Biomarkers of Metabolic Syndrome in Male Cigarette Smokers in Calabar
Background: There is an increasing but controversial evidence that smoking is associated with metabolic syndrome. Metabolic syndrome has recently attracted much attention due to increasing knowledge of its relationship with cardiovascular mortality and morbidity and other associated problems. Aim: This study assessed the biomarkers and frequency of metabolic syndrome as defined by the World Health Organization (WHO), International Diabetes Foundation (IDF) and the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) in adult male smokers. Methods: One hundred and forty one (141) apparently healthy male cigarette smokers and sixty (60) apparently healthy nonsmokers aged 18 to 45 years were recruited for the study. The smokers were subdivided into light (< 8 pack years), moderate (8-30 pack years) and heavy (> 30 pack years) smokers. Body mass index (BMI), waist circumference (WC), hip circumference, waist-hip ratio, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. Fasting blood sugar (FBS), total cholesterol (TC), triglycerides (TG) and high density lipoprotein-cholesterol (HDL-C) were estimated using colorimetric test methods while low density lipoprotein-cholesterol (LDL-C) and very low density lipoprotein (VLDL-C) were calculated using the Friedewald's equation. Serum insulin was estimated using enzyme linked immunosorbent assay. Insulin resistance was calculated using homeostasis model assessment of insulin resistance (HOMA-IR). Data were analyzed using Student's t-test and analysis of variance; P < 0.05 was considered statistically significant. Results: The smokers had significantly higher diastolic BP ( P = 0.0001), TC ( P = 0.008) and LDL-C ( P = 0.0001) and significantly lower HDL-C ( P = 0.0001) compared with the controls. There were no significant differences in the other parameters. Fasting blood sugar was significantly higher in the light smokers ( P = 0.001) than in the moderate and heavy smokers whereas, serum TC and LDL-C levels were significantly higher in heavy smokers ( P = 0.001) than in the light and moderate smokers. There were no significant variations in the other parameters among the groups. The percentage of smokers with metabolic syndrome was significantly higher than nonsmokers using the IDF ( P = 0.022) and NCEP-ATP III ( P = 0.032) criteria with dyslipidaemia being the most prevalent metabolic abnormality. Conclusion: The unfavorable changes in the lipid profile and blood pressure observed in this study may predispose smokers to a higher risk of cardiovascular disease and there is a higher frequency of metabolic syndrome among smokers in Calabar compared with the nonsmokers.