Association Between Cigarette Smoking and Metabolic Syndrome

M etabolic syndrome is highly prev-alent in the U.S. (age-adjustedprevalence of 23.7%) (1) and in Korea (20.8 % for men and 26.9 % for women) (2). This syndrome is well docu-mented to increase the risk for developing type 2 diabetes and cardiovascular dis-eases (CVDs) and is associated with an all-cause mortality (3–5). Physical inac-tivity, excessive weight gain, high alcohol intake, and certain dietary factors have been identified as important modifiable risk factors for metabolic syndrome and its consequences (2,6,7). Smoking is also a strong risk factor for atherosclerosis and CVD, with a dose-dependent relationship (8). Smokers have abnormalities in lipoprotein metab-olism (9) and endothelial function (10). Moreover, there is some evidence that smokers are at greater risk than nonsmok-ers of becoming insulin resistant and hy-perinsulinemic (11,12). Thus, based on these findings, smoking may be consid-ered as an important modifiable risk fac-tor for metabolic syndrome. However, this relationship has not been clarified, and reports on this issue are also scarce. The aim of this study was to search for associations between smoking and meta-bolic syndrome with a representative population-based sample in Korea.