Abstract
Backgroud: Cigarette smoking is closely associated with the presence of carotid atherosclerotic lesions (CAL); however, whether such association differs in participants with or without cardiometabolic disorders (CD) is largely unknown. Methods: A dynamic retrospective cohort study of health checkup data was used from the Beijing MJ Health Screening Centers. A total of 14 410 participants were included among those who took both routine tests and carotid ultrasonography (CU) at least twice from 2008 to 2018 and had no CAL at the first time. Information on smoking status was collected from self-reported questionnaires. CAL was defined as increased carotid intima-media thickness, carotid plaques, or carotid stenosis. CD was defined with the presence of hypertension, diabetes, and/or dyslipidemia. The associations of smoking with CAL among participants with or without CD and the joint effect of smoking and CD were estimated by logistic regression. Results: Among 5810 and 8600 participants with and without CD at baseline, 2016 and 1386 developed CAL during follow-up, respectively. We found the status of CD significantly modified the associations between smoking and CAL ( P interaction < 0.01). Among participants without CD, non-current smoking was independently associated with a decreased risk of CAL (odds ratio [OR] and 95% confidence interval [CI]: 0.80 [0.68-0.94]). Whereas, such association was not observed among CD patients. In joint analyses, compared with current smokers with CD (CD + &smoking + ), the ORs (95% CIs) were 0.72 (0.61-0.84), 0.94 (0.82-1.07), and 0.56 (0.49-0.64) for participants in the CD - &smoking + , CD + &smoking - , and CD - &smoking - group, respectively. Conclusion: Never and former smokers without CD might have a lower risk of CAL, but not the ones prevalent with CD, highlighting the carotid atherosclerotic benefits of early smoking cessation.
Published Version
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