title: Body fat distribution in relation to smoking and exogenous hormones in British women.
abstract: OBJECTIVE
  Both cigarette smoking and use of exogenous hormones are associated with changes in regional distribution of body fat, but their combined effects are less investigated. We examined the interrelation between smoking, exogenous hormones and fat distribution in premenopausal and postmenopausal women.
  
  
  METHODS
  We used data from 20, 962 women without known cardiovascular disease (CVD) who were employees of a major department store in Britain. They completed a health questionnaire and attended a clinical examination that included waist and hip circumference measurements. The cross-sectional analyses were conducted using linear regression models.
  
  
  RESULTS
  Cigarette smoking, particularly smoking ≥20 cigarettes/day, was associated with larger waist circumference and higher waist/hip ratio (WHR) in pre- and postmenopausal women after adjusting for potential confounding factors (all P < 0·001). Premenopausal women using combined oral contraceptive (COC) and postmenopausal women using oestrogen-only hormone replacement therapy (HRT) had lower WHR than non-hormone users in both smokers and nonsmokers. However, smokers had higher WHR than nonsmokers in both groups of hormone users and nonusers. There was no significant interaction between smoking and hormone use in premenopausal and postmenopausal women (P > 0·05).
  
  
  CONCLUSIONS
  Although exogenous hormones use was related to a more favourable fat distribution in women, smoking was associated with greater abdominal fat accumulation.
authors.affiliation: School of Biomedicine, University of Manchester, Manchester, UK. see.kwok@manchester.ac.uk
authors.forename: See
authors.initials: S
authors.lastname: Kwok
authors.forename: Dexter
authors.initials: D
authors.lastname: Canoy
authors.forename: Handrean
authors.initials: H
authors.lastname: Soran
authors.forename: David W
authors.initials: DW
authors.lastname: Ashton
authors.forename: Gordon D O
authors.initials: GD
authors.lastname: Lowe
authors.forename: David
authors.initials: D
authors.lastname: Wood
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Humphries
authors.forename: Paul N
authors.initials: PN
authors.lastname: Durrington
mesh_terms: D050153:Abdominal Fat; D000428:Alcohol Drinking; D050218:Body Fat Distribution; D015992:Body Mass Index; D015331:Cohort Studies; D003277:Contraceptives, Oral, Combined; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D015914:Estrogen Replacement Therapy; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D012907:Smoking / Q000503:physiopathology*; D055105:Waist Circumference; D049629:Waist-Hip Ratio
chemical_list: D003277:Contraceptives, Oral, Combined; D004041:Dietary Fats; D004043:Dietary Fiber