Diabetes & Metabolic Syndrome: Clinical Research & Reviews 9 (2015) 180–182
Contents lists available at ScienceDirect
Diabetes & Metabolic Syndrome: Clinical Research & Reviews journal homepage: www.elsevier.com/locate/dsx
Original Article
Relationships between the smoking status and plasma fibrinogen, white blood cell count and serum C-reactive protein in Japanese workers Tomoyuki Kawada * Department of Hygiene and Public Health, Nippon Medical School, Japan
A R T I C L E I N F O
A B S T R A C T
Keywords: Fibrinogen White blood cell count C-reactive protein Smoking
Objective: Confirmation of the association between smoking status and biological inflammatory or anticoagulant markers is required in the field of occupational therapy to promote anti-smoking education. The associations between the smoking status and biological markers were clarified. Methods: The study was performed in 5102 working men aged 30–60 years old. The author measured the plasma fibrinogen, white blood cell count (WBC) and serum high-sensitivity C-reactive protein (CRP) as biomarkers of the smoking status. Results: After adjustment for age, the mean plasma fibrinogen level in never-smokers was significantly lower than that in current smokers. The mean WBC count was also significantly lower in the neversmokers than that in current smokers and ex-smokers who had quit within the previous 1 year. Furthermore, the mean log-transformed serum CRP value in never-smokers was significantly lower than that in current smokers smoking 20 cigarettes daily. Spearman’s rank correlation coefficients between the plasma fibrinogen and the serum CRP and WBC were 0.561 and 0.243, respectively. The mean plasma fibrinogen, serum CRP and WBC count in the ex-smokers showed a trend toward decreasing as the duration of abstinence became longer. Conclusion: Among the three biomarkers, the plasma fibrinogen was the most strongly associated with the smoking status, its value being to be the highest in current smokers smoking 20 cigarettes daily. The same trend was also observed for the WBC count. ß 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.
1. Introduction Plasma fibrinogen plays an essential role in blood coagulation, and is reported to be associated with the development of coronary, peripheral and cerebral vascular disease [1–3]. According to some epidemiological studies, increased plasma fibrinogen concentration is an independent risk factor for future cardiovascular events [4–7] and stroke [8,9]. Serum C-reactive protein (CRP) has been used as a surrogate marker of CVD [10,11], and combination of serum CRP and plasma fibrinogen has been shown to be associated with all-cause mortality and CVD mortality [12]. Cigarette smoking is one of the known risk factors for coronary heart disease [13] and stroke [14], especially in women [15]. No
* Correspondence to: Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bukyo-Ku, Tokyo 113-8602, Japan. Tel.: +81 3 3822 2131; fax: +81 3 5685 3065. E-mail address: [email protected] http://dx.doi.org/10.1016/j.dsx.2015.02.010 1871-4021/ß 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.
interaction has been reported between age and plasma fibrinogen [16]. In this study, the plasma fibrinogen, serum CRP and WBC count in non-smokers, ex-smokers and current smokers were compared, with special emphasis on the number of cigarettes smoked per day in current smokers and the duration of abstinence in ex-smokers. It was expected that the results would contribute to health education for smoking cessation. 2. Subjects and methods 2.1. Study population A total of 5862 male workers of a car-manufacturing company in Japan who attended an annual health examination in 2014 were enrolled in the study. A self-administered questionnaire was used to record the history of tobacco smoking. Smoking status was categorized as ‘‘never-smoker’’, ‘‘past smoker’’ or ‘‘current smoker’’. Subjects with
T. Kawada / Diabetes & Metabolic Syndrome: Clinical Research & Reviews 9 (2015) 180–182
181
Table 1 Body mass index and biological markers in subjects categorized according to the smoking status. Variables
Never
Past
Contents lists available at ScienceDirect
Diabetes & Metabolic Syndrome: Clinical Research & Reviews journal homepage: www.elsevier.com/locate/dsx
Original Article
Relationships between the smoking status and plasma fibrinogen, white blood cell count and serum C-reactive protein in Japanese workers Tomoyuki Kawada * Department of Hygiene and Public Health, Nippon Medical School, Japan
A R T I C L E I N F O
A B S T R A C T
Keywords: Fibrinogen White blood cell count C-reactive protein Smoking
Objective: Confirmation of the association between smoking status and biological inflammatory or anticoagulant markers is required in the field of occupational therapy to promote anti-smoking education. The associations between the smoking status and biological markers were clarified. Methods: The study was performed in 5102 working men aged 30–60 years old. The author measured the plasma fibrinogen, white blood cell count (WBC) and serum high-sensitivity C-reactive protein (CRP) as biomarkers of the smoking status. Results: After adjustment for age, the mean plasma fibrinogen level in never-smokers was significantly lower than that in current smokers. The mean WBC count was also significantly lower in the neversmokers than that in current smokers and ex-smokers who had quit within the previous 1 year. Furthermore, the mean log-transformed serum CRP value in never-smokers was significantly lower than that in current smokers smoking 20 cigarettes daily. Spearman’s rank correlation coefficients between the plasma fibrinogen and the serum CRP and WBC were 0.561 and 0.243, respectively. The mean plasma fibrinogen, serum CRP and WBC count in the ex-smokers showed a trend toward decreasing as the duration of abstinence became longer. Conclusion: Among the three biomarkers, the plasma fibrinogen was the most strongly associated with the smoking status, its value being to be the highest in current smokers smoking 20 cigarettes daily. The same trend was also observed for the WBC count. ß 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.
1. Introduction Plasma fibrinogen plays an essential role in blood coagulation, and is reported to be associated with the development of coronary, peripheral and cerebral vascular disease [1–3]. According to some epidemiological studies, increased plasma fibrinogen concentration is an independent risk factor for future cardiovascular events [4–7] and stroke [8,9]. Serum C-reactive protein (CRP) has been used as a surrogate marker of CVD [10,11], and combination of serum CRP and plasma fibrinogen has been shown to be associated with all-cause mortality and CVD mortality [12]. Cigarette smoking is one of the known risk factors for coronary heart disease [13] and stroke [14], especially in women [15]. No
* Correspondence to: Department of Hygiene and Public Health, Nippon Medical School, 1-1-5 Sendagi, Bukyo-Ku, Tokyo 113-8602, Japan. Tel.: +81 3 3822 2131; fax: +81 3 5685 3065. E-mail address: [email protected] http://dx.doi.org/10.1016/j.dsx.2015.02.010 1871-4021/ß 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.
interaction has been reported between age and plasma fibrinogen [16]. In this study, the plasma fibrinogen, serum CRP and WBC count in non-smokers, ex-smokers and current smokers were compared, with special emphasis on the number of cigarettes smoked per day in current smokers and the duration of abstinence in ex-smokers. It was expected that the results would contribute to health education for smoking cessation. 2. Subjects and methods 2.1. Study population A total of 5862 male workers of a car-manufacturing company in Japan who attended an annual health examination in 2014 were enrolled in the study. A self-administered questionnaire was used to record the history of tobacco smoking. Smoking status was categorized as ‘‘never-smoker’’, ‘‘past smoker’’ or ‘‘current smoker’’. Subjects with
T. Kawada / Diabetes & Metabolic Syndrome: Clinical Research & Reviews 9 (2015) 180–182
181
Table 1 Body mass index and biological markers in subjects categorized according to the smoking status. Variables
Never
Past
