title: Lifetime cigarette smoking is associated with abdominal obesity in a community-based sample of Japanese men: The Shiga Epidemiological Study of Subclinical Atherosclerosis (SESSA).
abstract: Studies from Western countries suggest that smokers tend to display greater abdominal obesity than non-smokers, despite showing lower weight. Whether this holds true in a leaner population requires clarification. Using indices of abdominal obesity including visceral adipose tissue, we examined whether lifetime cigarette smoking is associated with unfavorable fat distribution among Japanese men. From 2006 to 2008, we conducted a cross-sectional investigation of a community-based sample of Japanese men at 40-64 years old, free of cardiovascular diseases and cancer. Areas of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were calculated using computed tomography. We divided participants into four groups: never-smokers; and tertiles of pack-years of smoking among ever-smokers. Using multivariable linear regression, we calculated adjusted means of obesity indices (VAT, SAT, VAT-SAT ratio [VSR], and waist-hip ratio [WHR]) for each group, and mean differences between consecutive groups. We analyzed 513 men (median age, 58.2 years; current smokers, 40.1%). Two-thirds showed body mass index (BMI) < 25 kg/m(2) (median, 23.5 kg/m(2)). Overall, greater lifetime smoking group was associated with greater WHR and VSR. On average, one higher smoking group was associated with 0.005 higher WHR (95% CI, 0.001-0.008; P = 0.005) and 0.041 greater VSR (95% CI, 0.009-0.073; P = 0.012) after adjustment for potential confounders, including BMI. In this sample of relatively lean Japanese men, greater lifetime smoking was associated with a metabolically more adverse fat distribution. Although smoking is commonly associated with lower BMI, minimizing the amount of lifetime smoking should be advocated.
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fujiyoshi
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Kadowaki
authors.affiliation: Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Azuma
authors.affiliation: Department of Medical Statistics, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hisamatsu
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Japan.
authors.forename: Hisatomi
authors.initials: H
authors.lastname: Arima
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Kadota
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Miyagawa
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Takashima
authors.affiliation: Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Yoshino
authors.initials: Y
authors.lastname: Saitoh
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Sayuki
authors.initials: S
authors.lastname: Torii
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Itsuko
authors.initials: I
authors.lastname: Miyazawa
authors.affiliation: Department of Medicine, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Maegawa
authors.affiliation: Department of Radiology, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Murata
authors.affiliation: Department of Public Health, Shiga University of Medical Science, Shiga, Japan; Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Shiga, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Ueshima
keywords: Abdominal obesity; Smoking; Visceral adipose tissue