Yonsei Med J.  2015 Jul;56(4):921-927. 10.3349/ymj.2015.56.4.921.

Association between Fibrinogen and Carotid Atherosclerosis According to Smoking Status in a Korean Male Population

• Cho HM
• Kang DR
• Kim HC
• Oh SM
• Kim BK
• Suh I

• KMID: 2366330
• DOI: http://doi.org/10.3349/ymj.2015.56.4.921

Abstract

PURPOSE
Although inconsistent, reports have shown fibrinogen levels to be associated with atherosclerosis. Accordingly, since cigarette smoking is associated with increased levels of fibrinogen and atherosclerosis, it may also affect the association between fibrinogen and atherosclerosis. We investigated the associations between fibrinogen and carotid intima-media thickness (IMT) according to smoking status in a Korean male population.
MATERIALS AND METHODS
Plasma fibrinogen levels were measured in 277 men aged 40-87 years without a history of myocardial infarction or stroke. High-resolution B-mode ultrasonography was used to examine the common carotid arteries. IMT level was analyzed both as a continuous (IMT-max, maximum value; IMT-tpm, 3-point mean value) and categorical variable (higher IMT; presence of plaque). Serial linear and logistic regression models were employed to examine the association between fibrinogen and IMT according to smoking status.
RESULTS
Fibrinogen levels were positively associated with IMT-max (standardized beta=0.25, p=0.021) and IMT-tpm (standardized beta=0.21, p=0.038), even after adjusting for age, body mass index, systolic blood pressure, fasting glucose, and total cholesterol to high-density lipoprotein cholesterol ratio in current smokers (n=75). No significant association between fibrinogen and IMT, however, was noted in former smokers (n=80) or nonsmokers (n=122). Adjusted odds ratios (95% confidence interval) for having plaque per one standard deviation higher fibrinogen level were 2.06 (1.09-3.89) for current smokers, 0.68 (0.43-1.10) for former smokers, and 1.06 (0.60-1.87) for nonsmokers.
CONCLUSION
Our findings suggest that cigarette smoking may modify the association between fibrinogen and carotid atherosclerosis. Further studies are required to confirm this finding in different populations.

Keyword

Fibrinogen; smoking; atherosclerosis; intima-media thickness

MeSH Terms

Adult
Aged
Aged, 80 and over
Asian Continental Ancestry Group/*statistics & numerical data
Atherosclerosis/*ultrasonography
Blood Pressure
Body Mass Index
Carotid Artery Diseases/*blood/epidemiology/ultrasonography
Carotid Artery, Common
*Carotid Intima-Media Thickness
Cholesterol/blood
Cholesterol, HDL
Cross-Sectional Studies
Fibrinogen/*analysis
Humans
Lipoproteins, HDL/blood
Logistic Models
Male
Middle Aged
Republic of Korea/epidemiology
Risk Factors
Sex Factors
Smoking/*adverse effects/blood/epidemiology
Surveys and Questionnaires
Cholesterol
Cholesterol, HDL
Lipoproteins, HDL
Fibrinogen

Figure

• 

  Fig. 1 Relationship between fibrinogen and IMT-tpm according to smoking status. (A) Nonsmokers. IMT-tpm=0.7056+0.0046×fibrinogen, p=0.8802. (B) Former smokers. IMT-tpm=0.7023+0.021×fibrinogen, p=0.3592. (C) Current smokers. IMT-tpm=0.5077+0.0734×fibrinogen, p=0.0291. IMT, intima-media thickness; IMT-tpm, mean value of IMT at three points.

• 

  Fig. 2 Relationship between fibrinogen and IMT-max according to smoking status. (A) Nonsmokers. IMT-max=0.9395+0.0115×fibrinogen, p=0.8594. (B) Former smokers. IMT-max=0.9893+0.0183×fibrinogen, p=0.7532. (C) Current smokers. IMT-max=0.5245+0.1596×fibrinogen, p=0.0119. IMT, intima-media thickness; IMT-max, maximum IMT value.

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