Oral contraceptive use and coronary risk factors in women

The relationship between oral contraceptive use and other coronary artery disease risk factors was examined in 215 nonsmoking women grouped as never, current, or previous users. Current oral contraceptive users had higher triglyceride levels (p less than or equal to 0.001) than other groups, higher systolic blood pressure, and lower plasma HDL-cholesterol levels (p less than or equal to 0.05) than previous users. The effect of oral contraceptive use on plasma triglyceride values persists on multivariate regression analysis independently of age, body mass index, dietary sodium and cholesterol intake, cigarette smoking, and level of physical activity. Oral contraceptive use also has an independent relationship to the plasma total cholesterol/HDL- cholesterol ratio. These findings indicate that oral contraceptive use is adversely associated with plasma lipid and lipoprotein values.     

Oral contraceptive use and fasting triglyceride, plasma cholesterol and HDL cholesterol.

Fasting plasma triglyceride, plasma cholesterol and high-density lipoprotein (HDL) cholesterol levels were studied for 190 white women, ages 21--39 years, who were classified according to their oral contraceptive (OC) usage patterns at two community surveys, 3 years apart. The mean level of fasting triglyceride was higher among current OC users (95 mg/100 ml) than among nonusers (73 mg/100 ml) (p = 0.002). After adjustment for the possible confounding effects of age, weight, current cigarette smoking and fasting glucose level, current OC users still had a mean plasma triglyceride level 19 mg/100 ml higher than that of nonusers (p = 0.007). Current OC users also appeared to have somewhat higher levels of total cholesterol which were of borderline significance in crude and adjusted analyses. There was a nonsignificant inverse relationship of OC use with HDL cholesterol levels. Past use did not affect these results, indicating that the OC-induced lipid changes were reversible.     

Effects of cigarette smoking on fasting triglyceride,total cholesterol,and HDL-cholesterol in women

We examined the relationships of cigarette smoking with fasting triglycerides, total cholesterol, and high-density lipoprotein cholesterol (HDL-C) levels among a group of 191 white women aged 20 to 40 years. The mean triglyceride level among current smokers was 100.0 mg/100 ml and among nonsmokers was 68.4 mg/dl (p < 0.005). Mean total cholesterol values among current smokers and nonsmokers were, respectively, 197.0 and 189.1 mg/dl (p < 0.1). Mean HDL-C levels were 45.0 mg/dl among women who were smoking and 52.1 mg/dl among nonsmokers (p < 0.005). Simultaneous adjustments for the effects of age, weight, height, blood glucose, resting pulse, and oral contraceptive use did not materially alter these relationships. A modest portion of the effect of cigarette smoking on risk of coronary heart disease may be explained by an adverse effect of cigarette smoking on blood lipids.     

Leisure time exercise and lipid and lipoprotein levels in an older population

Plasma lipid and lipoprotein levels were measured in 1,019 men and 1,273 women, aged 50 to 89, who were classified according to whether they reported participation in regular strenuous exercise. In men and women, strenuous exercisers had significantly (P less than .01) higher age-adjusted high-density lipoprotein (HDL) cholesterol levels than nonstrenuous exercisers, and male strenuous exercisers also had lower plasma triglyceride levels. Adjusting for differences in cigarette smoking, alcohol consumption, or obesity did not alter these results. A subgroup of 498 consecutive men and 615 consecutive women that completed a more detailed exercise questionnaire were classified into categories of light, moderate, heavy, or no exercise. In men, age-adjusted HDL cholesterol levels were higher and triglyceride levels lower with higher exercise-intensity categories (P for trend less than .001). In the heavy exercise category, HDL cholesterol levels were 15% higher and plasma triglyceride levels were 41% lower than in the sedentary group. In women, HDL cholesterol levels were significantly higher and triglyceride levels lower at the more moderate levels of exercise. In both genders results among exercise-intensity groups did not change after adjusting for age, cigarette smoking, and alcohol consumption. In men, adjusting for obesity did not significantly alter the intergroup differences, whereas in women adjusting for body mass index or waist-to-hip ratio reduced differences in HDL cholesterol levels between exercising and sedentary participants to nonsignificance. We conclude that exercise levels attainable by older adults may significantly improve HDL cholesterol levels and could theoretically reduce the risk of ischemic heart disease.     

Overweight/obesity, smoking, and heavy alcohol consumption are important determinants of plasma PAI-1 levels in healthy men

BACKGROUND: Plasma plasminogen activator inhibitor-1 (PAI-1) is thought to contribute to the pathogenesis of atherosclerosis and is a predictor of ischemic heart disease. METHODS: We investigated the effects of overweight/obesity and lifestyle (smoking and alcohol intake) on plasma PAI-1 levels in 203 healthy men (age 44.5+/-8.1) who visited our department for health check. Information on alcohol intake and smoking habit was obtained by a questionnaire. RESULTS: Plasma PAI-1 was significantly correlated to plasma leptin, body mass index (BMI), percent body fat, plasma levels of triglyceride, and gamma-glutamyl transpeptidase. Plasma PAI-1 was also increased significantly in smokers and in heavy drinkers. Plasma PAI-1 levels increased in an additive manner by the combination of risk factors (BMI > or =25 kg/m2, smoking, and heavy alcohol consumption). Nonobese, nonsmoking, nondrinkers showed the lowest plasma PAI-1 levels, whereas overweight/obese, smoking, heavy drinkers showed the highest levels (11.2+/-2.2 ng/mL versus. 34.0+/-4.3 ng/mL, P < 0.0001). CONCLUSIONS: These results suggest that overweight/obesity and unfavorable lifestyle such as smoking and heavy alcohol consumption may increase plasma PAI-1 levels and might be linked to the risk of ischemic heart disease.     

脂源性激素促酰化蛋白在冠心病患者中的变化及意义

为探讨冠心病患者血浆中脂源性激素促酰化蛋白浓度的变化,并进一步研究促酰化蛋白与冠心病患者血脂变化的相关性,收集冠心病患者62例,正常健康者47例,记录临床资料,包括身高、体重、性别、年龄和血压,采用酶联免疫吸附法检测血浆促酰化蛋白浓度,并用酶法检测总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、载脂蛋白A1和载脂蛋白B100水平.结果发现,冠心病患者促酰化蛋白浓度明显高于正常对照组,差异有显著性(P＜0.05).冠心病组体重指数、血压及血浆总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白及载脂蛋白B100水平与正常对照组相比均存在显著性差异(P＜0.05).冠心病患者血浆促酰化蛋白与体重指数、总胆固醇、甘油三酯、低密度脂蛋白、载脂蛋白B100呈显著正相关(分别为r=0.42,P＜0.01;r=0.36,P＜0.01;r=0.20,P＜0.05;r=0.31,P＜0.05;r=0.45,P＜0.01).结果提示,促酰化蛋白参与了冠心痛患者脂质代谢紊乱的发生,血浆促酰化蛋白水平可作为评估冠心病发病危险因素的一项新指标.     

Analysis of selected risk factors of coronary artery disease in a healthy population aged 35-55 years

BACKGROUND: This report comprises an analysis of results of examinations performed as a part of a cardiovascular disease prevention programme funded by the National Health Fund. AIM: To determine the relationship between body mass index (BMI) and blood pressure, blood glucose and lipid metabolism abnormalities in an ethnically homogeneous population of males and females aged 35 to 55 years with sense of full health without prior diagnosis of cardiovascular disease or diabetes. METHODS: The study was carried out in the population of a 175,000-resident city during 9 months, involving 1080 subjects (696 females and 384 males) aged 35 to 55 years (mean age - 47.2+/-5.4). The following variables were assessed: systolic and diastolic blood pressure, body weight and height, BMI, fasting blood glucose, total cholesterol, triglycerides and HDL cholesterol levels. RESULTS: The studied male population had significantly higher blood pressure, blood glucose, total cholesterol, triglycerides and lower HDL cholesterol levels compared to age-matched females. The female population was found to have a more prominent relationship between increased BMI and blood pressure, blood glucose and serum cholesterol levels than males. Significant differences in favour of females regarding systolic blood pressure, blood glucose and serum cholesterol failed to be present in the obese women subgroup (no statistically significant differences were found compared to obese males). In females aged 45 to 55 years, significantly higher body weight, blood pressure as well as blood glucose, cholesterol and triglyceride levels were observed than in younger women (35-45 years old). CONCLUSIONS: Overweight and obesity are associated with increase of arterial blood pressure, lipid metabolism disturbances and elevation of blood glucose. The relationship between BMI and studied risk factors was influenced by age and gender. Menopause is associated with increasing body weight and unfavourable evolution of studied risk factors.     

Vitamin C, high density lipoproteins and heart disease in elderly subjects.

Plasma vitamin C, total and high density lipoprotein (HDL) cholesterol and cortisol levels were measured in a random sample of 337 elderly subjects living at home in S. Wales; measurements of relative body weight and information about fruit intake, smoking habits and symptoms of cardiovascular disease were also collected. There was a sex difference, over all age groups, in plasma vitamin C and in total HDL cholesterol levels. Plasma vitamin C was strongly correlated with fruit intake in both sexes. Both HDL cholesterol and low and very density lipoprotein (LDL + VLDL) cholesterol levels tended to increase with increasing plasma vitamin C but this reached significance only for the LDL + VLDL fraction. In addition, HDL cholesterol was negatively correlated with Quetelet's index in the women. Symptoms and medication for heart disease did not correlate significantly with plasma vitamin C or with HDL cholesterol levels, but reported angina showed a weak positive association with total cholesterol in the men, and there was some evidence of increased cortisol levels in subjects with heart disease.     

Factors associated with plasma lipids and lipoproteins in type 1 diabetes mellitus: the EURODIAB IDDM Complications Study.

AIM: To assess the determinants and prevalence of hyperlipidaemia in Type 1 diabetic patients in the EURODIAB IDDM Complications Study. METHODS: Standardized questionnaire data were obtained and anthropometric and biochemical measurements performed on 3159 Type 1 diabetic patients, randomly selected from 31 diabetes clinics. Plasma lipid levels were determined centrally, using enzymatic methods RESULTS: Plasma total cholesterol, high-density lipoprotein cholesterol (HDL-C), and HDL subfractions were higher in women than in men, while plasma triglycerides were higher in men (P < 0.001). Total cholesterol, low-density lipoprotein cholesterol (LDL-C) and HDL-C and HDL-C subfractions were, as expected, significantly associated with age and HbA1c in both sexes. Age and HbA1c adjusted values of triglyceride, total cholesterol, LDL-C, HDL-C and HDL3-C in men and triglyceride and HDL2-C in women showed significant associations with central obesity, measured as the waist to hip ratio (WHR). Current smokers had lipid profiles characteristic of insulin resistance in comparison to nonsmokers. Significant positive associations were observed between hypertension and plasma triglycerides, total cholesterol and LDL-C in men and women. In men, degree of physical activity was negatively associated with triglyceride and positively related to HDL-C and HDL3-C. The prevalence of LDL-hypercholesterolaemia (LDL-C > 3.35 mmol/L) was 45% in men and in women, while plasma triglyceride levels > 1.7 mmol/L were observed in 12% of men and 8% of women. CONCLUSION: The results of this study indicate that lipid levels in Type 1 diabetic patients are strongly influenced by smoking habit and central obesity in a way that is characteristic of the insulin resistance syndrome.     

Obesity increases the risk of development of atherosclerosis in elderly type 2 diabetic patients*

Background: Obesity has been suggested to have no effect on the rates of mortality from cerebro‐ and cardiovascular diseases in the elderly. The purpose of the present study was to determine whether obesity influences atherosclerotic risk factors in elderly diabetic patients. Methods: The relationships between body mass index (BMI) and representative atherosclerotic risk factors were investigated using data from patients with type 2 diabetes who were aged from 65 to 91 years (mean ± standard deviation, 72.3 ± 5.2 years). Results: BMI significantly correlated with systolic and diastolic arterial pressures and serum triglyceride, uric acid and sialic acid levels. BMI also showed significant negative correlations with duration of diabetes and serum HDL cholesterol levels. Multiple regression analysis using BMI as a target variable and age, sex, duration of diabetes, mean arterial pressure, serum uric acid and triglyceride as explanatory variables showed that BMI significantly correlated with arterial pressure and serum triglyceride level (R = 0.459). After adjustment for history of drug therapy for each disease (hypertension, dyslipidemia or hyperuricemia), BMI also significantly correlated with arterial pressure, serum triglyceride, HDL cholesterol and uric acid levels. In the subjects with BMI of 25 or over, the mean levels of systolic and diastolic arterial pressures, serum triglyceride and sialic acid were higher and the mean level of serum HDL cholesterol was lower, after adjustment for age and sex, than those in the subjects with BMI below 22. Conclusion: These results suggest that obesity is related to arterial pressure, blood lipid and uric acid levels and increases the risk of development of atheroclerosis in elderly diabetic patients.     

Prevalence of high plasma triglyceride combined with low HDL-C levels and its association with smoking, hypertension, obesity, diabetes, sedentariness and LDL-C levels in the Canadian population. Canadian Heart Health Surveys Research Group.

OBJECTIVE: To report the associations of plasma triglyceride, high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) with nonlipid coronary artery disease risk factors. In particular, the associations for persons with high triglyceride and low HDL-C levels were examined. DESIGN: A stratified random probability sample of 29,855 men and women aged 18 to 74 years from the Canadian Heart Health Surveys (1986 to 1992) in 10 provinces. Blood samples were obtained from 18,555 participants who had fasted for 8 h or more. Plasma lipids were determined at the J Alick Little Lipid Research Laboratory, Toronto, Ontario, with standardization of the Centers for Disease Control Lipid Standardization Program, Atlanta. OUTCOME MEASURES: Fasting plasma total cholesterol, triglyceride, LDL-C and HDL-C levels. MAIN RESULTS: The prevalence of men with triglyceride levels above 1.7 mmol/L and HDL-C levels below 0.9 mmol/L was 10%, compared with 3% for men with triglyceride levels below 1.7 mmol/L and HDL-C levels below 0.9 mmol/L. The prevalence of women with triglyceride levels above 1.7 mmol/L and HDL-C levels below 0.9 mmol/L was 3% compared with a prevalence of less than 1% for women with triglyceride levels below 1.7 mmol/L and HDL-C levels below 0.9 mmol/L. Even when plasma LDL-C was low at less than 3.4 mmol/L, there was an age trend for increasing prevalences of the combination of triglyceride levels 2.3 mmol/L or greater and HDL-C levels less than 0.9 mmol/L in both sexes. The prevalence of a triglyceride levels 2.3 mmol/L or greater combined with an HDL-C level below 0.9 mmol/L was increased in groups who were cigarette smokers, diabetic, hypertensive, obese or sedentary, or who had higher LDL-C levels in both sexes, and the increase was even greater in the presence of two or more of these other risk factors. CONCLUSIONS: Among men or women with low HDL-C and high triglyceride levels, smoking, diabetes, sedentariness, hypertension and obesity were much more prevalent than among those at low risk with high HDL-C and low triglyceride levels.     

Dubbo Study of the elderly: hypertension and lipid levels.

Untreated hypertension in age groups below 60 years has been shown to be associated with significant elevations in serum cholesterol and triglyceride levels. Drug therapy of hypertension has also been shown to have adverse effects on lipoproteins. We have investigated lipid and lipoprotein levels in a community-based sample of men and women 60 years and older belonging to one of the following groupings: (a) normal blood pressure (n = 1075); (b) untreated hypertension (n = 329); (c) drug-treated hypertension (n = 880). Serum lipid, lipoprotein, apolipoprotein or plasma glucose levels did not vary significantly between untreated hypertensives and normotensives of either sex. In a multiple regression model controlling for possible influences of age, overweight, alcohol and tobacco usage, and presence of coronary heart disease, anti-hypertensive drug therapy significantly predicted increased serum triglycerides (P less than 0.001) and reduced high density lipoprotein (HDL) cholesterol levels (P less than 0.01) in both sexes, reduced apolipoprotein A-I levels in males (P less than 0.001), and increased apolipoprotein B (P less than 0.01) and plasma glucose levels (P less than 0.001) in females. Adjusted triglycerides were 20% higher and HDL cholesterol was 7% lower in the presence of anti-hypertensive drug therapy. These effects were partially consistent with the known actions of thiazide diuretics and beta-blockers which were used by more than 50% and 40% of subjects, respectively.     

A study in the relationships between leptin, insulin, and body fat in Asian subjects

OBJECTIVE: To study the relationship of leptin concentrations with indices of obesity, fasting insulin, insulin resistance and lipid profiles (total cholesterol, low density lipoprotein (LDL)-cholesterol, high density lipoprotein (HDL)- cholesterol and triglyceride) in an Asian cohort. DESIGN: Cross sectional study. SUBJECTS: A total of 133 healthy volunteers were enrolled (64 female: age: 25-61 y, body mass index (BMI): 18.7-45.1 kg/m2 and 69 male: age: 25-61 y, BMI: 19.3-35.0 kg/m2). MEASUREMENTS: Weight, height, waist and hip circumferences, blood pressure, lean body mass (by bioelectric impedence analysis (BIA)), plasma leptin and lipid profiles were taken after a 10 h fast. RESULTS: Percentage of body fat measured by bioelectric impedance was the strongest determinant of plasma leptin (r = 0.844, P < 0.0001). Females had higher leptin concentrations than males for the same fat mass. In a multiple linear regression model, body fat percentage, (percentage body fat* gender), hip circumference and fasting insulin were significant determinants of leptin concentration (r = 0.882, P < 0.0001). CONCLUSION: Leptin concentration correlated closely with percentage body fat in Asian subjects. Hip circumference as a corollary for peripheral obesity, was better associated with leptin than waist circumference or waist-to-hip ratio (WHR). Distribution of fat in females tended to be peripheral and may partly explain the gender difference. Fasting insulin level and central obesity were correlated with HDL-cholesterol, triglyceride and blood pressure, while fasting leptin had little correlation with these metabolic parameters. Therefore, insulin resistance was a better guide to cardiovascular risk assessment than plasma leptin.     

上海市心血管病主要危险因素变化趋势分析

目的：评价上海地区人群心血管病主要危险因素的变化趋势。方法：采用重复横断面调查的方法,1992、1995、1996和1999年共4次对上海市某工厂人群进行心血管病主要危险因素调查,共1118人,对收缩压、舒张压、体重指数、高血压的患病率和吸烟情况的变化趋势进行了分析。结果：（1）1992年人群基线心血管病危险因素如血压、吸烟率、血清总胆固醇、甘油三酯、HDL－胆固醇、腰臀比、体重指数结果与MONICA北京的地区监测结果相近。（2）无论男性或女性,收缩压和舒张压水平均呈上升趋势。男性收缩压平均升高12.3mmHg, 舒张压平衡升高6.4mmHg;女性依次为11.5mmHg和4.9mmHg;（3）男性高血压患病率呈上升趋势;女性变化趋势不明显。（4）男性与女性体重指数各年度比较均无显著性差异,无逐渐肥胖的倾向。（5）男性吸烟率一直维持在较高水平,1996年较1992年有明显下降,1996至1999年下降趋势不明显;女性吸烟率维持在较低水平,趋势平稳。结论：上海地区应重视吸烟和高血压的预防控制。     

Transitions of cardiovascular risk from adolescence to young adulthood--the Bogalusa Heart Study: I. Effects of alterations in lifestyle

Adolescence and young adulthood represents a transition period for biologic and lifestyle characteristics. In a preliminary investigation of young adults (ages 18-20 years), the Bogalusa Heart Study documented patterns of alcohol, tobacco, and oral contraceptive use, as well as changes in education, occupational, marital and parenting status. Such behaviors accelerate the cardiovascular disease process and may differentially influence risk factor patterns of race and sex groups. Adverse levels of systolic blood pressure and alpha-lipoprotein cholesterol were more frequent in married vs single men; elevated triglyceride levels were more frequent in married vs single whites. However adverse levels of beta- and alpha-lipoprotein cholesterol were more frequent in nonparents than in parents. Cigarette smoking and oral contraceptive use were independently related to elevated beta-lipoprotein cholesterol and decreased alpha-lipoprotein cholesterol levels of young white women. Alcohol consumption was highest among white males, with 32% reporting daily consumption of the equivalent of two or more beers or one mixed drink. Alcohol consumption was negatively correlated with blood pressure in white males and positively correlated with alpha-lipoprotein cholesterol in black males. Since such lifestyle factors are related to physiologic risk factors that result in heart disease and adult cardiovascular morbidity and mortality in the older ages, early targeting during adolescence and young adulthood is important.     

Coronary Risk Factors in a Rural Community Which Includes Aborigines: lnverell Heart Disease Prevention Programmed

Abstract: A coronary risk factor screening and referral service was established in Inverell, New South Wales, in July 1978. In non-Aboriginal subjects, there was an increasing prevalence of coronary risk factors with age (hyperlipi-daemia, hypertension and obesity), except for cigarette smoking which showed a reverse trend. Allowing for minor differences in sampling, the average level of plasma chalesterol, blood pressure and cigarette smoking in rural Inverell closely resembled that in Sydney. However, Inverell subjects of both sexes were consistently more overweight at all ages. Aboriginal subjects of both sexes showed an increased prevalence of hypertriglyceri-daemia and cigarette smoking compared with non-Aboriginal subjects, whilst hypertension and obesity were also more prevalent in the Aboriginal females. High coronary risk Inverell subjects sustained significant improvements in serum cholesterol, cigarette smoking and body weight levels over one year of follow-up. Community-wide control of hypertension was initially unsatisfactory and this remained so .     

Cigarette smoking, alcohol intake, and oral contraceptives: relationships to lipids and lipoproteins in adolescent school-children.

The effects of cigarette smoking, alcohol intake, and oral contraceptives on plasma cholesterol, triglyceride, high density lipoprotein cholesterol (C-HDL), and low density lipoprotein cholesterol (C-LDL) were assessed in 965 12--19-year-old school-children in the Cincinnati Lipid Research Clinic's Princeton school survey. After pair matching for age, sex, race, and total plasma cholesterol, adolescent children who smoked had mean C-HDL 6.1 mg/dl lower, and mean C-LDL 4.1 mg/dl higher, than nonsmokers (p less than 0.01). These findings for C-HDL were replicated by covariance analysis, adjusting for age, race, sex, alcohol intake, and triglyceride levels. Adolescents who drank alcohol had higher C-HDL and triglyceride levels and lower C-LDL than nondrinkers, but the differences were not significant. Adolescent females taking oral contraceptives had higher triglyceride, C-HDL, and C-LDL levels than matched controls, but the differences were not significant. If a portion of smoking's contribution to coronary heart disease risk is mediated through its inverse association with C-HDL, and if smoking habits initiated in adolescence continue into adulthood, this report provides additional physiologic data relevant to programs designed to prevent, reduce, or stop cigarette smoking in the adolescent years.     

Differential indicators of diabetes-induced oxidative stress in New Zealand White rabbits: role of dietary vitamin E supplementation

Determination of reliable bioindicators of diabetes-induced oxidative stress and the role of dietary vitamin E supplementation were investigated. Blood (plasma) chemistries, lipid peroxidation (LPO), and antioxidant enzyme activities were measured over 12 weeks in New Zealand White rabbits (control, diabetic, and diabetic + vitamin E). Cholesterol and triglyceride levels did not correlate with diabetic state. Plasma LPO was influenced by diabetes and positively correlated with glucose concentration only, not cholesterol or triglycerides. Liver glutathione peroxidase (GPX) activity negatively correlated with glucose and triglyceride levels. Plasma and erythrocyte GPX activities positively correlated with glucose, cholesterol, and triglyceride concentrations. Liver superoxide dismutase activity positively correlated with glucose and cholesterol concentration. Vitamin E reduced plasma LPO, but did not affect the diabetic state. Thus, plasma LPO was the most reliable indicator of diabetes-induced oxidative stress. Antioxidant enzyme activities and types of reactive oxygen species generated were tissue dependent. Diabetes-induced oxidative stress is diminished by vitamin E supplementation.     

Plasma leptin is independently associated with the intima-media thickness of the common carotid artery.

OBJECTIVE: To investigate whether intima-media thickness (IMT) of the common carotid artery (CCA), an early marker of asymptomatic atherosclerosis, is significantly and independently associated with plasma concentrations of leptin, an adipose tissue hormone that has recently been proposed as a cardiovascular risk factor in obese patients. DESIGN: Cross-sectional sample of normal-weight and obese men and women. SUBJECTS: One-hundred and twenty healthy subjects (52 men and 68 women), aged 18-45 y and with a wide range of BMI, were recruited for the study. MEASUREMENTS: Fasting plasma leptin concentrations and the IMT of the CCA were measured in all subjects. Leptin concentrations were measured by radioimmunoassay and the IMT of the CCA was quantified by high resolution B-mode ultrasound imaging. Central fat (measured by waist circumference), smoking habits, blood pressure, insulin sensitivity (measured by the insulin tolerance test), and fasting plasma glucose, insulin and lipid pattern (cholesterol, HDL-cholesterol, triglycerides, LDL-cholesterol) were also measured. RESULTS: IMT of the CCA was positively correlated with log leptin concentrations (P<0.005 in men and P<0.001 in women), body mass index (P<0.001 in men and women), waist circumference (P<0.001 in men and women), age (P<0.001 in men and P<0.05 in women), and negatively associated with insulin sensitivity in both sexes (P<0.05). IMT was also directly correlated with cholesterol (P<0.05), LDL-cholesterol (P<0.01) and systolic blood pressure in men (P<0.05), and with diastolic blood pressure levels in women (P<0.05). When a multiple linear regression model was used without body mass index (BMI), the correlation between leptin and IMT was maintained in both men (P<0.01) and women (P<0.005), independent of age, insulin sensitivity, smoking habits, systolic blood pressure, fasting glucose, triglycerides, cholesterol, LDL-cholesterol and HDL-cholesterol. By contrast, BMI-adjusted leptin concentrations were not significantly associated with IMT (Pc (partial correlation): 0.41 in men and 0.15 in women). Moreover, when BMI was entered into a multiple linear regression model without leptin, the correlation between BMI and IMT was maintained in both men (P<0.005) and women (P<0.01), independent of the same parameters. CONCLUSION: Plasma leptin concentrations are independently associated with the IMT of the CCA, suggesting that the increase of adipose tissue mass (or leptin per se) may have an unfavourable influence on the development of atherosclerosis. However, the association between IMT and leptin seems to be dependent and/or confounded by the relationship between IMT and obesity.     

Relationship of cigarette smoking to blood pressure and serum lipids

The relationship between cigarette smoking and blood pressure and serum lipids was studied in 1775 men aged 20-59 years, in non-drinkers and drinkers separately, controlling for body mass index and physical fitness (VO2max). While systolic blood pressure was not associated with cigarette smoking, diastolic blood pressure decreased with increasing levels of cigarette smoking in non-drinkers but not in drinkers. Total cholesterol was inversely associated with smoking cigarettes in drinkers and was not associated in non-drinkers. High density lipoprotein (HDL)-cholesterol decreased with an increasing degree of cigarette consumption in non-drinkers but not in drinkers. An increase in total cholesterol/HDL-cholesterol ratio and triglyceride levels was positively associated with smoking cigarettes regardless of drinking habit. The present study suggests that cigarette smoking is a cardiovascular risk factor, partly due to its effect of increasing the atherogenic index, but it remains to be consolidated whether chronic smoking has an effect of lowering diastolic blood pressure.