Evaluation of 10 Years Atherosclerotic Cardiovascular Risk, Vitamin D and Metabolic Profiles in Smokers Atherosclerotic cardiovascular disease and smokers
International Journal of Medical Toxicology and Forensic Medicine,
Vol. 15 No. 02 (2025),
7 June 2025
https://doi.org/10.32598/ijmtfm.v15i02.47674
Abstract
Background: Cardiovascular diseases (CVD) are the primary cause of death and a significant contributor to disability. Atherosclerosis cardiovascular diseases (ASCVD) are responsible for high mortality rates, causing millions of deaths each year. The most important avoidable cause of ASCVD and death is cigarette smoking. This study examined the relationship between 10-year ASCVD in smokers with 25(OH)D and metabolic profiles.
Methods: This cross-sectional study was conducted at the Beheshti Hospital in Kashan City, Iran. A total of 144 smokers between the ages of 40 and 75 participated in this study. Addiction and cardiovascular specialists evaluated the patient health questionnaire, and the appropriate tool was used to quantify the 10-year ASCVD risk. Nitric oxide (NO), γ-glutamyl-l-cysteinyl-glycine (GSH), high-sensitivity C-reactive protein (Hs-CRP), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), total antioxidant capacity (TAC) and 25(OH)D were determined, too.
Results: About 93% of the 144 participants in this study were men and their mean age was 52.6±8.56 years. The average risk of ASCVD was 10.44±8.72%. Patients’ lifetime and 10-year risk for ASCVD was significantly and negatively correlated with blood 25(OH) D, HDL, GSH, NO and TAC (P<0.05) and positively with TG, LDL, Hs-CRP, smoking duration, and number of cigarettes (P<0.05). Additionally, a negative correlation was seen between the amount of 25(OH)D and the amount of time spent smoking (P<0.05).
Conclusion: The results of this study showed that with increased levels of vitamin D, HDL cholesterol, NO, glutathione, and TAC, the risk of developing atherosclerotic CVD was reduced over 10 years. Also, the risk of developing ASCVD over the next 10 years increased with increased levels of TC, LDL-c, TG, Hs-CRP levels and duration and amount of smoking and hypertension.
- Cardiovascular diseases (CVD)
- 25(OH)D
- Metabolic profiles
- Cigarette smoking
How to Cite
References
Zhang, G., et al., Safety assessment of electronic cigarettes and their relationship with cardiovascular disease. International journal of environmental research and public health, 2018. 15(1): p. 75.
Rippe, J.M. and T.J. Angelopoulos, Lifestyle strategies for risk factor reduction, prevention and treatment of cardiovascular disease. Lifestyle Medicine, Third Edition, 2019: p. 19-36.
Bao, X., et al., Cigarette tar mediates macrophage ferroptosis in atherosclerosis through the hepcidin/FPN/SLC7A11 signaling pathway. Free Radical Biology and Medicine, 2023. 201: p. 76-88.
Abtahian, F., et al., Comparison by optical coherence tomography of the frequency of lipid coronary plaques in current smokers, former smokers, and nonsmokers. The American Journal of Cardiology, 2014. 114(5): p. 674-680.
He, J., et al., Oxidative stress, inflammation, and autophagy: potential targets of mesenchymal stem cells-based therapies in ischemic stroke. Frontiers in Neuroscience, 2021. 15: p. 641157.
Klein, L.W., Pathophysiologic mechanisms of tobacco smoke producing atherosclerosis. Current Cardiology Reviews, 2022. 18(6).
Fu, X., et al., Nicotine: Regulatory roles and mechanisms in atherosclerosis progression. Food and Chemical Toxicology, 2021. 151: p. 112154.
Lee, P.N., Tar level of cigarettes smoked and risk of smoking-related diseases. Inhalation toxicology, 2018. 30(1): p. 5-18.
Shi, H., J. Liu, and H. Gao, Benzo (α) pyrene induces oxidative stress and inflammation in human vascular endothelial cells through AhR and NF-κB pathways. Microvascular Research, 2021. 137: p. 104179.
Jin, S., et al., Aniline exposure activates receptor-interacting serine/threonineprotein kinase 1 and causes necroptosis of AML12 cells. Toxicology and Industrial Health, 2022. 38(8): p. 444-454.
Kondylis, V., et al., The interplay of IKK, NF‐κB and RIPK 1 signaling in the regulation of cell death, tissue homeostasis and inflammation. Immunological reviews, 2017. 277(1): p. 113-127.
Umar, M., K.S. Sastry, and A.I. Chouchane, Role of vitamin D beyond the skeletal function: a review of the molecular and clinical studies. International journal of molecular sciences, 2018. 19(6): p. 1618.
Vanherwegen, A.-S., C. Gysemans, and C. Mathieu, Vitamin D endocrinology on the cross-road between immunity and metabolism. Molecular and cellular endocrinology, 2017. 453: p. 52-67.
Zhou, R., et al., Lower vitamin D status is associated with an increased risk of ischemic stroke: a systematic review and meta-analysis. Nutrients, 2018. 10(3): p. 277.
Berridge, M.J., Vitamin D deficiency and diabetes. Biochemical Journal, 2017. 474(8): p. 1321-1332.
Lucato, P., et al., Low vitamin D levels increase the risk of type 2 diabetes in older adults: A systematic review and meta-analysis. Maturitas, 2017. 100: p. 8-15.
Yang, L., et al., Smoking behavior and circulating vitamin D levels in adults: A meta‐analysis. Food Science & Nutrition, 2021. 9(10): p. 5820-5832.
Verma, P., et al., Effect of vitamin D supplementation on CD4 count in HIV-infected children and adolescents in north India: a non-randomized comparative study. Journal of Tropical Pediatrics, 2022. 68(5): p. fmac066.
Jung, B.J. and D. Jee, Association between serum 25-hydroxyvitamin D levels and myopia in general Korean adults. Indian journal of ophthalmology, 2020. 68(1): p. 15-22.
Richard, A., S. Rohrmann, and K.C. Quack Lötscher, Prevalence of vitamin D deficiency and its associations with skin color in pregnant women in the first trimester in a sample from Switzerland. Nutrients, 2017. 9(3): p. 260.
Kim, S.H., et al., The factors associated with Vitamin D deficiency in community dwelling elderly in Korea. Nutrition research and practice, 2018. 12(5): p. 387-395.
Cuomo, A., et al., Prevalence and correlates of vitamin D deficiency in a sample of 290 inpatients with mental illness. Frontiers in psychiatry, 2019. 10: p. 167.
Jääskeläinen, T., et al., Vitamin D status is associated with sociodemographic factors, lifestyle and metabolic health. European journal of nutrition, 2013. 52: p. 513-525.
Dr. Hermann, A., et al., Premenopausal smoking and bone density in 2015 perimenopausal women. Journal of Bone and Mineral Research, 2000. 15(4): p. 780-787.
Thuesen, B., et al., Determinants of vitamin D status in a general population of Danish adults. Bone, 2012. 50(3): p. 605-610.
Morrone, L.F., et al., Vitamin D in patients with chronic kidney disease: A position statement of the Working Group “Trace Elements and Mineral Metabolism” of the Italian Society of Nephrology. Journal of nephrology, 2016. 29: p. 305-328.
Hengist, A., et al., Mobilising vitamin D from adipose tissue: The potential impact of exercise. Nutrition bulletin, 2019. 44(1): p. 25-35.
Zibaeenejad, F., et al., Ten-year atherosclerosis cardiovascular disease (ASCVD) risk score and its components among an Iranian population: a cohort-based cross-sectional study. BMC Cardiovascular Disorders, 2022. 22(1): p. 162.
Lu, S.-X., et al., Combined effects of hypertension, hyperlipidemia, and diabetes mellitus on the presence and severity of carotid atherosclerosis in community-dwelling elders: a community-based study. Journal of the Chinese Medical Association, 2023. 86(2): p. 220-226.
Pourghadamyari, H., et al., Inflammatory indices IL-6, TNF-α, CRP, and hs-CRP in candidates for coronary artery bypass graft surgery. Acta Biochimica Iranica, 2023.
Ghasemi, A., et al., The influence of cigarette and qalyan (hookah) smoking on serum nitric oxide metabolite concentration. Scandinavian journal of clinical and laboratory investigation, 2010. 70(2): p. 116-121.
Yuan, L. and J. Ni, The association between tobacco smoke exposure and vitamin D levels among US general population, 2001–2014: temporal variation and inequalities in population susceptibility. Environmental Science and Pollution Research, 2022. 29(22): p. 32773-32787.
Wu, X., J. Cheng, and K. Yang, Vitamin D-related gene polymorphisms, plasma 25-hydroxy-vitamin D, cigarette smoke and non-small cell lung cancer (NSCLC) risk. International Journal Of Molecular Sciences, 2016. 17(10): p. 1597.
Mousavi, S.E., et al., Air pollution, environmental chemicals, and smoking may trigger vitamin D deficiency: Evidence and potential mechanisms. Environment international, 2019. 122: p. 67-90.
Kosecik, M., et al., Increased oxidative stress in children exposed to passive smoking. International journal of cardiology, 2005. 100(1): p. 61-64.
Thomas, G.N., et al., Vitamin D levels predict all-cause and cardiovascular disease mortality in subjects with the metabolic syndrome: the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study. Diabetes care, 2012. 35(5): p. 1158-1164.
Thompson, B., et al., Vitamin D supplementation and major cardiovascular events: D-Health randomised controlled trial. bmj, 2023. 381.
Scragg, R., et al., Effect of monthly high-dose vitamin D supplementation on cardiovascular disease in the vitamin D assessment study: a randomized clinical trial. JAMA cardiology, 2017. 2(6): p. 608-616.
Nayor, M., K.J. Brown, and R.S. Vasan, The molecular basis of predicting atherosclerotic cardiovascular disease risk. Circulation research, 2021. 128(2): p. 287-303.
Budoff, M., Triglycerides and triglyceride-rich lipoproteins in the causal pathway of cardiovascular disease. The American journal of cardiology, 2016. 118(1): p. 138-145.
Teimouri, M., et al., Anti-inflammatory effects of resveratrol in patients with cardiovascular disease: A systematic review and meta-analysis of randomized controlled trials. Complementary Therapies in Medicine, 2022. 70: p. 102863.
Gao, Y., et al., The predictive value of the hs-CRP/HDL-C ratio, an inflammation-lipid composite marker, for cardiovascular disease in middle-aged and elderly people: evidence from a large national cohort study. Lipids in Health and Disease, 2024. 23(1): p. 66.
Tanriverdi, H., et al., Cigarette smoking induced oxidative stress may impair endothelial function and coronary blood flow in angiographically normal coronary arteries. Circulation Journal, 2006. 70(5): p. 593-599.
Steven, S., et al., Vascular inflammation and oxidative stress: major triggers for cardiovascular disease. Oxidative medicine and cellular longevity, 2019. 2019(1): p. 7092151.
- Abstract Viewed: 270 times
- pdf Downloaded: 237 times