Abstract:
Cigarette smoking increases morbidity and the mortality risk of cardiovascular
diseases. B vitamins regulate the metabolism of homocysteine via remethylation and
transsulfuration pathways. The purpose of this study was to investigate homocysteine
concentrations, vitamin status, dietary pattern anthropometric and haematological
measurements of 174 smokers compared with 97 nonsmoking subjects. Total
homocysteine concentrations in plasma were significantly higher in smokers than
nonsmokers. Vitamin B2, folate, B12 and C concentrations were significantly lower
among smokers than nonsmokers but vitamin B6 was not significantly different between
these groups. Total homocysteine concentration significantly and positively correlated
with the waist/hip ratio and smoking characteristics such as the number of cigarettes per
day and pack-years and significantly but negatively correlated with folate and vitamin
B12. The percentage of hyperhomocysteinemia in smokers (62%) was higher than in
nonsmokers (33%). Dietary intake assessment showed that smokers consumed
significantly less energy from carbohydrate compared to nonsmokers, while energy
derived from protein and fat did not differ between groups. Furthermore, smokers
consumed less dietary fiber, iron, calcium, phosphorus, vitamin A, vitamin B1, vitamin
B2 and vitamin C, compared with nonsmokers. Therefore, increased plasma total
homocysteine concentrations in healthy smokers may be explained by low B vitamin
status that is linked to the homocysteine metabolism as well as vitamin B2, folate, and
B12. The risk for smokers of developing cardiovascular diseases not only is associated,
besides others, to high level of homocyteine but also to insufficient intake of
micronutrients. Public health attempts therefore should not only aim towards smoking
cessation, which often proves to be unsuccessful, but also to a balanced diet in terms of
the vitamin and trace element content.