Association between alpha1-antitrypsin (α1-AT) levels, lipid profile and ventilatory pulmonary function in predicting the cardiovascular risk in simptomatic smokers
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Hospital of Pneumophthisiology, Pneumology, Romania
'Victor Babes' University of Medicine and Pharmacy, Pneumology, Romania
Pneumophthisiology Hospital, Pneumology, Romania
University Hospital for Infectious Diseases, Infectious Diseases, Romania
'Gr. T. Popa' University of Medicine and Pharmacy, Pneumology, Romania
Publication date: 2018-03-01
Tob. Induc. Dis. 2018;16(Suppl 1):A284
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Cigarette smoke oxidants can cause oxidative inactivation of methionine residues of α1-AT, leading to lipid binding, with dyslipidemia, inflammation and endothelial dysfunction, the early stage of atherosclerosis. The aim of the study was to assess the relationship between serum α1-AT levels, pulmonary function and lipids in predicting the risk of cardiovascular disease among symptomatic smokers adult subjects in an Out-patient Pulmonology Health Unit.

100 respiratory symptomatic adults mean aged 53.34±9.69 year-old, were grouped in smokers (current and former heavy smokers) (n=64) and nonsmokers (n=36). Demographic, anthropometric, pack-years smoking, serum α1-AT, plasma lipid profile {(total cholesterol-TC, low density lipoprotein cholesterol-LDLc, high density lipoprotein cholesterol-HDLc, triglycerides-TG, nonhigh density lipoprotein cholesterol-nonHDLc, very low density lipoprotein cholesterol-VLDL), by which were calculated lipid indices}, were performed. All subjects underwent spirometry according to the international recommendations. Lung function was expressed as forced vital capacity (FVC% predicted), forced expiratory volume in one second (FEV1% predicted), Forced Expiratory volume in 1 second/Forced Vital Capacity ratio (FEV1/FVC% predicted). Cardiovascular disease risk was evaluated through Framingham Risk Score (FRS). Statistical analysis included Spearman correlations tests and one-way ANOVA test.

α1-AT (p=0.008), FEV1 (p=0.008), FVC (p=0.03) was significantly lower, while LDLc/HDLc ratio (p=0.01), Atherogenic Index of Plasma (AIP) (p=0.04), FRS (p=0.003) increased in smokers versus nonsmokers. In smokers, statistically significant correlations were found between α1-AT and FVC (r=-0.26;p=0.03); FEV1/FVC ratio (r=0.30;p=0.01); TC (r=0.35;p=0.003); LDLc (r=0.27; p=0.02); nonHDLc (r=0.26;p=0.03).

α1-AT interacts with lipid oxidation pathways, decreasing in smokers. A better understanding of the relationships between smoking, oxidative modifications of α1-AT, lung function and, lipid profile can better predict the risk of heart disease. Smoking is a modifiable health risk factor and tobacco cessation may prevent the occurence of cardiovascular diseases.