Gender Differences in Intermediate Atherogenic Pathways by Cigarette Smoking among Middle-Aged US Adults

Objective: This study investigates mediating atherogenic pathways caused by cigarette smoking (anthropometric, metabolic, hemodynamic, inflammatory factors) among middle-aged adults and whether there are gender differences in these pathways. Methods: The data were obtained from the Los Angeles Atherosclerosis Study. The sample consists of 573 middle-aged healthy U.S. adults (age 40-60 yrs). Common carotid arterial intima-medial thickness (IMT) measured by B-mode ultrasound was used as a surrogate indicator for subclinical atherosclerosis. Results and Conclusion: Besides high levels of low-density lipoprotein cholesterol and total cholesterol, cigarette smoking was also associated with manifestations of metabolic syndrome (central obesity, atherogenic dyslipidemia, sympathetic overactivity, elevated inflammation markers). Most intermediate physiologic profiles for former smokers were similar to those for never smokers, suggesting that smoking effects are partly reversible after quitting. The common atherogenic mediating pathways by smoking for men and women was central obesity. The unique pathway for women was dyslipidemia (low HDL cholesterol and high triglycerides), and the unique pathways for men were elevated levels of LDL cholesterol and total cholesterol, sympathetic overactivity, and elevated inflammation markers.