Smoking Status and Metabolic Syndrome in the Multi-Ethnic Study of Atherosclerosis. A cross-sectional study
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Hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Université P. & M. Curie, Faculté de médecine, Paris, France
Center for Family and Community Medicine, Columbia University, New York, NY, USA
Johns Hopkins University School of Medicine, Baltimore, MD, USA
Wake Forest University School of Medicine, Winston-Salem, NC, USA
Submission date: 2012-03-30
Acceptance date: 2012-06-09
Publication date: 2012-06-20
Corresponding author
Ivan Berlin   

Hôpital Pitié-Salpêtrière, Assistance publique-Hôpitaux de Paris, Université P. & M. Curie, Faculté de médecine, INSERM 894, Paris, France
Tobacco Induced Diseases 2012;10(June):9
Current smoking is associated with type 2 diabetes mellitus and impaired glucose tolerance but its association with the metabolic syndrome (metS), particularly with sufficiently sampled African American representation, has not been clearly established.

To assess whether a) metS is associated with smoking; b) any increased risk of metS among smokers is independent of body mass index (BMI) compared with non-smokers; c) smoking status is differentially associated with the metS and its components across different ethnic groups.

Cross sectional analysis of the Multi-Ethnic Study of Atherosclerosis (MESA) a community populationbased sample free of cardiovascular disease.

Current smokers (N = 769) had higher risk of metS (odds ratio [OR, 95% confidence interval]: 1.4, 1.1-1.7) versus never (reference, N = 2981) and former smokers (1.0, 0.8-1.1, N = 2163) and for metS components: high waist circumference (WC) (OR:1.9, 1.2-2.1), low high density lipoprotein cholesterol (HDL-C) (1.5, 1.3-1.8), elevated plasma triglycerides (TG) (OR:1.4, 1.2-1.7) as well as high C-reactive protein (CRP, an inflammatory marker) concentration (OR: 1.6,1.3-2.0) compared to never and former smokers after adjustment for BMI. A smoking status by ethnicity interaction occurred such that African American current and former smokers had greater likelihood of low HDL-C than White counterparts.

This study found that smoking is associated with the metS and despite the lower BMI of current smokers the prevalence of low HDL-C, elevated TG and CRP is higher among them than among non-smokers. African Americans generally have higher HDL-C than Whites but smoking wipes out this advantage. Multi-Ethnic Study of Atherosclerosis (MESA) Identifier: NCT00005487

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