International Journal of Epidemiology 2001;30:1465-1472
© International Epidemiological Association 2001
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Serum bilirubin concentration in a Belgian population: the association with smoking status and type of cigarettes
a University of Leuven, Department of Public Health, Division of Nutritional Epidemiology, Kapucijnenvoer 33–35, B3000 Leuven, Belgium.
b Wageningen University, Human Nutrition and Epidemiology, PO Box 8129, 6700 EV Wageningen, The Netherlands.
Pascale GA Van Hoydonck, Department of Public Health, Division of Nutritional Epidemiology, Kapucijnenvoer 35, B-3000 Leuven, Belgium. E-mail: Pascale.Vanhoydonck{at}med.kuleuven.ac.be
Abstract
Background The endogenous antioxidant serum bilirubin may scavenge free radical species from cigarette smoke. Smokers are expected to have lower serum bilirubin levels than never smokers, but this has never been evaluated in a random population sample of women and men. In addition, in vitro studies indicate that filter cigarette smoke might enhance bilirubin oxidation more than non-filter cigarette smoke.
Methods In this paper, data were analysed from the Belgian Interuniversity Research on Nutrition and Health (BIRNH) study. We investigated the association of smoking and type of cigarettes with serum bilirubin concentrations in men and women using multiple regression models taking into account differences in baseline and smoking characteristics.
Results In men, current smokers had lower crude and adjusted serum bilirubin concentrations compared with never smokers (P = 0.0001). For women, the association between smoking and serum bilirubin concentrations adjusted for age was in the same direction as for men, but did not reach statistical significance. Male former smokers had serum bilirubin concentrations in between those of current smokers and never smokers, while female former smokers had even higher (+ 0.50 µmol/l) serum bilirubin concentrations than never smokers. Male subjects smoking filter cigarettes showed a higher serum bilirubin concentration than those smoking cigarettes without a filter (adjusted difference: 0.49 µmol/l; P = 0.03). The duration of smoking was inversely and significantly related to serum bilirubin concentrations (P = 0.0003).
Conclusion Smoking may lower serum bilirubin concentrations in men, especially in those smoking non-filter cigarettes. The duration of smoking is a more important determinant for serum bilirubin concentrations than the number of cigarettes smoked per day, which may indicate the cumulative negative effects of smoking on the endogenous antioxidant system. Results for females pointed in the same direction, but were less clear, possibly due to low numbers of smoking women, who were largely young and smoked mainly filter cigarettes for a shorter period of time.
Keywords Bilirubin, smoking status, type of cigarettes
Accepted 4 January 2001
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