Abstract
BackgroundEpidemiological evidence suggests that smoking has been associated with emergence of metabolic syndrome. However, data on this issue are inconsistent and controversial. We therefore conducted a meta-analysis to examine the association between smoking and metabolic syndrome.Methodology and Principal FindingsWe searched the Medline, Embase and the Cochrane Library database up to March 2012 to identify prospective cohort studies related to smoking and metabolic syndrome. Reference lists of retrieved articles were also reviewed. Summary effect estimates were derived using a random-effects model and stratified by gender, smoking dose, follow-up duration and geographical area. Primary analysis of 13 studies involving 56,691 participants and 8,688 cases detected a significant positive association between active smoking and risk of metabolic syndrome (pooled relative risk [RR] 1.26, 95% CI: 1.10–1.44). Estimates of effects were substantially consistent in the stratified analyses. In the dose-response analysis, risk of metabolic syndrome was stronger for active male smokers (pooled RR 1.34, 95% CI: 1.20–1.50) than it was for former male smokers (pooled RR 1.19, 95% CI: 1.00–1.42), and greater for heavy smokers (pooled RR 1.42, 95% CI: 1.27–1.59) compared with light smokers (pooled RR 1.10, 95% CI: 0.90–1.35). No evidence of statistical publication bias was found (Egger' s test P = 0.227, Begg' s test P = 0.113).ConclusionsActive smoking is associated with development of metabolic syndrome. Smoking cessation appears to reduce the risk of metabolic syndrome.
Highlights
The adverse effect of tobacco use on health has been well established for over half a century
Active smoking is associated with development of metabolic syndrome
A borderline significant increased risk of metabolic syndrome was found in former male smokers (Figure 3, pooled relative risk (RR) 1.19, 95% confidence interval (CI): 1.00– 1.42)
Summary
The adverse effect of tobacco use on health has been well established for over half a century. The association of tobacco use with the onset of metabolic syndrome has been recognized in the past decade. Cigarette smoking has been proven to play a role in emergence of various components of metabolic syndrome and could lead to occurrence and progression of the disease through multiple mechanisms. Available data from epidemiological studies on this issue are inconsistent and controversial. One study conducted among Turkish women even found a protective effect of smoking on metabolic syndrome [5]. Different definitions of metabolic syndrome and individual baseline information of the study population might lead to inconsistent results on this issue. Epidemiological evidence suggests that smoking has been associated with emergence of metabolic syndrome. Data on this issue are inconsistent and controversial. We conducted a meta-analysis to examine the association between smoking and metabolic syndrome
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