{"id":34919,"date":"2020-09-25T10:24:50","date_gmt":"2020-09-25T10:24:50","guid":{"rendered":"https:\/\/biomedpharmajournal.org\/?p=34919"},"modified":"2020-10-23T10:42:33","modified_gmt":"2020-10-23T10:42:33","slug":"high-sensitive-c-reactive-protein-and-atherogenic-lipid-levels-in-a-group-of-university-students-with-habitual-smoking","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol13no3\/high-sensitive-c-reactive-protein-and-atherogenic-lipid-levels-in-a-group-of-university-students-with-habitual-smoking\/","title":{"rendered":"High-Sensitive C-reactive Protein and Atherogenic Lipid Levels in a Group of University Students with Habitual Smoking"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

The use of tobacco is increasing and broadly spreading throughout the world. It is a bad human behavior and is practiced by people when addicted to nicotine, which causes many harmful diseases1<\/sup>. smoking is the highest risk factor in the progress of specific health problems, such as cardiovascular disease and chronic obstructive pulmonary disease2<\/sup>. Cigarette smoke consists of over 4000 components, including toxicants, carcinogens, oxidants, and free radicals components3<\/sup>.<\/p>\n

Hs-CRP is one of an acute-phase reactant proteins, an indicator of systemic inflammation4<\/sup>. Hs-CRP is usually related to CVD risk factors, predominantly, with lifestyle features like smoking as well as physical activity behaviors5,6<\/sup>. Dyslipidaemia in smokers shows a superior risk of atherogenic disorder, which comparably correlates to the number of cigarettes, and smoking duration7<\/sup><\/strong>.<\/p>\n

Magnesium misbalances are associated with many pathological states such as hypertension, CVD and ischemic brain injury, a rising of extracellular and intracellular magnesium levels can control the addiction to nicotine and tobacco smoking8<\/sup>. Several studies reported the associations between hs-CRP and CVD among adolescents and youth2,7<\/sup>. In this current study, we targeted the investigation of some CVD risk factors, specifically, hs-CRP, total cholesterol, and LDL-C among Sudanese young adult males aged between 18\u00a0 and 25 years.<\/p>\n

Materials and Methods<\/strong><\/p>\n

In this cross-sectional comparative study, approved by research committee of Sudan University of Science and Technology, 80 healthy current daily cigarettes smoker male were randomly selected from Sudan university of Science and Technology. The smoker males, age between 18 and 25 years, smokes 10 or less cigarettes per day and at least on smoking for 30 days before participation in this study.\u00a0 Participant with diabetes, diagnosed CVD, cerebrovascular disease, stable hypertension treated by drugs, dyslipidemia, renal problems, and chronic hepatic disease, were excluded from this study.\u00a0 After getting their informed consent, 3ml venous blood samples were taken from participants in the morning in lithium heparin containers after a minimum of 8 hours of overnight fasting. Then specimens were centrifuged at 3000 rpm for 5 minutes, plasma was separated and used for high sensitive hs-CRP which was measured by turbidimetric9<\/sup>, and plasma magnesium by chemical method 10<\/sup>, total cholesterol, triglyceride, and HDL-C by enzymatic methods11-13<\/sup>. Simultaneously, LDL-C was calculated according to Friedewald formula: LDL cholesterol (mg\/dL) = total cholesterol \u2013 HDL cholesterol \u2013 (triglycerides\/5)12<\/sup><\/p>\n

The precision and accuracy of the techniques used in this study were checked each time a batch was analyzed by including commercially prepared control sera.<\/p>\n

Statistical analysis<\/strong><\/p>\n

A convenient descriptive and analytical, statistical approach was followed using a statistical package SPSS version 20. descriptive statistic, Pearson\u2019s correlation \u00a0was used to compare and correlate hs-CRP magnesium, and lipid profile levels with variables in the study group and the level of significance were expressed as P value \u02c2 0.05<\/p>\n

Results<\/strong><\/p>\n

The study population included 80 non-diabetic, non-hypertensive university student smokers (light smokers: 1 \u2013 10 cigarettes\/day), age 18\u201325 years, 59 out of 80 participants practice sport two times per week, the mean of BMI (22.9 \u00b1 3.9) kg\/m2<\/sup>.<\/p>\n

Table 1 shows 16 participants (20%) had >3.0 mg\/L of hs-CRP, 5 (6.3%) high level of total cholesterol, 5 (6.3%) had very high level of LDL-C, while 45 (58.2%) had low level of HDL-C.<\/p>\n

Table 2 shows the statistics of measured hs-CRP, serum magnesium and lipid profile parameters compared according to duration of smoking per year. results were found to be significantly increased for hs-CRP, total cholesterol, triglycerides, LDL-C\u00a0 and significantly decreased for HDL-C, and magnesium in male smokes more than 10 years when compared with smokes less than 10 years (P<0.05).<\/p>\n

Table 3\u00a0shows a comparison between biochemical parameters according to sport practice (two times per week, for at least 30 minutes) among smokers.\u00a0 The results reflect that there was a significant increase in means of HDL-C level, and decrease in body mass index, while total cholesterol, triglycerides, LDL-C and magnesium, there were no statistical difference in the means according to sport practices.<\/p>\n

Table 4 shows Pearson\u2019s correlation between hs-CRP, lipid profile, magnesium levels and duration of smoking per year. The results reflect statistically significant, positive correlation between the hs-CRP, total cholesterol, triglycerides, LDL-C with duration of smoking per year.<\/p>\n

Table 1:\u00a0 Biomarkers frequency among young smokers: <\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Parameters<\/td>\nFrequency<\/td>\nPercentage (%)<\/td>\n<\/tr>\n
hs-CRP (mg\/L)<\/strong><\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0\u00a0\u00a0 Low Risk (< 1.0)<\/td>\n48<\/td>\n60<\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0\u00a0 Moderate Risk (1.0 \u2013 3.0)<\/td>\n16<\/td>\n20.0<\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0\u00a0 High Risk (>3.0)<\/td>\n16<\/td>\n20.0<\/td>\n<\/tr>\n
TC (mg\/dL)<\/strong><\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0\u00a0 Optimal (<200)<\/td>\n66<\/td>\n82.0<\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0\u00a0 Border line high (200 \u2013 239)<\/td>\n9<\/td>\n11.0<\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0\u00a0 High (\u2265 240)<\/td>\n5<\/td>\n6.3<\/td>\n<\/tr>\n
HDL-C (mg\/dL) <\/strong><\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0\u00a0 No Risk (\u2265 40)<\/td>\n16<\/td>\n20.0<\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0 Moderate Risk (35 \u2013 39)<\/td>\n19<\/td>\n23.8<\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0 High Risk (< 35)<\/td>\n45<\/td>\n58.2<\/td>\n<\/tr>\n
LDL-C (mg\/dL)<\/strong><\/td>\n<\/tr>\n
\u00a0\u00a0 Optimal (< 100)<\/td>\n40<\/td>\n50<\/td>\n<\/tr>\n
\u00a0\u00a0 Near Optimum (100 \u2013 129)<\/td>\n23<\/td>\n28.8<\/td>\n<\/tr>\n
\u00a0\u00a0 Border Line High (130 \u2013 159)<\/td>\n11<\/td>\n13.7<\/td>\n<\/tr>\n
\u00a0\u00a0 High (160 \u2013 189)<\/td>\n1<\/td>\n1.3<\/td>\n<\/tr>\n
\u00a0\u00a0 Very high (\u2265 190)<\/td>\n5<\/td>\n6.3<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

TC: Total cholesterol. HDL-C: high density lipoprotein- cholesterol, LDL-C, low density lipoprotein cholesterol, hs-CRP: high sensitive C- reactive protein.<\/p>\n

Table 2:<\/strong> Comparison between means of the biochemical parameter according to the duration of smoking per year<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n
Duration<\/td>\n\u02c2 10 years<\/p>\n

(n = 43)<\/td>\n

\u226510 years<\/p>\n

(n = 37)<\/td>\n

P<\/em>– value<\/td>\n<\/tr>\n
\u00a0Variables<\/td>\nMean \u00b1 SD<\/td>\n<\/td>\n<\/tr>\n
Plasma hs-CRP (mg\/L)<\/td>\n1.41 \u00b1 0.92<\/td>\n2.09\u00b1 1.85<\/td>\n0.02*<\/td>\n<\/tr>\n
Plasma magnesium\u00a0 (mg\/dL)<\/p>\n

 <\/td>\n

2.26 \u00b1 0.50<\/td>\n1.97 \u00b1 0.32<\/td>\n0.00**<\/td>\n<\/tr>\n
Plasma T.Cholesterol (mg\/dl)<\/td>\n146 \u00b1 30.2<\/td>\n185 \u00b1 64.0<\/td>\n0.00**<\/td>\n<\/tr>\n
Plasma Triglyceride (mg\/dL)<\/td>\n83.0 \u00b1 42.4<\/td>\n141 \u00b1 102<\/td>\n0.00**<\/td>\n<\/tr>\n
Plasma HDL-C (mg\/dL)<\/td>\n34.0 \u00b1 8.0<\/td>\n30.1 \u00b1 8.1<\/td>\n0.03*<\/td>\n<\/tr>\n
Plasma LDL-C (mg\/dL)<\/td>\n95.9 \u00b1 29.1<\/td>\n128 \u00b1 57.4<\/td>\n0.00**<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Independent Student\u2019s t-test was used to compared between means<\/p>\n

Statistical significance were considered as P value \u2264 0.05<\/p>\n

Table 3: Comparison between biochemical parameters and <\/strong>sport practice<\/strong>. <\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Variable<\/strong><\/td>\nSport practice \u201cYES\u201d<\/strong><\/p>\n

n=59<\/strong><\/td>\n

Sport practice\u00a0 \u201cNO\u201d<\/strong><\/p>\n

n=21<\/strong><\/td>\n

P<\/em> value<\/strong><\/td>\n<\/tr>\n
Means \u00b1 SD<\/strong><\/td>\n<\/tr>\n
Plasma hs-CRP (mg\/L)<\/td>\n1.72 \u00b1 1.3<\/td>\n2.00 \u00b1 1.3<\/td>\n0.07<\/td>\n<\/tr>\n
Plasma magnesium\u00a0 (mg\/dL)<\/td>\n2.14 \u00b1 0.37<\/td>\n2.11 \u00b1 0.61<\/td>\n0.83<\/td>\n<\/tr>\n
Plasma T.Cholesterol (mg\/dl)<\/td>\n164 \u00b1 58.4<\/td>\n166.9 \u00b1 29.5<\/td>\n0.83<\/td>\n<\/tr>\n
Plasma Triglyceride (mg\/dL)<\/td>\n106 \u00b1 68.5<\/td>\n121.7 \u00b1 110.6<\/td>\n0.45<\/td>\n<\/tr>\n
Plasma HDL-C (mg\/dL)<\/td>\n34.1 \u00b1 7.3<\/td>\n26.7 \u00b1 8.5<\/td>\n0.00**<\/td>\n<\/tr>\n
Plasma LDL-C (mg\/dL)<\/td>\n109 \u00b1 52.9<\/td>\n115 \u00b1 24.7<\/td>\n0.48<\/td>\n<\/tr>\n
BMI (kg\/m2)<\/td>\n21.8 \u00b1 1.70<\/td>\n26.3 \u00b1 1.80<\/td>\n0.00*<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Independent Student\u2019s t<\/em>-test \u00a0was used to compared between means<\/p>\n

Statistical significance were considered as P value \u2264 0.05<\/p>\n

Table 4<\/strong>: Pearson\u2019s correlation of BMI, hs-CRP, lipid profile, and magnesium with the duration of the smoking per year<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n
Parameters<\/strong><\/td>\nDuration of smoking\/year<\/strong><\/td>\n<\/tr>\n
R <\/em><\/strong>value<\/td>\nP <\/em><\/strong>value<\/td>\n<\/tr>\n
BMI (kg\/m2)<\/td>\n0.229<\/td>\n0.041*<\/td>\n<\/tr>\n
Plasma hs-CRP (mg\/L)<\/td>\n0.339<\/td>\n0.002*<\/td>\n<\/tr>\n
Plasma T.Cholesterol (mg\/dl)<\/td>\n0.314<\/td>\n0.005*<\/td>\n<\/tr>\n
Plasma Triglyceride (mg\/dL)<\/td>\n\u00a00.206<\/td>\n0.067<\/td>\n<\/tr>\n
Plasma HDL-C (mg\/dL)<\/td>\n-0.258<\/td>\n0.021*<\/td>\n<\/tr>\n
Plasma LDL-C (mg\/dL)<\/td>\n\u00a00.338<\/td>\n0.002*<\/td>\n<\/tr>\n
Plasma magnesium\u00a0 (mg\/dL)<\/td>\n-0.303<\/td>\n0.006*<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Pearson\u2019s correlation R-value, P-value \u2264 0.05 was considered significant.<\/strong><\/p>\n

Discussion<\/strong><\/p>\n

Cigarette smoking is a classical and a major risk factor in the development of several diseases with an inflammatory component, including the development of cardiovascular disease (CVD) and atherosclerosis13<\/sup>. CVD referred to as an in\ufb02ammatory disease2<\/sup> Cigarette smoking alters plasma lipid and lipoprotein levels,\u00a0 nicotine stimulates sympathetic adrenal system leading to increased secretion of catecholamines resulting in increased lipolysis and increased concentration of plasma free fatty acids (FFA) which further result in increased secretion of hepatic FFAs and hepatic triglycerides along with VLDL in the blood stream 14<\/sup>.<\/p>\n

In the present study, although the factors that affect the hs-CRP, lipid profile and magnesium were excluded, we found that 20.0% (16\/80) of the studied group had high level of hs-CRP (hs-CRP >3mg\/L), These results are comparable with the findings of several studies 15,16<\/sup>.<\/p>\n

Our study reveals that there were significant increase in means of hs-CRP, total cholesterol, triglycerides and LDL-C and \u00a0significant decrease in HDL-C, and magnesium in participants smokes for \u2265 10 years, also there was significant positive correlation between duration of smoking and hs-CRP, total cholesterol and LDL-C. Our findings are in accordance with the findings of many research workers 6,17-19<\/sup>. A direct association between elevated levels of hs-CRP, as well as other markers of inflammation, and cigarette smoking has been reported in several investigations18,19<\/sup> and most studies showing a dose-response relationship between CRP levels and smoking intensity and\/or duration20,21<\/sup>. The change in the serum cholesterol and lipoprotein levels became more marked with the number of cigarettes smoked per day and\u00a0 duration\u00a0 of\u00a0 smoking 6<\/sup>.<\/p>\n

Nicotine and other toxic substances from tobacco smoke increases the amount of bad fats (total cholesterol (TC), LDL-C, and triglycerides (TG) circulating in the blood vessels and decreases the amount of good cholesterol \u00a0HDL-C availability 22<\/sup>. Nicotine induces oxidative stress, generates free radicals that attack on the membrane lipids resulting in the formation of malondialdehyde (MDA), which causes peroxidative tissue damage 23<\/sup>.<\/p>\n

In this study, there was an insignificant difference between means of hs-CRP among the smoker who practice sport when compared with the smoker not practice sports.\u00a0 Only 21 out of the 80 participants practiced sport twice in a week. Our results were similar to Mazurek et al., who reported that no relationship between hs -CRP concentration and the physical activity 24<\/sup>, and disagree with another study; hs-CRP concentration levels were conversely identified with cardiorespiratory fitness 25<\/sup>. Stewart et al. reported exercise training \u00a0decrease the risk of CVD as defined by a reduction in the concentration of CRP in healthy individuals 26<\/sup>.<\/p>\n

The study revealed that serum magnesium significantly negatively correlated with duration of smoking .This result is in agreement with a previous study 27<\/sup>; as cigarette smoking causes decreased supply of magnesium due to lesser appetite and reduced absorption due to digestive system disturbances 28<\/sup>. Experimental evidence indicates that magnesium insufficiency promotes atherosclerosis and that magnesium fortification attenuates atherogenesis28,29<\/sup>. Evidence from observational studies indicates that high circulating magnesium levels and magnesium intake are associated with a modest reduction in risk of cardiovascular disease, including coronary heart disease 30,31<\/sup>.<\/p>\n

Conclusion<\/strong><\/p>\n

Study results revealed that smoker status was associated with substantial changes in hs-CRP, atherogenic lipid profile, and magnesium that considered risk factors for cardiovascular disease among young adults smoker. Consistent advice for young men considers a healthy lifestyle rich in physical activity and free of smoking.<\/p>\n

Acknowledgments <\/strong><\/p>\n

Our appreciation and gratefulness to all who were contributed to the success of this study.<\/p>\n

Conflicts of Interest<\/strong><\/p>\n

The authors declare no conflicts of interest regarding the publication of this paper.<\/p>\n

Funding Source<\/strong><\/p>\n

This study did not receive any official funding.<\/p>\n

References<\/strong><\/p>\n

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