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The characteristics of the enrolled subjects are shown in Table 1. Compared with nonsmoking individuals and former smoking subjects, a significantly higher proportion of current smoking patients had the habit of alcohol consumption (40.2% vs. 21.4% vs. 10.1%, P < 0.001, Table 1). There were also significant differences among the three groups in terms of age, body mass index (BMI), gender, and morbidity of CAD (age: 55 ± 10 vs. 59 ± 10 vs. 56 ± 12 years, P = 0.003; BMI: 26.09 ± 3.48 vs. 26.03 ± 3.31 vs. 25.06 ± 3.56 kg/m2, P = 0.001; rate of male gender: 93.0% vs. 96.1% vs. 41.3%, P < 0.001; morbidity of CAD: 73.0% vs. 83.5% vs. 55.8%, P < 0.001; respectively, Table 1). Moreover, the HDL-C levels of CS patients were substantially low (1.01 ± 0.26 vs. 1.06 ± 0.32 vs. 1.17 ± 0.36 mmol/L, P < 0.001, Table 1), and the difference was significant (adjusted P value = 0.006) even after adjusting for traditional risk factors consisting of gender, age, BMI, alcohol consumption history, family history of CAD, systolic blood pressure, hemoglobin A1C (HbA1C), and CAD. The level of TG was elevated in current smoking patients (1.82 ± 0.81 vs. 1.64 ± 0.68 vs. 1.64 ± 0.79 mmol/L, P = 0.002, Table 1), but the increasing tendency disappeared after adjusting for traditional risk factors (adjusted P = 0.094). The difference in TC levels among the current smoking, former smoking, and nonsmoking groups was not statistically significant even after adjusting for traditional risk factors; in addition, the levels of LDL-C were almost equal among the three groups.
Variables Non Smoking (n = 518) Former Smoking (n = 103) Current Smoking (n = 256) P Value Adjusted P Value Clinical Characteristics Male Gender [n (%)] 214 (41.3%) 99 (96.1%) 240 (93.0%) < 0.001 - Age (years) 56 ± 12 59 ± 10 55 ± 10 0.003 - BMI (kg/m2) 25.06 ± 3.56 26.03 ± 3.31 26.09 ± 3.48 0.001 - Drinking [n (%)] 52 (10%) 22 (21.4%) 103 (40.2%) < 0.001 - FH of CAD [n (%)] 81 (15.6%) 18 (17.5%) 46 (18.0%) 0.336 - Dislipidemia [n(%)] 281 (54.2%) 58 (56.3%) 148 (57.8%) 0.803 - Hypertension[n (%)] 279 (53.9%) 63 (61.2%) 155 (60.5%) 0.307 - Diabetes [n (%)] 95 (18.3%) 26 (25.2%) 56 (21.9%) 0.113 - CAD [n (%)] 289 (55.8%) 86 (83.5%) 187 (73%) < 0.001 - ACEI/ARB [n (%)] 97 (18.7%) 23 (22.3%) 42 (16.4%) 0.415 - β-blocker [n (%)] 84 (16.2%) 27 (26.2%) 57 (22.3%) 0.056 - CCB [n (%)] 93 (18.0%) 28 (27.2%) 54 (21.2%) 0.173 - Lipid Profiles TG (mmol/L) 1.64 ± 0.79 1.64 ± 0.68 1.82 ± 0.81 0.002 0.094 TC (mmol/L) 4.83 ± 0.92 4.65 ± 0.95 4.70 ± 0.87 0.046 0.554 HDL-C (mmol/L) 1.17 ± 0.36 1.06 ± 0.32 1.01 ± 0.26 < 0.001 0.006 LDL-C (mmol/L) 3.18 ± 0.87 3.12 ± 0.88 3.19 ± 0.87 0.707 - HDL subfractions Large HDL-C (mg/dL) 15.11 ± 7.84 13.10 ± 5.26 11.34 ± 5.19 < 0.001 0.002 Medium HDL-C (mg/dL) 21.22 ± 5.95 20.39 ± 6.73 19.47 ± 4.59 < 0.001 0.005 Small HDL-C (mg/dL) 7.85 ± 2.66 7.64 ± 3.09 8.40 ± 2.90 0.019 0.032 Large HDL (%) 32.85 ± 8.42 31.37 ± 6.95 28.21 ± 7.29 < 0.001 0.009 Medium HDL (%) 48.81 ± 5.25 49.75 ± 4.37 49.91 ± 4.17 0.063 0.552 Small HDL (%) 18.31 ± 5.67 18.86 ± 5.70 21.85 ± 6.21 < 0.001 0.001 LDL subfractions Large LDL-C (mg/dL) 27.82 ± 9.53 27.60 ± 9.35 26.51 ± 8.17 0.415 - Medium LDL-C (mg/dL) 17.84 ± 8.05 18.80 ± 7.98 20.19 ± 8.13 0.002 0.029 Small LDL-C (mg/dL) 6.24 ± 6.51 6.21 ± 6.55 8.22 ± 8.18 0.042 0.283 Large LDL (%) 14.93 ± 3.99 15.28 ± 3.83 14.69 ± 3.96 0.302 - Medium LDL (%) 9.43 ± 3.49 10.23 ± 3.12 10.87 ± 3.25 < 0.001 0.003 Small LDL (%) 3.27 ± 3.27 3.30 ± 3.36 4.27 ± 3.84 0.013 0.355 Mean LDL particle size (Å) 267.83 ± 4.90 267.60 ± 4.66 266.44 ± 4.89 0.008 0.285 Note. The data shown are the mean ± SD or n (%). Adjusted traditional risk factors include gender, age, BMI, alcohol consumption history, family history of CAD, systolic blood pressure, HbA1C, and CAD. BMI = body mass index; CAD = coronary artery disease; ACEI = angiotensin converting enzyme inhibitors; ARB = angiotensin receptor blockers; CCB = calcium channel blockers; FH = family history; HbA1C = hemoglobin A1C; TG = triglyceride; TC = total cholesterol; HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol. Table 1. Baseline Characteristics, Lipid Parameters, and Lipoprotein Subfractions in the Current Smoking and Nonsmoking Patients
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Lipoprotein subfractions were measured in 256 current smoking patients, 103 former smoking patients and 518 nonsmoking individuals. To demonstrate the changes clearly, we elected the typical figure of HDL and LDL subfractions from nonsmoking group, former smoking group, and current smoking group respectively (Figure 2).
Figure 2. The distribution of lipoprotein subfractions in typical patients from the nonsmoking group (A: HDL subfractions; B: LDL subfractions), former smoking group (C: HDL subfractions; D: LDL subfractions), and current smoking group (E: HDL subfractions; F: LDL subfractions)
As shown in Table 1 and Figure 3, compared with the nonsmoking and former smoking groups, in the unadjusted analysis, the current smoking group presented a significant reduction in large HDL-C subfraction concentration and percentage and in medium HDL-C concentration (15.11 ± 7.84 vs. 13.10 ± 5.26 vs. 11.34 ± 5.19 mg/dL, P < 0.001, after adjusted P = 0.002; 32.85% ± 8.42% vs. 31.37% ± 6.95% vs. 28.21% ± 7.29%, P < 0.001, after adjusted P = 0.009; 21.22 ± 5.95 vs. 20.39 ± 6.73 vs. 19.47 ± 4.59 mg/dl, P < 0.001, after adjusted P = 0.005; respectively); nevertheless, the small HDL subfraction concentration and percentage were distinctly higher (7.85 ± 2.66 vs. 7.64 ± 3.09 vs. 8.40 ± 2.90 mg/dL, P = 0.019, after adjusted P = 0.032; 18.31% ± 5.67% vs. 18.86% ± 5.70% vs. 21.85% ± 6.21%, P < 0.001, after adjusted P = 0.001, respectively). Table 1 also indicates that compared with nonsmoking individuals and former smoking subjects, the medium LDL-C concentration and percentage were significantly higher in the current smoking patients (17.84 ± 8.05 vs. 18.80 ± 7.98 vs. 20.19 ± 8.13 mg/dL, P = 0.002, after adjusted P = 0.029; 9.43% ± 3.49% vs. 10.23% ± 3.12% vs. 10.87% ± 3.25%, P < 0.001, after adjusted P = 0.003; respectively). Moreover, the results demonstrate that the mean LDL particle size of current smoking patients showed a decreasing tendency (267.83 ± 4.90 vs. 267.60 ± 4.66 vs. 266.44 ± 4.89 Å, P = 0.008) while the small LDL-C concentration and small LDL percentage showed increasing tendencies (6.24 ± 6.51 vs. 6.21 ± 6.55 vs. 8.22 ± 8.18 mg/dL, P = 0.042; 3.27% ± 3.27% vs. 3.30% ± 3.36% vs. 4.27% ± 3.84%, P = 0.013; respectively), but these tendencies disappeared after adjusting for traditional risk factors. However, no significant difference was observed among the other lipoprotein subfractions in the three groups.