title: Biomarkers of potential harm among adult smokers and nonsmokers in the total exposure study.
abstract: BACKGROUND
  There is overwhelming medical and scientific consensus that cigarette smoking causes lung cancer, heart disease, emphysema, and other serious diseases in smokers. In the Total Exposure Study, 29 biomarkers of potential harm (BOPH) were measured in a cross-sectional sample of 3,585 adult smokers (AS) and 1,077 nonsmokers (NS). The BOPH included markers of oxidative stress, inflammation, platelet activation, endothelial function, lipid metabolism, hematology, metabolism, the cardiovascular system, lung function, kidney function, and liver function.
  
  
  METHODS
  Multiple stepwise regression was used to examine the effect of demographic factors (age, gender, body mass index [BMI], and race) and smoking (number of cigarettes smoked per day or nicotine equivalents [NE] per 24 hr and smoking duration) on each BOPH.
  
  
  RESULTS
  As compared with NS, AS had >10% higher levels of 8-epi-prostaglandin F(2α) (8-epi-PG F(2α), 42%), 11-dehydrothromboxane B₂ (11-DHTB, 29%), white blood cell (WBC) count (19%), high-sensitivity C-reactive protein (15%), triglycerides (16%), and alkaline phosphatase (11%) and had 18% lower total bilirubin. Multiple stepwise regression revealed that although NE (milligrams per 24 hours) was statistically significant for 18 of the 29 BOPH, it was the most important factor only for WBCs and 11-DHTB. Smoking duration was the most important factor for forced expiratory volume in 1 second. In contrast, BMI was the most important factor for 12 BOPH.
  
  
  CONCLUSIONS
  These results contribute to the understanding of the relationship between tobacco smoking and potential biological effects.
authors.affiliation: Altria Client Services, 601 East Jackson Street, Richmond, VA 23219, USA. kimberly.frost.pineda@altria.com
authors.forename: Kimberly
authors.initials: K
authors.lastname: Frost-Pineda
authors.forename: Qiwei
authors.initials: Q
authors.lastname: Liang
authors.forename: Jianmin
authors.initials: J
authors.lastname: Liu
authors.forename: Lonnie
authors.initials: L
authors.lastname: Rimmer
authors.forename: Yan
authors.initials: Y
authors.lastname: Jin
authors.forename: Shixia
authors.initials: S
authors.lastname: Feng
authors.forename: Sunil
authors.initials: S
authors.lastname: Kapur
authors.forename: Paul
authors.initials: P
authors.lastname: Mendes
authors.forename: Hans
authors.initials: H
authors.lastname: Roethig
authors.forename: Mohamadi
authors.initials: M
authors.lastname: Sarkar
mesh_terms: D000293:Adolescent; D000328:Adult; D000469:Alkaline Phosphatase; D001663:Bilirubin / Q000097:blood; D015415:Biomarkers / Q000097:blood* / Q000652:urine*; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D050356:Lipid Metabolism / Q000502:physiology; D008297:Male; D018384:Oxidative Stress / Q000502:physiology; D012907:Smoking / Q000009:adverse effects / Q000097:blood* / Q000652:urine*; D013147:Spirometry; D013929:Thromboxane B2 / Q000031:analogs & derivatives / Q000097:blood; D014280:Triglycerides; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014280:Triglycerides; D013929:Thromboxane B2; C049235:11-dehydro-thromboxane B2; D002097:C-Reactive Protein; D000469:Alkaline Phosphatase; D001663:Bilirubin