Joint Impact of Smoking and Metabolic Syndrome on Cardiovascular Disease: A Cohort Study.

IF 2.8 2区医学 Q2 PERIPHERAL VASCULAR DISEASE

Journal of atherosclerosis and thrombosis Pub Date : 2025-08-30 DOI:10.5551/jat.65812

Huan Hu, Tohru Nakagawa, Toru Honda, Shuichiro Yamamoto, Hiroko Okazaki, Hiroshi Ide, Seitaro Dohi, Toshiaki Miyamoto, Makoto Yamamoto, Naoki Gommori, Takeshi Kochi, Takayuki Ogasawara, Maki Konishi, Isamu Kabe, Tetsuya Mizoue

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Abstract

Aims: This study examined whether or not the coexistence of smoking and metabolic syndrome synergistically increases the risk of cardiovascular disease (CVD) beyond their individual effects.

Methods: This prospective cohort study included 68,743 workers from the Japan Epidemiology Collaboration on Occupational Health Study. The participants were categorized into four groups based on their smoking status and metabolic syndrome. Biological interactions were evaluated using relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S).

Results: During a mean follow-up of 7.2 (range: 0.1-10.9) years, 346 participants developed CVD. Current smokers with metabolic syndrome had the highest CVD risk (hazard ratio: 6.45, 95% confidence interval [CI]: 4.73-8.80). Approximately 35% of CVD cases among individuals exposed to both factors were attributed to their biological interactions (RERI: 2.27, 95% CI: 0.56-3.98; AP: 0.35, 95% CI: 0.15-0.55; S: 1.71, 95% CI: 1.16-2.52). An analysis of CVD subtypes revealed a significant biological interaction for myocardial infarction (RERI: 5.14, 95% CI: 0.65-9.62; AP: 0.52, 95% CI: 0.26-0.78; S: 2.38, 95% CI: 1.22-4.62) but not for stroke (RERI: 1.34, 95% CI: -0.46-3.13; AP: 0.25, 95% CI: -0.03-0.53; S: 1.44, 95% CI: 0.89-2.34).

Conclusion: Smoking and metabolic syndrome interact synergistically to elevate CVD risk, particularly for myocardial infarction. Targeting both factors is essential for CVD prevention.

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吸烟和代谢综合征对心血管疾病的共同影响：一项队列研究

目的：本研究探讨吸烟和代谢综合征共存是否会协同增加心血管疾病（CVD）的风险。方法：本前瞻性队列研究包括68,743名来自日本职业健康流行病学合作研究的工人。参与者根据他们的吸烟状况和代谢综合征被分为四组。利用相互作用的相对过量风险（rei）、可归因比例（AP）和协同作用指数(S)评估生物相互作用。结果：在平均7.2年（0.1-10.9年）的随访期间，346名参与者发生了心血管疾病。当前吸烟者合并代谢综合征的心血管疾病风险最高（危险比：6.45,95%可信区间[CI]: 4.73-8.80）。在暴露于这两种因素的个体中，大约35%的CVD病例归因于它们的生物相互作用（相对危险度：2.27,95% CI: 0.56-3.98；相对危险度：0.35,95% CI: 0.15-0.55；相对危险度：1.71,95% CI: 1.16-2.52）。一项分析显示，心血管疾病的不同类型与心肌梗死之间存在显著的生物相互作用（相对危险度：5.14,95% CI: 0.65-9.62；相对危险度：0.52,95% CI: 0.26-0.78；相对危险度：2.38,95% CI: 1.22-4.62），但与卒中之间没有显著的生物相互作用（相对危险度：1.34,95% CI: -0.46-3.13；相对危险度：0.25,95% CI: -0.03-0.53；相对危险度：1.44,95% CI: 0.89-2.34）。结论：吸烟和代谢综合征相互作用，增加心血管疾病的风险，特别是心肌梗死。针对这两个因素对预防心血管疾病至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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