51% (men) and 43% (women) in obese subjects and lowest at 35% (men) and 33% (women) in people with BMI of 25-30 kg/m(2). For women current smokers, mean WC and WHR were higher and HC was lower compared with nonsmokers (P<0.001). In men, only HC was lower in current smokers compared with nonsmokers for the entire sample (P<0.001). CONCLUSION: Cigarette smoking is associated with a lower BMI in adults over 24 y particularly in men, but not in younger people. In women, smoking is linked to the development of central adiposity. The gender-related central adiposity of men is not further increased by smoking, but a lower HC could suggest a reduction in muscle mass.     

Increased serotonin receptor density and platelet GPIIb/IIIa activation among smokers

This study sought to determine whether depressive symptoms and/or platelet serotonin receptor (5HT2A) density are associated with increased platelet activation (PA) found among smokers. Flow cytometric detection of PA was used to study 36 smokers and 16 nonsmokers, aged 18 to 48 years. Subjects were tested at baseline and after either smoking 2 cigarettes (smokers) or a similar resting interval (nonsmokers). Assessment of PA included both platelet secretion and fibrinogen receptor (GPIIb/IIIa) binding. Platelet 5HT2A receptor binding and saturation were tested using [3H]LSD, and depressive symptoms were measured using the Beck Depression Inventory. Platelet 5HT2A receptor density was increased among smokers versus nonsmokers (82.7+/-67.7 versus 40.0+/-20.2 fmol/mg protein; P<0.005), and there was a dose-dependent relationship between receptor density and packs/d among smokers. Baseline wound-induced GPIIb/IIIa binding at 1 minute and GPIIb/IIIa binding in response to collagen stimulation in vitro was increased among smokers (P<0.05); there were no changes in PA among smokers after smoking, and platelet secretion was not elevated among smokers. Depressive symptoms were associated with 5HT2A receptor density among nonsmokers (P<0.005), but no such relationship was evident among smokers; PA was unrelated to 5HT2A receptor density in either group. The findings indicate that smoking is associated with increased platelet serotonin receptor density and with increased GPIIb/IIIa receptor binding, although these 2 factors are not related to each other or to depressive symptoms among smokers. Serotonergic dysfunction may be an important factor in the development of cardiovascular disease among smokers.     

The influence of thinness and smoking on bone loss and response to hormone replacement therapy in early postmenopausal women

We studied the influence of thinness and smoking in 153 early postmenopausal women from a 3-yr period, comparing treatments of 1 or 2 mg estradiol with placebo. The baseline body mass index (BMI) was significantly associated with bone resorption (r = -0.26, P < 0.01 for urinary CrossLaps with 21% difference between extreme tertiles) with a consequent association between BMI and bone mineral density (BMD; r = 0.38, P < 0.001 for BMD of hip with 10% difference between extreme tertiles). A low BMI led to an increased rate of loss (r = 0.45, P < 0.01 for BMD of spine), whereas response to treatment with either 1 or 2 mg estradiol was independent of BMI. Smoking was associated with a 4% lower BMD at baseline compared with that in nonsmokers. This effect was additive with that of BMI. For smokers the increase in serum estradiol during hormone replacement therapy was only half of that in nonsmokers. For women treated with placebo or 2 mg estradiol, serum FSH levels were similar in smokers and nonsmokers, but during treatment with 1 mg estradiol, serum FSH was significantly less suppressed in smokers. This was mirrored in the BMD response, where smokers responded similarly to 2 mg estradiol and placebo as did nonsmokers, whereas smokers receiving 1 mg estradiol experienced only half the increase compared to nonsmokers. In conclusion, thinness and smoking are important risk factors for osteoporosis development, but are counteracted by hormone replacement therapy.     

Effect of smoking habit on age-related changes in serum lipids: a cross-sectional and longitudinal analysis in a large Japanese cohort

To observe the effect of smoking habit on age-related serum lipid levels, we examined a large cohort of Japanese cross-sectionally and longitudinally. The participants included 103,648 Japanese men and women 17-94 years of age, who had received annual health examinations from 1989 to 2003. In cross-sectional analysis, total and LDL cholesterol levels of smokers were lower than those of nonsmokers up to an elderly age in men and up to middle age in women. Smoking was associated with decreased HDL cholesterol levels up to the 65-74 years age group in men and 55-64 years in women. The triglyceride levels were higher in smokers in both genders than those of nonsmokers below 55-64 years. In the longitudinal analysis, although smoking was associated with lower total and LDL cholesterol up to 60 years of age in women, beyond the sixties an inverted association was observed. The associations of smoking with lower LDL cholesterol levels in men and lower HDL cholesterol in both genders were fairly consistent at any given age. The increase of triglyceride levels in female smokers remained rather constant between 25 and 75 years, whereas the increase in triglyceride levels in male smokers was greater with older ages up to middle age. These results suggest that the effect of smoking on the serum lipid levels is dependent on age and gender.     

Cyclooxygenase 2 polymorphism and colorectal cancer： -765G〉C variant modifies risk associated with smoking and body mass index

AIM： To explore whether cyclooxygenase 2 （COX-2） -765G〉C polymorphism is associated with susceptibility of colorectal cancer （CRC） and to evaluate the risk of colorectal cancer in relation to environmental exposures and polymorphism. METHODS： We conducted a case-control study of 137 patients with colorectal cancer and 199 cancerfree controls in northeast China. Multivariate logistic regression analysis was performed to calculate the adjusted odds ratio （OR） and 95% confidence interval （95% CI）. RESULTS： The -765G〉C polymorphism was not independently associated with CRC risk. However, risk associated with the polymorphism differed by smoking and body mass index （BMI）. Smoking and BMI associated risks were stronger among those with -765GG genotype, showing that smokers had a 2.682-fold greater risk of CRC than nonsmokers （51/43 vs 68/126, P = 0.006）. Compared to those with a normal body mass index （BMI 18.5-22.9）, those with overweight （BMI 23-24.9） had a 3.909-fold higher risk of CRC （OR = 3.909, 95% CI = 2.081-7.344; P 〈 0.001）, while those with obesity （BMI 〉 25） had a 2.031- fold higher risk of CRC （OR = 1.107, 95% CI = 1.107-3.726; P = 0.022）. is not associated with an increased risk of CRC, -765GG genotype appears to be related to an increased risk in the presence of smoking and higher BMI.     

Smoking, fat mass and activation of the tumor necrosis factor-alpha pathway

OBJECTIVE: Obesity may be associated with increased markers of inflammation that could be triggered by metabolic, physical, infectious or environmental processes. As smoking significantly increases cytokine production, we aimed to study how smoking influences the relationship between fat mass and soluble tumor necrosis factor-alpha (TNF-alpha) receptors 1 and 2 (sTNFR1 and sTNFR2). DESIGN: Cross-sectional, clinical observational study. SUBJECTS: A total of 133 healthy men (age: 27-53 y, body mass index (BMI): 24-30.2 kg/m(2)), 80 of whom were never-smokers and 53 smokers, matched for age, BMI and waist-to-hip ratio. MEASUREMENTS: Circulating soluble fractions of the TNF-alpha receptors sTNFR1 and sTNFR2 were measured to study their relationship with fat mass (bioelectric impedance). RESULTS: Smokers had significantly lower fat mass, lower fasting glucose, insulin and leptin concentrations than nonsmokers. Despite lower fat mass and insulin, smokers showed significantly increased circulating sTNFR2 levels (3.7+/-0.8 vs 3.4+/-0.7 ng/ml, P=0.03). The slopes of the relationships between sTNFR1 and fat mass, and between sTNFR2 and fat mass, were significantly steeper in smokers than in nonsmokers. In a stepwise multiple linear regression analysis, both fat mass (P<0.00001) and smoking (P=0.025) independently contributed to 13% of sTNFR1 variance and to 4% of sTNFR2 variance (P=0.03). CONCLUSION: Both fat mass and smoking are related to increased activity of the TNF-alpha axis.     

Obesity and smoking: relationship with waist circumference and obesity-related disorders in men undergoing a health screening

This study investigated whether smoking habits had a differential influence on waist circumference and obesity-related disorders in nonobese and obese men. We investigated 359 men with smoking habits confirmed by their spouses, including 172 nonobese men (BMI<25) and 187 obese men (BMI>or=25). There were 113 nonobese smokers and 129 obese smokers. Obesity-related disorders were defined as hypertension, dyslipidemia, hyperglycemia, hyperuricemia, or treatment for one or more of these disorders. Nonobese subjects showed no differences of age, BMI, and waist circumference between smokers and nonsmokers, but smokers had a higher incidence of obesity-related disorders. Obese smokers were younger than obese nonsmokers and had a larger waist circumference, but a similar prevalence of obesity-related disorders. The prevalence of obesity-related disorders was similar between obese nonsmokers and smokers, but the smokers were younger. In nonobese subjects, smoking may increase obesity-related disorders by a mechanism other than visceral fat accumulation. In obese subjects, however, smoking may promote visceral fat accumulation. Further investigations will be necessary to better elucidate the relationship between the promotion of visceral fat accumulation in obese subjects by smoking and obesity-related disorders.     

The Platelet Count/Mean Corpuscular Hemoglobin Ratio Distinguishes Combined Iron and Vitamin B<Subscript>12</Subscript> Deficiency from Uncomplicated Iron Deficiency

Combined deficiencies of iron and cobalamin are common. The aims of this study were to investigate the significance of the parameters of the complete blood count (CBC) in differentiating microcytic anemia due to pure iron deficiency anemia (IDA) from anemia due to combined deficiencies of vitamin B(12) and iron (IDA-B12). The study was carried out with 122 patients (100 female) who had microcytic red blood cell indices with IDA-B12 and 105 patients (95 female) with IDA. Group IDA-B12 patients had decreased hemoglobin levels, mean corpuscular volumes, mean corpuscular hemoglobin (MCH) levels, and MCH concentrations but had increased platelet counts (PLT). Using these parameters, we developed a PLT/MCH ratio parameter that has high values when IDA is accompanied by cobalamin deficiency. The cutoff value of >12.00, with a 74.6% sensitivity and a 41.9% specificity, appears to be the most convenient value for screening. We advise measuring the levels of cobalamin in patients with IDA associated with a high PLT/MCH ratio.     

Age-dependent associations of smoking and drinking with non-high-density lipoprotein cholesterol

Serum high-density lipoprotein (HDL) cholesterol levels are influenced by habitual smoking and drinking. Non-HDL cholesterol is known to be a potent predictor of cardiovascular disease. However, it remains to be determined whether the associations of non-HDL cholesterol with smoking and drinking differ with age. The objectives of this study were to investigate relationships among smoking, drinking, and non-HDL cholesterol and to investigate interactions of age with smoking and drinking regarding serum non-HDL cholesterol levels. Subjects (54,020 Japanese men aged 20-69 years) were divided into drinkers and nondrinkers or into smokers and nonsmokers and were further divided into 5 age groups with 10-year intervals. Subjects in each age group were divided into 3 subgroups according to alcohol or cigarette consumption. The mean levels of serum non-HDL cholesterol calculated after adjustment for age and body mass index were compared among the groups. In nondrinkers, non-HDL cholesterol levels of subjects in their 40s or older were significantly higher in heavy smokers than in nonsmokers, whereas non-HDL cholesterol levels of subjects in their 20s and 30s were not significantly different among non-, light, and heavy smokers. In drinkers, non-HDL cholesterol levels of subjects in all age groups were not higher in light and heavy smokers than in nonsmokers. In nonsmokers, non-HDL cholesterol in subjects in their 30s or older was significantly lower in light and heavy drinkers than in nondrinkers, whereas this difference was not observed in subjects in their 20s. In smokers, non-HDL cholesterol levels of subjects in all age groups were significantly lower in light and heavy drinkers than in nondrinkers, and the differences in non-HDL cholesterol between drinkers and nondrinkers tended to increase with advance of age. The difference in non-HDL cholesterol between drinkers and nondrinkers tended to be greater in smokers than in nonsmokers. Thus, the associations of non-HDL cholesterol with smoking and drinking were modified by drinking and smoking, respectively. Smoking is associated with high non-HDL cholesterol in nondrinkers, and drinking is associated with low non-HDL cholesterol in nonsmokers; these associations are shown at middle and elderly ages but not at young ages.     

Effect of smoking on platelet count and platelet parameters: an observation.

Arterial thrombosis occurs with increased frequency in cigarette smokers. It is believed that disturbance of platelet function, especially aggregation, is the essential mechanism responsible for this pathology. However, the effect of smoking on the quantity of platelets might be another contributing factor. The effect of smoking on platelet count is still controversial. We performed a cross section-al study to compare the platelet count and platelet parameters in Thai police who are smokers and non-smokers. A total of 30 Thai police in Bangkok were included in this study. Of the 30 police, there are 5 non-smokers and 25 smokers. The platelet counts and platelet parameters of the subjects were not significantly different between smokers and non-smokers.     

Use of capillary blood count parameters in adults

BACKGROUND AND OBJECTIVES: Capillary samples can provide blood for cell counts in haematologic patients and blood donors. However, some accept only values from venous blood. This study compares capillary and venous blood counts to verify the hypothesis that they are equivalent. MATERIALS AND METHODS: We analysed 463 capillary (fingerstick) and venous blood samples from 428 adults of both sexes (71% haematologic patients, 29% potential blood and apheresis donors). Both samples were taken at the same time from each subject. Haemoglobin (Hb), haematocrit (Hct), white blood cells (WBC), platelets, red blood cells (RBC), mean corpuscular volume (MCV), mean corpuscular Hb (MCH) and mean corpuscular Hb concentration (MCHC) were measured using a haematology analyser (Advia 120, Bayer). RESULTS: Capillary Hb, Hct, WBC, RBC, MCV and MCH were all significantly higher than the venous values [+0.2 mmol/l (+0.3 g/dl), +0.02 l/l (+2%), +0.2 x 10(9)/l, +0.1 x 10(12)/l, +3.1 fl and +0.01 fmol, respectively], whereas the capillary MCHC was lower (-0.6 mmol/l). There was no difference in platelets (-1 x 10(9)/l). Capillary Hb and Hct values were higher in patients with anaemia and polycythaemia, respectively. However, no significant differences occurred in severe thrombocytopenia. CONCLUSION: In adult haematologic patients, however, only the differences in Hb and Hct values may be of clinical relevance. For potential blood and apheresis donors, Hb and platelet screening are equivalent with either capillary and venous blood using a haematology analyser.     

Protein C pathway impairment in nonsymptomatic cigarette smokers

Increased risk of thrombosis in cigarette smokers implies the existence of an underlying prethrombotic state. It is known that oxidative damage to the endothelium surface occurs in chronic smokers. Protein C activation takes place mostly on the endothelium of small vessels and the anticoagulant activity of protein C requires the presence of lipid membranes that are vulnerable to oxidation. Our objective was to analyze the relationship between smoking and plasma levels of activated protein C, protein C zymogen, activated protein C complexed with serpins, total and free protein S, C4b-binding protein, and thrombomodulin, as well as fibrinogen, fibrinopeptide A, and protease-cleaved antithrombin III. Of the 189 plasma donors used in this study 83 were nonsymptomatic smokers (age range 20-44 years, women/men ratio = 1.13) and 106 were healthy nonsmokers (age range 22-59 years, women/men ratio = 1.36). Smokers had 23.3% lower circulating activated protein C than nonsmokers (p = 0.003) and the differences were more pronounced in males than in females. Protein C levels were also significantly lower in smokers than in nonsmokers (p = 0.034). Correlations were negative between the intensity of smoking and circulating activated protein C levels (r = -0.31, p = 0.004) and between smoking and the ratio of activated protein C to protein C zymogen (r = -0.37, p = 0.001). Positive correlations were found between smoking intensity and fibrinogen (r = 0.21, p = 0.042), or fibrinopeptide A (r = 0.219, p = 0.034). Other parameters tested did not show a statistically significant dose-response for the number of cigarettes smoked. Cigarette smoke dose-dependent hypercoagulability due to acquired activated protein C deficiency could contribute to the increased risk of thrombosis in smokers.