Regular articleThe effects of cessation from cigarette smoking on the lipid and lipoprotein profiles: a meta-analysis
Introduction
Cigarette smoking is widely accepted as a major risk factor for the development of cardiovascular disease [1]. Several possible explanations have been proposed for this association, including altered blood coagulation, impaired integrity of the arterial wall, and changes in blood lipid concentrations [2].
A meta-analysis of cross-sectional studies on the association of lipid profiles and cigarette smoking status revealed that smokers had higher serum concentrations of total cholesterol (3.0%), triglycerides (9.1%), very-low-density lipoprotein cholesterol (10.4%), and low-density lipoprotein cholesterol (1.7%) and lower serum concentrations of high-density lipoprotein cholesterol (−5.7%) and apolipoprotein A1 (−4.2%) than nonsmokers [3].
However, prospective cohort studies and experimental studies [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21], [22], [23], [24], [25], [26], [27], [28], [29], [30] examining the effects of cigarette smoking cessation on lipid profile have so far provided only inconclusive results. We therefore performed a meta-analysis to estimate of the effects of cigarette smoking cessation on lipid profile.
Section snippets
Methods
The databases of MEDLINE (January 1966–August 2000) and Cochrane Library/CCTR (2000, Issue 2) were searched for all prospective studies measuring smoking status and lipid profile simultaneously. Our aim was to summarize the degree of the effect of smoking cessation itself, not of smoking cessation intervention, on lipid profile. Database search strategies used the Medical Subject Heading (MeSH) terms “tobacco use cessation,” “cholesterol,” “triglycerides,” and “smoking,” “tobacco,” “cigar,”
Initial search and preliminary selection (Fig. 1; Table 1)
After the initial screening, 91 of 375 original citations were accepted for further assessment. Of these, 61 did not meet the inclusion criteria because of the following reasons: including the cases of smoking cessation failures (n = 31), cross-sectional studies (n = 11), not reporting the lipid profiles (n = 10), not reporting the changes in lipid profiles (n = 3), not reporting the changes in smoking status (n = 3), the study for smokeless tobacco users (n = 1), the study for nonsmoker (n =
Discussion
This meta-analysis showed that the level of HDL-C significantly elevated after cigarette smoking cessation. This result is fairly consistent since most of HDL-C cohorts (19/29) showed significant elevation. In contrast to HDL-C, TC, LDL-C, and TG did not show a significant change after cigarette smoking cessation.
Gordon et al. summarized prospective studies on risk factors for coronary heart disease (CHD) and estimated that 1 mg/dl increase in HDL-C after adjustment for other coronary risk
Conclusion
This meta-analysis showed that cigarette smoking cessation increases the level of HDL-C but not of TC, LDL-C, and TG. We should take into account the beneficial effect of HDL-C elevation after cigarette smoking cessation when we estimate their benefits.
References (36)
Update on the role of cigarette smoking in coronary artery disease
Am Heart J
(1981)- et al.
Changes associated with quitting cigarette smokingthe Framingham Study
Am Heart J
(1975) Effect of cigarette smoking cessation on risk factors for coronary atherosclerosis. A control clinical trial
Atherosclerosis
(1984)- et al.
Variation in serum lipid and lipoprotein levels associated with changes in smoking behaviour in non-obese Caucasian males
Atherosclerosis
(1985) - et al.
Effects of smoking cessation on weight gain, metabolic rate, caloric consumption, and blood lipids
Am J Clin Nutr
(1986) Effects of cessation of smoking on serum lipids and high density lipoprotein-cholesterol
Atherosclerosis
(1988)- et al.
High density lipoprotein concentrations after cessation of smokingthe importance of alterations in diet
Atherosclerosis
(1989) - et al.
Smoking cessation and change in diastolic blood pressure, body weight, and plasma lipids. MRFIT Research Group
Prev Med
(1991) - et al.
Effect of smoking cessation on serum apolipoprotein A-I and A-II concentrations
Pathology
(1991) - et al.
Cholesterol changes in smoking cessation using the transdermal nicotine system. Transdermal Nicotine Study Group
Prev Med
(1994)
Changes in cardiovascular risk profile during the cessation of smoking
Am J Med
A prospective study of the effects of changes in smoking habits on blood count, serum lipids and lipoproteins, body weight and blood pressure in occupationally active men. The Israeli CORDIS Study
J Clin Epidemiol
Effect of smoking cessation on lipoprotein A-I and lipoprotein A-IA-II levels
Metabolism
Effects of the transdermal nicotine patch on normalization of HDL-C and its subfractions
Prev Med
Variance imputation for overviews of clinical trials with continuous response
J Clin Epidemiol
Meta-analysis in clinical trials
Control Clin Trials
Smoking and cardiovascular disease
Am J Med
Cigarette smoking and serum lipid and lipoprotein concentrationsan analysis of published data
BMJ
Cited by (187)
Sex difference in association between suicide attempts and lipid profile in first-episode and drug naive patients with major depressive disorder
2024, Journal of Psychiatric ResearchHyperlipidemia
2023, Encyclopedia of Human Nutrition: Volume 1-4, Fourth EditionMeta-analysis of the effects of smoking and smoking cessation on triglyceride levels
2023, Toxicology ReportsSmoking and apolipoprotein levels: A meta-analysis of published data
2022, Toxicology ReportsCitation Excerpt :Studies assessing the association of smoking status and smoking cessation with lipid parameters are abundant in the literature. A review of the association of HDL-C levels and smoking status was performed by Maeda et al. [17], demonstrating increased levels of HDL-C after smoking cessation. To date, no meta-analyses have been published comparing the effects of smoking status or smoking cessation on the levels of apolipoproteins, which is the objective of the present review.
Comparative Study of Lipid Profile among Young Smokers and Nonsmokers in South Indian Population
2023, Medical Journal of Dr. D.Y. Patil Vidyapeeth