Joint Association of Adiposity and Smoking with Mortality among U.S. Adults.
ABSTRACT OBJECTIVE: Assessment of death risk for different combinations of body-mass index (BMI) and smoking status among a nationally representative cohort of U.S. adults. METHOD: A total of 210,818 participants of the National Health Interview Surveys 1987-1995 were followed through 2006. Relative risks of death from all causes, cardiovascular disease (CVD), and cancer were estimated for each joint group of smoking and BMI by age, using Cox models with the adjustment for age, gender, education, and race. RESULTS: Across all the joint groups of BMI and smoking, extremely obese and underweight current smokers were the two groups having the highest risks of death from all causes, CVD, and cancer. For example, among middle-aged adults, the hazard ratios of death from all causes were 4.47 (95% confidence interval [CI], 3.59-5.57) and 5.28 (4.38-6.37) for extremely obese and underweight current smokers, respectively. Overweight was associated with a higher risk of death in middle-aged never smokers, but not in the elderly or in current smokers. CONCLUSION: The coexistence of obesity or underweight with current smoking was associated with an especially large risk of death and the associations of BMI with mortality varied by smoking status, age, and cause of death.
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ABSTRACT: This study aimed to identify changes in the level of neuropeptides among current smokers, former smokers, and individuals who had never smoked, and how smoking habits affect obesity and metabolic syndrome (MetS). Neuropeptide levels, anthropometric parameters, and metabolic syndrome diagnostic indices were determined among male workers; 117 of these had never smoked, whereas 58 and 198 were former and current smokers, respectively. The total sample comprised 373 male workers. The results obtained from anthropometric measurements showed that current smokers attained significantly lower body weight, body mass index, waist circumference, and abdominal fat thickness values than former smokers and those who had never smoked. Current smokers' eating habits proved worse than those of non-smokers and individuals who had never smoked. The level of brain-derived neurotrophic factor (BDNF) in the neuropeptides in the case of former smokers was 23.6 ± 9.2 pg/ml, higher than that of current smokers (20.4 ± 6.1) and individuals who had never smoked (22.4 ± 5.8) (F = 6.520, p = 0.002). The level of adiponectin among former smokers was somewhat lower than that of current smokers, whereas leptin levels were higher among former smokers than current smokers; these results were not statistically significant. A relationship was found between adiponectin and triglyceride among non-smokers (odds ratio = 0.660, β value = -0.416, p < 0.01) and smokers (odds ratio = 0.827, β value = -0.190, p < 0.05). Further, waist circumference among non-smokers (odds ratio = 1.622, β value = 0.483, p < 0.001) and smokers (odds ratio = 1.895, β value = 0.639, p < 0.001) was associated with leptin. It was concluded that cigarette smoking leads to an imbalance of energy expenditure and appetite by changing the concentration of neuropeptides such as adiponectin, BDNF, leptin, and hsCRP, and influences food intake, body weight, the body mass index, blood pressure, and abdominal fat, which are risk factors for MetS and cardiovascular disease.06/2014; 30(2):91-7. DOI:10.5487/TR.2014.30.2.091