Effects of smoking tobacco on exercise tolerance in healthy subjects

The aim of the study was to investigate the effects of smoking on exercise tolerance in middle aged smokers. Sixty two healthy subjects 55 males and 7 females with mean age 35 +/- 7 years were studied. There were 47 smokers (smoking 21.5 cigarettes per day for a mean of 16 years) and 15 non-smokers (control group). Resting pulmonary function was normal in both groups, however smokers had significantly lower VC as well as MEF 50 and MEF 75. A maximal incremental exercise on cycloergometer using ramp protocol was performed. Ventilatory parameters (breath by breath method) together with transcutaneous oxygen saturation (every minute), heart rate (continuously) and blood pressure (every minute) were recorded. Significant differences in exercise tolerance in studied groups were observed. Smokers tolerated a lower maximal workload for a shorter time and deferred significantly in both maximal oxygen consumption and oxygen consumption at anaerobic threshold. Five persons, all smokers did not reach the anaerobic threshold. In five smokers a decrease in ECG ST segment was observed. No differences were found in breathing reserve, heart reserve or maximal oxygen pulse. It seems that a decreases exercise performance is due to cardiac limitation.     

Decreased postprandial high density lipoprotein cholesterol and apolipoproteins A-I and E in normolipidemic smoking men: relations with lipid transfer proteins and LCAT activities

We have previously reported that normolipidemic smokers are lipid intolerant due to increased responses of triglyceride-rich lipoproteins (TRL) apolipoprotein B-48, triglyceride (TG), and retinyl esters to a mixed meal compared to non-smokers. To investigate whether postprandial high density lipoprotein (HDL), apolipoprotein A-I (apoA-I), apolipoprotein A-II (apoA-II), and apolipoprotein E (apoE) concentrations or lipid transfer protein activities are affected by cigarette smoking, we investigated 12 male smokers and 12 non-smokers with comparable fasting lipoprotein profile, BMI, and age. Plasma samples obtained after an overnight fast and postprandially were separated by density gradient ultracentrifugation. Postprandial apoA-I, lipoprotein AI-particles (LpA-I), HDL-cholesterol, and HDL apoE concentrations decreased in smokers, but remained unchanged in controls. Concomitantly, cholesterol and apoE concentrations increased significantly in TRL fractions in smokers. Fasting lecithin:cholesterol acyltransferase (LCAT) and phospholipid transfer protein (PLTP) activity levels, as well as esterification rates (EST) and phospholipid transfer rates were comparable between the groups. Cholesteryl ester transfer protein (CETP) activity levels were lower in the smokers. Postprandially EST increased, but CETP and PLTP activities deceased in smokers as compared to controls. We conclude, that even healthy, normolipidemic smokers have altered postprandial high density lipoprotein (HDL) cholesterol and apolipoprotein composition, as well as lipid transfer protein activities. The shift of cholesterol and apoE from HDL to the triglyceride-rich lipoprotein (TRL) fraction, together with decreased plasma apoA-I and LpA-I concentrations during alimentary lipemia may indicate impaired reverse cholesterol transport. Both the postprandial increase in TRL and the lowering of HDL may promote atherogenesis in smokers.     

Effects of cigarette smoking on antioxidant vitamin and activities of antioxidases

Levels of plasma vitamin C and E (P-VC, P-VE), beta-carotene (P-beta-Car), lipoperoxides (P-LPO), and activity of erythrocyte superoxide dismutase (E-SOD) were measured in 871 healthy smokers and 348 healthy non-smokers to study the relationship between cigarette smoking and antioxidant vitamins and oxygen free radicals. Results showed that levels of P-VC, P-VE, P-beta-Car and E-SOD reduced significantly, and level of P-LPO increased significantly in smokers, as compared with those in non-smokers. Levels of P-VC, P-VE, P-beta-Car and E-SOD reduced and level of P-LPO increased in 65 male smokers at the same age, with the increase of duration of smoking and quantity of cigarettes smoked, showing a linear correlationship. It suggested that there existed serious imbalance between oxidation and antioxidation in the bodies of smokers, and oxygen free radical reaction and reaction of lipoperoxidation obviously intensified.     

Contrasting renal effects of nicotine in smokers and non-smokers

BACKGROUND: Cigarette smoking is associated with acute increase in arterial pressure due to systemic vasoconstriction and decreased skin and coronary blood flow. Virtually all cardiovascular effects of cigarette smoking are due to nicotine. However, whether nicotine also affects the renal circulation and function in humans is at present unknown. METHODS: In the current study the acute effects of a 4-mg nicotine gum on arterial pressure, heart rate as well as renal haemodynamics and function were assessed in non-smokers and chronic smokers. RESULTS: In non-smokers, mean arterial pressure (+8 +/- 1 mmHg, P<0.001) and heart rate (+13 +/- 3 beats/min, P<0.001) increased whereas effective renal plasma flow (ERPF) and glomerular filtration rate (GFR) decreased by 15 +/- 4% and 14 +/- 4% respectively; in addition, urinary cyclic GMP decreased by 51 +/- 12% in response to nicotine administration. In smokers, mean arterial pressure and heart rate increased similarly; however, in contrast with non-smokers, ERPF and GFR remained unchanged whereas urinary cyclic GMP rose by 87 +/- 43%. Changes in ERPF induced by nicotine were positively correlated with changes in urinary cyclic GMP. CONCLUSIONS: These findings indicate that nicotine administration is associated with renal vasoconstriction in healthy non-smokers, possibly through alteration of a cyclic-GMP-dependent vasoactive mechanism. Tolerance to the renal effect of nicotine was observed in chronic smokers, despite the maintenance of the systemic response to nicotine.     

Outcomes measurement in today''s health care environment

The effects of smoking habits on thyroid function, echo-texture (nodules and/or cysts) and thyroid gland volume were determined by using ultrasound and measuring serum Thyroxin (T4), Triiodothyronine (T3), Thyrotropin (TSH) and TPO antibodies (ab-TPO) in 189 healthy smokers and non-smokers, randomly selected (111 females and 78 males) among the employees of our hospital and their relatives. When the entire group of subjects was considered the mean ratio of thyroid gland volume/body weight was found to be significantly higher in male (P < 0.05) and female (P < 0.05) smokers compared with non-smokers. In female smokers, mean serum thyroid-stimulating hormone (TSH) was lower (P < 0.05) and the degree of smoking was positively correlated with the ratio of thyroid gland volume/body weight (P < 0.05). However, when the subjects with a family history of goitre in first degree relatives were excluded from our study (14 females and 9 males), no significant differences in mean ratio of thyroid volume/weight or TSH between the remaining smokers and non-smokers were detected. In both sexes, the correlation between the degree of smoking and thyroid volume, although positive, did not reach statistical significance. No difference in prevalence of abnormal echogenicity and echo-texture (nodules and cysts) between smokers and non-smokers was detected. It is concluded that smoking habits present a goitrogenic effect only in subjects with a family history of goitre but have no influence on thyroid gland texture.     

The effects of smoking outside workplaces on non-regular smokers

The introduction of workplace smoking bans has resulted in smokers smoking outside their workplaces (exiled smoking). Social identity theory postulates that this may cause antagonism between smokers and non-smokers, or where non-smokers were friends with smokers, pressure on non-smokers to smoke. This study examines perceptions and beliefs about exiled smoking in 166 non-smoking workers. They saw smokers as having a work benefit not available to them, but otherwise they were generally not drawn to the activity. Half had joined smokers outside for breaks, but of these only one-third had ever smoked. Those would smoked reported that they did not have a regular pattern of joining the same group of smokers. Although it may provide a conduit for susceptible non-smokers to take up smoking, exiled smoking does not appear to influence those who are not otherwise vulnerable.     

Bilirubin binding capacity of albumin isolated from cord-blood serum is less than that from serum of adults

As estimated by Sephadex gel filtration, the bilirubin binding capacity of albumin isolated from cord-blood serum by ion-exchange chromatography is less than that of albumin isolated from serum of adults. Albumin isolated from cord-blood serum showed increased bilirubin binding as compared with the albumin in the native serum. These findings suggest that the lower bilirubin binding capacity of serum from newborns as compared with serum from adults is a result of both an intrinsic deficiency in binding capacity of neonatal albumin and the presence of substances in neonatal serum that interfere with bilirubin binding.     

Results of limited initial periodontal therapy in smokers and non-smokers

Eighty-seven adult patients (54 non-smokers and 33 smokers) with moderate to advanced periodontitis were treated with 1-hour full-mouth subgingival scaling and root planing, with no maintenance recalls, during this 9-month study. Clinical parameters assessed at target sites included probing depth, clinical attachment level, bleeding on probing, gingival index, and plaque index. Data were collected at baseline, and 3, 6, and 9 months. Baseline probing depth for non-smokers was 5.46 +/- .46 mm and for smokers 5.70 +/- 0.66 mm. Data analysis (t test) revealed that both non-smokers and smokers had a statistically significant decrease (P < 0.05) in probing depth at 3 months which was maintained throughout the study. At 9 months non-smokers maintained a mean decrease in probing depth of 0.60 mm and smokers a mean decrease of 0.65 mm. Both smokers and non-smokers displayed a significant gain (P < 0.05) in clinical attachment level after initial therapy when compared to baseline readings. At 9 months the mean gain in clinical attachment level for non-smokers was 0.47 mm and 0.59 mm for smokers. Plaque index scores remained consistent for smokers and non-smokers for the duration of the study. The gingival index at baseline was significantly (P < 0.05) lower in smokers (1.32 +/- 0.45) than non-smokers (1.45 +/- 0.40). By 9 months only the gingival index of non-smokers decreased significantly compared to baseline (1.26 +/- 0.37). Bleeding on probing was a prerequisite for target sites at baseline. At 9 months both smokers (0.67 +/- 0.39) and non-smokers (0.78 +/- 0.30) had a significant decrease in bleeding on probing compared to baseline. At 9 months there were no significant differences between smokers and non-smokers comparing probing depth, clinical attachment level, plaque index, bleeding on probing, and gingival index. The data have shown that smokers and non-smokers responded similarly after 9 months to the limited amount of initial therapy provided.     

Independent responsiveness of frog liver low-density lipoprotein receptor and HMGCoA reductase to estrogen treatment

We examined the mutagenicity of cigarette smoker's urine in 32 healthy male cigarette smoker and 37 healthy male non-smoker. Twenty-four-hour urine specimens were subjected to blue rayon extraction which selectively adsorb polycyclic compounds, after which the elutions were fractionated by carboxymethyl cellulose column chromatography for removing antimutagenic compounds. The mutagens were measured by using an S9-mediated Salmonella mutagenicity test on strain TA98. Compared with those with non-smokers, smokers' urine showed a significantly higher urinary level of mutagens in the acid-elutable and in the sum of all chromatography fractions. A similar tendency was also seen in the alkali-elutable fraction. The subjects were classified into three groups according to the number of smoked cigarettes. Heavy smokers, who smoked more than 20 cigarettes per day, showed a significantly higher urinary level of mutagens than both non-smokers and light smokers especially in the acid-elutable and in the sum of all chromatography fractions. Our findings suggest that smokers are exposed to a great amount of polycyclic carcinogens and mutagens by cigarette smoking. These results also suggest that urinary level of mutagens measured by using blue rayon extraction combined with carboxymethyl cellulose chromatography could be a good index for estimating the exposure to carcinogens and mutagens such as polycyclic compounds.     

Trace elements in human scalp hair and soil in Irian Jaya

Benzo[a]pyrene (BaP) and other polycyclic aromatic hydrocarbons (PAHs) which are present in cigarette smoke, are common air and food genotoxic contaminants and possible human carcinogens. We measured the following PAH levels: benzo[a]anthracene, benzo[b]fluoranthene, benzo[k]fluoranthene, BaP, dibenzo[a,h]anthracene, benzo[g,h,i]perylene as well as (+/-) syn and anti BaP diol-epoxide (BPDE) DNA adducts in autopsy samples from the lungs of non-smokers, ex-smokers and smokers who had lived in Florence, Italy. PAH levels in lung tissue were similar in all groups, with the exception of dibenzo[a,h]anthracene (DBA), which was higher in lung samples from smokers (n = 10, 0.18+/-0.17 ng/g d.w, mean +/- S.D.) compared to non-smokers (n = 15, 0.046+/-0.025 ng/g d.w) (P < 0.05), whereas ex-smokers (n = 5), had intermediate levels (0.07+/-0.03 ng/g d.w). The average level of total BPDE-DNA adducts was 4.46+/-5.76 per 10(8) bases in smokers, 4.04+/-2.37 per 10(8) in ex-smokers and 1.76+/-1.69 per 10(8) in non-smokers. The levels of non-smokers were significantly different (P < 0.05) from the levels of the smokers and ex-smokers combined. Total BPDE-DNA adducts were correlated with BaP levels in the lung samples in which both determinations were obtained (r = 0.63). Our results demonstrate that the biological load of PAHs due to environmental pollution is similar in individuals who smoke and those who do not, but BPDE-DNA adducts are higher in smokers and ex-smokers compared to non-smokers. This study further confirms the usefulness of BPDE-DNA adduct levels determination in the lungs from autopsy samples for monitoring long-term human exposure to BaP, a representative PAH.     

Bronchus associated lymphoid tissue (BALT) in human lung: its distribution in smokers and non-smokers

BACKGROUND: Bronchus associated lymphoid tissue (BALT) is a normal component of the lung's immune system in many animals and may be analogous to gut associated lymphoid tissue (GALT). This study aimed at assessing the nature and extent of BALT in human lung and determining whether its expression is induced within the human airway in response to smoking. METHODS: Paraffin embedded, formalin fixed full thickness bronchial wall sections were examined from 31 whole lung specimens derived from both smokers and non-smokers. Samples were taken from throughout the bronchial tree to include main stem bronchi, lobar bronchi and segmental bronchi, as well as first to third generation carinae. Standard 4 microns step sections were stained by haematoxylin and eosin and immunocytochemical methods to show foci of BALT. RESULTS: Examination of 256 airway sites detected 46 foci of BALT. These differed from those described in other mammals in being distributed throughout the bronchial tree, in being found in relation to bronchial glandular epithelium as well as luminal bronchial epithelium, and in lacking any accompanying M cells. Analysis by smoking status showed that the expression of BALT was significantly more common in smokers than non-smokers (82% (14/17) v 14% (2/14) respectively). CONCLUSIONS: The findings support the view that BALT in humans is an integral feature in a comparatively small proportion of lungs from non-smokers while being significantly more prominent in lungs from smokers. The tissue shows several important differences from that described in other mammals.     

Cigarette smoking and periodontal destruction in young adults

The relationship between cigarette smoking and periodontal destruction was assessed in young adults. Eighty-two regular dental attenders (21 current cigarette smokers, 61 non-smokers) aged between 20 and 33 years were examined. The smokers consumed on average 15.4 (+/- 7.3) cigarettes per day and had smoked for an average of 11.8 (+/- 7) years. Cigarette smokers had almost the same levels of plaque as non-smokers but had more proximal surfaces with subgingival calculus (P < 0.01) and which bled on probing (P < 0.05). Smokers had significantly more pockets > or = 4 mm (14.6 +/- 19.9) than non-smokers (5.8 +/- 7.9), P < 0.01. Only 2 (10%) of the smokers and 1 (2%) of the non-smokers had deep pocketing (> or = 6 mm). Smokers had significantly more sites (21.8 +/- 24.9) with periodontal attachment loss of > or = 2 mm than non-smokers (9.3 +/- 12.2), P < 0.01. Severe loss of periodontal attachment (> or = 6 mm) was present in 4 (19%) of smokers compared with 2 (3%) of non smokers. In total 4 (19%) of the smokers had "established periodontitis" compared with 1 (2%) of the non-smokers. The odds ratio for the presence of "established periodontitis" and smoking was 14.1 (confidence interval 1.5 to 132.9). It is concluded that cigarette smoking was a major environmental factor associated with accelerated periodontal destruction in this selected group of young adult regular dental attenders.     

Smoking and vascular density of healthy marginal gingiva

The influence of smoking on the vascular characteristics in periodontally healthy individuals was studied over a period of 11 wk. Fourteen healthy female dental students, 7 smokers and 7 nonsmokers, aged 25 to 38 yr, volunteered for the experiment. Photodocumentation was performed on four occasions with the aid of a stereophotographic method. The characteristics of gingival vessels were evaluated according to a semi-quantitative vascular index. It was found that the vascular density was not statistically significantly different in smokers and nonsmokers. Furthermore, the vascular density remained stable in both smokers and nonsmokers. The results suggest that the vascular density of the marginal gingiva is uninfluenced by moderate smoking once healthy gingival conditions prevail.     

Idiopathic normal pressure hydrocephalus: analysis of factors related to cerebrospinal fluid dynamics determining functional prognosis

OBJECTIVE: To examine the effect of maternal smoking on the relationship between maternal hemoglobin levels and pregnancy outcome. DESIGN: A prospective study of healthy parous women from early pregnancy and of their infants. SETTING: Three Scandinavian university hospitals covering all deliveries from well defined geographical areas. SUBJECTS: Smoking (669) and non-smoking (368) mothers, para 1 and 2 and with > or = 37 weeks of gestational length. MAIN OUTCOME MEASURES: Birth weight and placental weight. Ponderal Index and Placental Index as measures of possible discordant fetal and placental growth. RESULTS: In non-smoking mothers the hemoglobin levels in the three trimesters had no relation to birth weight. In smoking mothers a significantly lower birth weight was seen with a high hemoglobin level in the third trimester, but hemoglobin levels in early or mid-pregnancy had no association to birth weight. Smoking mothers also had a significantly greater fall in hemoglobin concentration from first to second and third trimester as compared to non-smokers although ferritin levels were similar in smokers and non-smokers, implying similar iron stores. The ratio of placental weight to the weight of the newborn was significantly higher in smokers, but no association was found to different hemoglobin levels. CONCLUSIONS: Fetal growth impairment associated with maternal smoking is even more pronounced in smoking mothers with high hemoglobin levels in late pregnancy. Smoking mothers were also found to have disproportional fetal/placental growth with relatively high placental weights. In non-smoking mothers hemoglobin levels had no relation to birthweight.     

Relative hyperoxaluria, crystalluria and haematuria after megadose ingestion of vitamin C

The purpose of the present study was to compare the bleeding tendency as elicited by probing the marginal gingiva (BOMP) and probing to the bottom of the pocket (BOPP) in smokers and non-smokers in natural gingivitis and during experimental gingivitis. 11 smokers (sm) and 14 non-smokers (nsm) were recruited. When they had less than 20% approximal bleeding sites, they entered a 14-day trial period of 'experimental gingivitis'. Subjects returned 30 days later, after resuming normal oral hygiene procedures, for a final gingival assessment. A split-mouth design was chosen using 2 contra-lateral quadrants for each index (being either BOMP or BOPP). A consistently higher bleeding score of approximately 10% was observed by probing to the bottom of the pocket. At day 14 with both indices, a significant difference between smokers and non-smokers was detected (BOMP: sm=15%, nsm=30%; BOPP: sm=27%, nsm=44%). The increment between gingival health and experimental gingivitis was significantly higher in non-smokers than in smokers but comparable for both indices (BOMP: sm=8%, nsm=23%; BOPP: sm=9%, nsm=26%). Probing to the bottom of the pocket results in significantly more bleeding in gingival health and gingivitis as compared to probing of the marginal gingiva. This shows that evaluation of the gingival condition with BOMP, the method of choice with respect to gingivitis, can be used as a parameter for inflammation when comparing smokers and non-smokers. The suppressed inflammatory response to plaque accumulation, as observed in smokers, indicates that they should be identified as a separate group when they participate as panelists in (experimentally induced) gingivitis studies.     

The relationship between smoking, cholesterol, and HDL-C levels in adult women

The purpose of this study was to determine the independent relationship between smoking quantity and cholesterol (TC) and lipoprotein levels (HDL-C) in women. A total of 805 female subjects were grouped as: non-smokers, ex-smokers, light smokers, moderate smokers, and heavy smokers. TC and HDL-C were examined before and after controlling for the coexisting risk factors of age, body composition, fitness level, dietary fat intake, family history of coronary artery disease, oral contraceptive, and alcohol use. Preliminary analysis demonstrated significant differences (p < .01) in TC between heavy smokers and all other groups and significant differences in HDL-C between heavy to moderate smokers and ex- and non-smokers. After adjusting for confounding variables, the differences in TC and HDL-C remained unchanged between the groups. It was concluded that heavy to moderate smoking was independently associated with higher TC and lower HDL-C levels, and that smoking abstinence or smoking cessation may be associated with healthier lipoprotein profiles in adult women. Based on these findings, it was recommended that employers consider the provision of health promotion programs including seminars, behavioral modification workshops, as well as financial incentives for employees to stop smoking.     

Association between marginal bone loss around osseointegrated mandibular implants and smoking habits: a 10-year follow-up study

While many factors are conceivable, occlusal loading and plaque-induced inflammation are frequently stated as the most important ones negatively affecting the prognosis of oral implants. Currently, little is known about the relative importance of such factors. The aim of this study was to analyze the influence of smoking and other possibly relevant factors on bone loss around mandibular implants. The participants were 45 edentulous patients, 21 smokers and 24 non-smokers, who were followed for 10-year period after treatment with a fixed implant-supported prosthesis in the mandible. The peri-implant bone level was measured on intraoral radiographs, information about smoking habits was based on a careful interview, and oral hygiene was evaluated from clinical registration of plaque accumulation. Besides standard statistical methods, multiple linear regression models were constructed for estimation of the relative influence of some factors on peri-implant bone loss. The long-term results of the implant treatment were good, and only three implants (1%) were lost. The mean marginal bone loss around the mandibular implants was very small, about 1 mm for the entire 10-year period. It was greater in smokers than in non-smokers and correlated to the amount of cigarette consumption. Smokers with poor oral hygiene showed greater marginal bone loss around the mandibular implants than those with good oral hygiene. Oral hygiene did not significantly affect bone loss in non-smokers. Multivariate analyses showed that smoking was the most important factor among those analyzed for association with peri-implant bone loss. The separate models for smokers and non-smokers revealed that oral hygiene had a greater impact on peri-implant bone loss among smokers than among non-smokers. This study showed that smoking was the most important factor affecting the rate of peri-implant bone loss, and that oral hygiene also had an influence, especially in smokers, while other factors, e.g., those associated with occlusal loading, were of minor importance. These results indicate that smoking habits should be included in analyses of implant survival and peri-implant bone loss.     

Prospective study of effect of switching from cigarettes to pipes or cigars on mortality from three smoking related diseases

OBJECTIVE: To estimate the extent to which cigarette smokers who switch to cigars or pipes alter their risk of dying of three-smoking related diseases-lung cancer, ischaemic heart disease, and chronic obstructive lung disease. DESIGN: A prospective study of 21520 men aged 35-64 years when recruited in 1975-82 with detailed history of smoking and measurement of carboxyhaemoglobin. MAIN OUTCOME MEASURES: Notification of deaths (to 1993) classified by cause. RESULTS: Pipe and cigar smokers who had switched from cigarettes over 20 years before entry to the study smoked less tobacco than cigarette smokers (8.1 g/day v 20 g/day), but they had the same consumption as pipe and cigar smokers who had never smoked cigarettes (8.1 g) and had higher carboxyhaemoglobin saturations (1.2% v 1.0%, P < 0.001), indicating that they inhaled tobacco smoke to a greater extent. They had a 51% higher risk of dying of the three smoking related diseases than pipe or cigar smokers who had never smoked cigarettes (relative risk 1.51; 95% confidence interval 0.96 to 2.38), a 68% higher risk than lifelong non-smokers (1.68; 1.16 to 2.45), a 57% higher risk than former cigarette smokers who gave up smoking over 20 years before entry (1.57; 1.04 to 2.38), and a 46% lower risk than continuing cigarette smokers (0.54; 0.38 to 0.77). CONCLUSION: Cigarette smokers who have difficulty in giving up smoking altogether are better off changing to cigars or pipes than continuing to smoke cigarettes. Much of the effect is due to the reduction in the quantity of tobacco smoked, and some is due to inhaling less. Men who switch do not, however, achieve the lower risk of pipe and cigar smokers who have never smoked cigarettes. All pipe and cigar smokers have a greater risk of lung cancer than lifelong non-smokers or former smokers.     

The influence of oral glucose intake on binding and degradation of 125I-insulin by receptors on erythrocytes as well as on insulin and C-peptide serum levels in patients after myocardial infarction and healthy individuals

In this study, we investigated the influence of glucose administration on binding and degradation of 125I-insulin by receptors on erythrocytes as well as on insulin and C-peptide serum levels in 15 patients after myocardial infarction and in 15 age-matched healthy persons. Venous blood samples were taken directly before and at 30, 60 and 120 minutes after oral administration of 75 g of glucose. In the collected blood samples serum glucose, insulin and C-peptide levels were determined. Binding and degradation of 125I-insulin by specific receptors on red blood cells were evaluated using the method described by Gambhir and modified by the authors. Serum insulin and C-peptide levels were significantly higher while binding of 125I-insulin to erythrocytes was decreased in patients after myocardial infarction. These results seem to support the hypothesis that insulin resistance and hyperinsulinism play a role in the pathogenesis of ischaemic heart disease. Impaired degradation of 125I-insulin during the oral glucose tolerance test in the patients after myocardial infarction indicates that insulin resistance is located at the receptor level.     

The relationship between body mass and cigarette smoking using a biochemical index of smoking exposure

This study evaluated the relationship between smoking and body mass using objective indices of both smoking exposure (COHb) and body mass. The subjects were 4240 adults who participated in the Second National Health and Nutrition Examination Survey (NHANES II). Measurements of dietary intake, physical activity, demographics, body mass index (BMI) and blood carboxy-haemoglobin (COHb) were used in these analyses. After controlling for covariables of body mass, the results indicated that smokers displayed a significantly lower mass compared with non-smokers. Smokers with higher levels of COHb had lower BMIs than smokers at lower COHb levels. White smokers had lower BMIs with increasing COHb exposure whereas black smokers had BMIs at high COHb exposure similar to those of non-smokers. Results indicated that smokers weighed less than non-smokers and that the weight control 'benefits' of smoking were most pronounced in white subjects who were heavy smokers.