Impact of cigarette smoking cessation on high-density lipoprotein functionality.

BACKGROUND: Smoking cessation reduces the risk of cardiovascular disease (CVD) and improves clinical outcomes in public health. We studied the effect of smoking cessation on high-density lipoprotein (HDL) functionality. METHODS AND RESULTS: We randomly treated 32 smokers with varenicline or a transdermal nicotine patch as part of a 12-week smoking cessation program (The VN-SEESAW Study). The plasma lipid profiles, plasma and HDL malondialdehyde (MDA) levels, HDL subfractions as analyzed by capillary isotachophoresis, cholesterol efflux capacity, and antiinflammatory activity of HDL were measured before and after the anti-smoking intervention. After smoking cessation, HDL-C, apoA-I levels and HDL subfractions were not significantly different from the respective baseline values. However, cholesterol efflux capacity and the HDL inflammatory index (HII) were significantly improved after smoking cessation. The changes in both parameters (%∆ cholesterol efflux capacity and ∆HII) were also significantly improved in the successful smoking cessation group compared with the unsuccessful group. The changes in cholesterol efflux capacity and HII also correlated with those in end-expiratory CO concentration and MDA in HDL, respectively. CONCLUSIONS: Our findings indicate that smoking cessation leads to improved HDL functionality, increased cholesterol efflux capacity and decreased HII, without changing HDL-C or apoA-I levels or HDL subfractions. This may be one of the mechanisms by which smoking cessation improves the risk of CVD.

A randomized controlled open comparative trial of varenicline vs nicotine patch in adult smokers: efficacy, safety and withdrawal symptoms (the VN-SEESAW study).

BACKGROUND: It has been suggested that anti-smoking therapy gives encouraging results, but this has not been verified by well-randomized study protocols. The present study was a randomized controlled trial of varenicline vs nicotine patch in adult smokers for comparison of efficacy, safety and withdrawal symptoms. METHODS AND RESULTS: The 32 adult smokers were randomly divided into a varenicline group (VG, n=16) and a nicotine patch group (NG, n=16). The primary endpoints were the 12- and 24-week smoking-abstinence rates, safety and withdrawal symptoms including stress. No significant difference in abstinence rates was observed between the 2 groups over weeks 9-12 (71.4% vs 78.6% in the VG and NG, respectively), and weeks 9-24 (64.3% vs 71.4%, respectively). The frequencies of inability to concentrate at 2, 4, and 8 weeks, and wakeful nights at 2 weeks were higher in the VG than in the NG. Adverse side-effects associated with a gastrointestinal disorder occurred in 14 cases and 1 case in the VG and NG, respectively, and skin allergy was seen in 0 and 9 cases, respectively. CONCLUSIONS: The selection of treatment depends on the balance of desired acuteness of cessation of smoking and side-effects, such as psychiatric and gastrointestinal problems or skin allergy.

Impact of cigarette smoking cessation on plasma α-klotho levels.

Smoking cessation reduces the risk of cardiovascular disease and improves clinical outcomes. We studied the effect of smoking cessation on plasma levels of α-klotho, which is an antiaging protein. We treated 28 smokers (male:female = 23:5, 46 ±â€Š12 years) with varenicline (n = 14) or a transdermal nicotine patch (n = 14) as part of a 12-week smoking cessation program (the VN-SEESAW Study). Pulse rate, blood pressure, plasma levels of α-klotho, fibroblast growth factor (FGF)-19, FGF-21, hemoglobin (Hb), and expiratory carbon monoxide (CO) concentration were measured before and after the antismoking intervention. Smoking cessation significantly decreased pulse rate, α-klotho, Hb, and CO concentration, but not FGF-19 or FGF-21 in all subjects. On the contrary, body mass index significantly increased after the intervention. Changes in α-klotho levels (values at week 12 - values at week 0) were negatively associated with α-klotho levels at week 0 and positively associated with changes in Hb levels. In addition, the successful smoking cessation group (n = 21) showed significant reductions in pulse rate, systolic blood pressure, α-klotho, Hb, and CO concentration. In conclusion, smoking cessation significantly decreased serum levels of the antiaging molecule α-klotho. Our results are consistent with a previous report that an increase in α-klotho might be a compensatory response to smoking stress.