The relationship between smoking status and metabolic syndrome : a cross sectional study among employees at a university in Lebanon

Abstract

Background: Tobacco use is the leading cause of preventable death worldwide. The prevalence of smoking and metabolic syndrome (MetS) is increasing globally and in Lebanon. The objectives of this study are to assess the prevalence of tobacco use (waterpipe, cigarette, cigar, pipe, smokeless tobacco products) and to examine the independent associations between tobacco and MetS/ MetS components (low high-density lipoprotein, elevated triglyceride, hypertension, impaired fasting glucose and abdominal obesity) among a sample of Lebanese adults. Methods: A cross-sectional study was carried out on Notre Dame University (NDU) employees. A total of 316 participants aged between 20 and 74 years old were included. Sociodemographic and lifestyle characteristics, including smoking status, were gathered via a questionnaire. Anthropometric and biochemical measures were also assessed. MetS was defined according to the third Report of the National Cholesterol Education Program (NCEP- ATP III). The data were analyzed using the SPSS version 22. P < 0.05 was considered statistically significant. Logistic regression was used to examine the association between smoking and MetS/ MetS components. The prevalence of MetS was found to be significantly higher among smokers (63.2%), as compared to former smokers (5.9%) and people who never smoked (30.9%), p=0.002. Among MetS components, the prevalence of high blood pressure, high triglyceride levels, low high-density lipoprotein levels and abdominal obesity was higher among current smokers (53.2%, 56.6%, 63.7% and 56.2%, respectively) as compared to former smokers (6.5%, 6.1%, 3.9% and 3.2%, respectively) and people who never smoked (40.3%, 37.4%, 32.5% and 40.6%, respectively). After controlling for the effects of age, gender, income, level of education, physical activity level, marital status, clinical diagnosis of hypertension, diabetes and chronic conditions other than, diabetes, cardiovascular disease, stroke, hypertension, asthma, cancer, neurological disease, kidney disease, liver cirrhosis, thyroid gland disorder, family history of diabetes, hypertension, obesity, heart disease, hypercholesterolemia, hypertriglyceridemia, medication intake, body fat percentage (BF %) and CRP, smoking was significantly associated with MetS (OR=4.12; 95% CI: [1.52- 11.56], p=0.006), low high-density lipoprotein cholesterol (OR=2.56; 95% CI: [1.29-5.19], p=0.007), hypertriglyceridemia (OR=15.72; 95% CI: [1.07-231.19], p=0.045), and abdominal obesity (OR=2.63; 95% CI: [1.15-6.01], p=0.022). Conclusion: Smoking was found to be significantly associated with increased risk of metabolic syndrome and some of its components (low high-density lipoprotein, high triglyceride and abdominal obesity). However, no significant association was found between smoking and hypertension or impaired fasting glucose.