Cigarette Smoking, Nicotine Levels and Increased Risk for Metabolic Syndrome in Women with Polycystic Ovary Syndrome

Overview

Journal Gynecol Endocrinol

Publisher Informa Healthcare

Specialties Endocrinology
Gynecology & Obstetrics

Date 2013 May 10

PMID 23656383

Citations 11

Authors

Cindy Ta Pau

Candace C Keefe

Corrine K Welt

Affiliations

Soon will be listed here.

Abstract

Women with polycystic ovary syndrome (PCOS) are at risk for metabolic syndrome, which may be exacerbated by smoking. We hypothesized that smoking worsens androgen levels and the metabolic profile in women with PCOS. PCOS smokers (n = 47) and non-smokers (n = 64) and control smokers (n = 30) and non-smokers (n = 28), aged 18-45 years, underwent anthropomorphic measurements, pelvic ultrasound and blood sampling. Smokers had higher cotinine (801 ± 83 versus <11 nmol/L; smokers versus non-smokers, respectively; p < 0.001) and nicotine levels (37 ± 4 versus <12 µmol/L; p < 0.001). Triglyceride levels were higher in women with PCOS who smoked compared to non-smokers (1.55 ± 0.18 versus 0.95 ± 0.08 mmol/L; p < 0.001), even when adjusted for BMI. Metabolic syndrome was more common in smokers with PCOS compared to non-smokers with PCOS and smokers who were controls (28.6 versus 3.6%; p = 0.02). There were no differences in reproductive parameters including androgen levels. Cotinine (r = 0.3; p < 0.001) and nicotine levels (r = 0.2; p = 0.005) correlated with triglycerides. Nicotine levels also correlated with pulse rate (r = 0.2; p = 0.02) and waist:hip ratio (WHR; r = 0.2; p = 0.02). Taken together, smoking may worsen the already high risk for metabolic syndrome in women with PCOS.

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References

Kong C, Nimmo L, Elatrozy T, Anyaoku V, Hughes C, Robinson S . Smoking is associated with increased hepatic lipase activity, insulin resistance, dyslipidaemia and early atherosclerosis in Type 2 diabetes. Atherosclerosis. 2001; 156(2):373-8. DOI: 10.1016/s0021-9150(00)00664-x. View

Barbieri R, McShane P, Ryan K . Constituents of cigarette smoke inhibit human granulosa cell aromatase. Fertil Steril. 1986; 46(2):232-6. View

Craig W, Palomaki G, Haddow J . Cigarette smoking and serum lipid and lipoprotein concentrations: an analysis of published data. BMJ. 1989; 298(6676):784-8. PMC: 1836079. DOI: 10.1136/bmj.298.6676.784. View

Howe G, Westhoff C, Vessey M, Yeates D . Effects of age, cigarette smoking, and other factors on fertility: findings in a large prospective study. Br Med J (Clin Res Ed). 1985; 290(6483):1697-700. PMC: 1416131. DOI: 10.1136/bmj.290.6483.1697. View

Eliasson B, Mero N, Taskinen M, Smith U . The insulin resistance syndrome and postprandial lipid intolerance in smokers. Atherosclerosis. 1997; 129(1):79-88. DOI: 10.1016/s0021-9150(96)06028-5. View

. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2003; 19(1):41-7. DOI: 10.1093/humrep/deh098. View

Ehrmann D, Liljenquist D, Kasza K, Azziz R, Legro R, Ghazzi M . Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005; 91(1):48-53. DOI: 10.1210/jc.2005-1329. View

Freeman D, Caslake M, Griffin B, Hinnie J, Tan C, Watson T . The effect of smoking on post-heparin lipoprotein and hepatic lipase, cholesteryl ester transfer protein and lecithin:cholesterol acyl transferase activities in human plasma. Eur J Clin Invest. 1998; 28(7):584-91. DOI: 10.1046/j.1365-2362.1998.00328.x. View

Welt C, Arason G, Gudmundsson J, Adams J, Palsdottir H, Gudlaugsdottir G . Defining constant versus variable phenotypic features of women with polycystic ovary syndrome using different ethnic groups and populations. J Clin Endocrinol Metab. 2006; 91(11):4361-8. DOI: 10.1210/jc.2006-1191. View

10.

Benowitz N, Jacob 3rd P . Nicotine and cotinine elimination pharmacokinetics in smokers and nonsmokers. Clin Pharmacol Ther. 1993; 53(3):316-23. DOI: 10.1038/clpt.1993.27. View

11.

Griffin B, Freeman D, Tait G, Thomson J, Caslake M, Packard C . Role of plasma triglyceride in the regulation of plasma low density lipoprotein (LDL) subfractions: relative contribution of small, dense LDL to coronary heart disease risk. Atherosclerosis. 1994; 106(2):241-53. DOI: 10.1016/0021-9150(94)90129-5. View

12.

Legro R, Kunselman A, Dodson W, Dunaif A . Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999; 84(1):165-9. DOI: 10.1210/jcem.84.1.5393. View

13.

Cupisti S, Haberle L, Dittrich R, Oppelt P, Reissmann C, Kronawitter D . Smoking is associated with increased free testosterone and fasting insulin levels in women with polycystic ovary syndrome, resulting in aggravated insulin resistance. Fertil Steril. 2009; 94(2):673-7. DOI: 10.1016/j.fertnstert.2009.03.062. View

14.

Norman R, Davies M, Lord J, Moran L . The role of lifestyle modification in polycystic ovary syndrome. Trends Endocrinol Metab. 2002; 13(6):251-7. DOI: 10.1016/s1043-2760(02)00612-4. View

15.

. Cigarette smoking among adults and trends in smoking cessation - United States, 2008. MMWR Morb Mortal Wkly Rep. 2009; 58(44):1227-32. View

16.

Shimokata H, Muller D, Andres R . Studies in the distribution of body fat. III. Effects of cigarette smoking. JAMA. 1989; 261(8):1169-73. View

17.

Ehrmann D, Barnes R, Rosenfield R, Cavaghan M, Imperial J . Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999; 22(1):141-6. DOI: 10.2337/diacare.22.1.141. View

18.

Grundy S, Brewer Jr H, Cleeman J, Smith Jr S, Lenfant C . Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004; 109(3):433-8. DOI: 10.1161/01.CIR.0000111245.75752.C6. View

19.

Cryer P, Haymond M, Santiago J, Shah S . Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events. N Engl J Med. 1976; 295(11):573-7. DOI: 10.1056/NEJM197609092951101. View

20.

Asuncion M, Calvo R, San Millan J, Sancho J, Avila S, Escobar-Morreale H . A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000; 85(7):2434-8. DOI: 10.1210/jcem.85.7.6682. View