超重和肥胖男性吸烟与血清脂蛋白相关磷脂酶A2的相关性

Correlation between smoking and serum lipoprotein-associated phospholipase A2 level in overweight and obese men

目的:脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,Lp-PLA2)是一种具有血管特异性的炎症标志物,通过炎症反应加剧动脉粥样硬化,可用于预测不良心血管事件的发生及评估心血管疾病残余风险。本研究探讨超重和肥胖男性吸烟与血清Lp-PLA2水平的相关性,旨在为心血管疾病的预防提供依据。方法:选取2020年5月1日至2021年4月30日在中南大学湘雅三医院健康管理中心参加健康体检的男性为研究对象,应用健康体检自测量表收集吸烟情况等信息。根据吸烟状态分为从不吸烟组、现在吸烟组、吸烟已戒组和被动吸烟组。根据每日吸烟量将现在吸烟组分为<10支组、10~20支组、21~30支组和>30支组;根据吸烟年限将现在吸烟组分为<5年组、5~10年组、11~20年组和>20年组。对不同吸烟情况组的血清Lp-PLA2水平及其他临床指标进行检测并比较,采用logistic回归分析超重和肥胖男性吸烟与血清Lp-PLA2水平的关系。结果:现在吸烟组血清Lp-PLA2水平显著高于从不吸烟组(P<0.05)。Logistic回归分析显示:在未校正其他影响因素时,从吸烟状态来看,与从不吸烟组相比,现在吸烟组(OR=1.81,95%CI:1.27~2.58,P<0.01)和吸烟已戒组(OR=2.09,95%CI:1.12~3.90,P<0.05)均与血清Lp-PLA2水平呈正相关,而被动吸烟组与血清Lp-PLA2水平无相关性(OR=1.27,95%CI:0.59~2.73,P>0.05);从每日吸烟量来看,与从不吸烟组相比,10~20支组(OR=2.09,95%CI:1.40~3.12,P<0.001)和21~30支组(OR=1.98,95%CI:1.22~3.20,P<0.01)均与血清Lp-PLA2水平呈正相关,而<10支组(OR=1.45,95%CI:0.81~2.60,P>0.05)和>30支组(OR=1.17,95%CI:0.60~2.28,P>0.05)均与血清Lp-PLA2水平无相关性;从吸烟年限来看,与从不吸烟组相比,5~10年组(OR=1.94,95%CI:1.07~3.53,P<0.05)、11~20年组(OR=2.06,95%CI:1.33~3.18,P<0.01)、>20年组(OR=1.66,95%CI:1.11~2.47,P<0.05)均与血清Lp-PLA2水平呈正相关,而<5年组与血清Lp-PLA2水平无相关性(OR=1.12,95%CI:0.38~3.33,P>0.05)。校正年龄等指标后,上述吸烟分组中除吸烟年限5~10年组与血清LpPLA2水平相关性变为差异不具有统计学意义外(OR=1.77,95%CI:0.95~3.29,P>0.05),其他分组与血清Lp-PLA2水平的相关性均同校正前。结论:超重和肥胖男性吸烟与血清Lp-PLA2水平具有相关性。

Objective:Lipoprotein-associated phospholipase A2(Lp-PLA2)is a vaso-specific inflammatory marker that exacerbates atherosclerotic through inflammatory responses.It can be used to predict the occurrence of adverse cardiovascular events and to assess the residual risk of cardiovascular diseases.This study aims to investigate the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men,and to provide evidence for preventing the cardiovascular diseases.Methods:Male subjects,who participated in health examination at the Health Management Center,Third Xiangya Hospital,Central South University from May 1,2020 to April 30,2021,were selected.The smoking status and other information were collected by the Self-test Scale of Physical Examination.According to the smoking status,they were divided into a never-smoking group,a current smoking group,a quit smoking group and a passive smoking group.According to the daily smoking amount,the current smoking subjects were divided into a<10 cigarettes group,a 10 to 20 cigarettes group,a 21 to 30 cigarettes group,and a>30 cigarettes group.According to the smoking years,the current smoking subjects were divided into a<5 years group,a 5 to 10 years group,a 11 to 20 years group,and a>20 years group.Serum Lp-PLA2 levels and other clinical indexes in different smoking groups were measured and compared,the correlation between smoking and serum Lp-PLA2 levels in overweight and obese men was analyzed by logistic regression analysis.Results:Serum Lp-PLA2 levels were significantly different between the never-smoking group and the current smoking group(P<0.05).Logistic regression analysis showed that,before adjusting other influencing factors and in terms of smoking status,the current smoking group(OR=1.81,95%CI 1.27 to 2.58,P<0.01)and the quit smoking group(OR=2.09,95%CI 1.12 to 3.90,P<0.05)were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group,while the passive smoking group had no correlation with serum Lp-PLA2 levels(OR=1.27,95%CI 0.59 to 2.73,P>0.05).In terms of daily smoking amount,the 10 to 20 cigarettes group(OR=2.09,95%CI 1.40 to 3.12,P<0.001)and the 21 to 30 cigarettes group(OR=1.98,95%CI 1.22 to 3.20,P<0.01)were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group,while the<10 cigarettes group(OR=1.45,95%CI 0.81 to 2.60,P>0.05)and the>30 cigarettes group(OR=1.17,95%CI 0.60 to 2.28,P>0.05)had no correlation with serum Lp-PLA2 levels.In terms of smoking years,the 5 to 10 years group(OR=1.94,95%CI 1.07 to 3.53,P<0.05),the 11 to 20 years group(OR=2.06,95%CI 1.33 to 3.18,P<0.01),and the>20 years group(OR=1.66,95%CI 1.11 to 2.47,P<0.05)were positively correlated with serum Lp-PLA2 levels compared with the never-smoking group,while the<5 years group had no correlation with serum Lp-PLA2 levels(OR=1.12,95%CI 0.38 to 3.33,P>0.05).After adjusting for age and other indicators,the correlation between smoking years and serum Lp-PLA2 levels was the same as before adjustment among the above smoking groups,except that the correlation between the smoking 5 to 10 years group and serum Lp-PLA2 levels was not significant(OR=1.77,95%CI 0.95 to 3.29,P>0.05).Conclusion:Smoking is correlated with serum Lp-PLA2 levels in overweight and obese men.