J Neurol Res

Journal of Neurology Research, ISSN 1923-2845 print, 1923-2853 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Neurol Res and Elmer Press Inc

Journal website http://www.neurores.org

Original Article

Volume 1, Number 5, December 2011, pages 201-209

Smoking Attenuates the Beneficial Effect of Physical Activity on Intima-Media Thickness of Carotid Artery in Young and Middle-Aged Smokers

**Table 1.** Clinical Characteristics of Three Smoking Status Groups
	Total (n = 1090)	Current smoker (n = 252)	Former smoker (n = 245)	Never smoker (n = 593)
Plus-Minus Values are Means ± SD. HDL cholesterol: high-density-lipoprotein cholesterol; IMT: intima-media thickness. P < 0.01, *P < 0.05, Bonferonni/Dunn post-hoc test following Kruskal-Wallis test, compared to current smoker.
High physical activity group (%)	303	48 (19.0)	92 (37.6)	163 (27.5)
Moderate physical activity group (%)	191	40 (15.9)	42 (17.1)	109 (18.4)
Low physical activity group (%)	596	164 (65.1)	111 (45.3)	321 (54.1)
Age	54.1 ± 9.9	53.7 ± 9.0	57.5 ± 8.5*	54.1 ± 9.9
Male sex (%)	756 (69.4)	235 (93.3)	226 (92.2)	296 (49.9)*
Body mass index	23.5 ± 9.1	23.5 ± 3.2	23.7 ± 2.8	23.3 ± 12.1
Systolic blood pressure	114.4 ± 37.6	112.4 ± 17.3	115.5 ± 17.4	114.8 ± 48.5
Diastolic blood pressure	69.6 ± 13.1	69.5 ± 11.5	73.0 ± 13.8*	68.2 ± 13.1
Blood Sugar	102.3 ± 18.4	102.4 ± 20.8	105.6 ± 20.3	100.9 ± 16.1
Total cholesterol	206.4 ± 35.0	201.2 ± 34.6	205.0 ± 31.7*	209.2 ± 36.5*
HDL cholesterol	60.2 ± 15.2	54.9 ± 13.8	59.8 ± 15.3*	62.9 ± 15.1**
Triglyceride	120.1 ± 84.3	147.4 ± 113.2	124.7 ± 82.1*	106.5 ± 66.1*
Bathel index	-	701.8 ± 408.1	-	-
Periods since ceasing smoking	-	-	15.9 ± 9.4	-
Maximum IMT	1.08 ± 0.75	1.19 ± 0.76	1.14 ± 0.70	1.02 ± 0.77*

Table 1. Clinical Characteristics of Three Smoking Status Groups

Total (n = 1090)

Current smoker (n = 252)

Former smoker (n = 245)

Never smoker (n = 593)

Plus-Minus Values are Means ± SD. HDL cholesterol: high-density-lipoprotein cholesterol; IMT: intima-media thickness. *P < 0.01, **P < 0.05, Bonferonni/Dunn post-hoc test following Kruskal-Wallis test, compared to current smoker.

High physical activity group (%)

303

48 (19.0)

92 (37.6)

163 (27.5)

Moderate physical activity group (%)

191

40 (15.9)

42 (17.1)

109 (18.4)

Low physical activity group (%)

596

164 (65.1)

111 (45.3)

321 (54.1)

Age

54.1 ± 9.9

53.7 ± 9.0

57.5 ± 8.5*

54.1 ± 9.9

Male sex (%)

756 (69.4)

235 (93.3)

226 (92.2)

296 (49.9)*

Body mass index

23.5 ± 9.1

23.5 ± 3.2

23.7 ± 2.8

23.3 ± 12.1

Systolic blood pressure

114.4 ± 37.6

112.4 ± 17.3

115.5 ± 17.4

114.8 ± 48.5

Diastolic blood pressure

69.6 ± 13.1

69.5 ± 11.5

73.0 ± 13.8*

68.2 ± 13.1

Blood Sugar

102.3 ± 18.4

102.4 ± 20.8

105.6 ± 20.3

100.9 ± 16.1

Total cholesterol

206.4 ± 35.0

201.2 ± 34.6

205.0 ± 31.7*

209.2 ± 36.5*

HDL cholesterol

60.2 ± 15.2

54.9 ± 13.8

59.8 ± 15.3*

62.9 ± 15.1**

Triglyceride

120.1 ± 84.3

147.4 ± 113.2

124.7 ± 82.1*

106.5 ± 66.1*

Bathel index

701.8 ± 408.1

Periods since ceasing smoking

15.9 ± 9.4

Maximum IMT

1.08 ± 0.75

1.19 ± 0.76

1.14 ± 0.70

1.02 ± 0.77*

**Table 2.** Multigroup Analysis of Maximum IMT With Reference to Smoking Status and Each Intensity of Physical Activity
	Current-smoker groups	Former-smoker groups	Never-smoker groups
P: Kruskal-Wallis test, P*: Bonferroni/Dunn post-hoc test.
P*	0.657	0.252	0.003
P** (low vs moderate physical activity groups)	-	-	0.343
P** (moderate vs high physical activity groups)	-	-	0.253
P** (low vs high physical activity groups)	-	-	0.011

Table 2. Multigroup Analysis of Maximum IMT With Reference to Smoking Status and Each Intensity of Physical Activity

Current-smoker groups

Former-smoker groups

Never-smoker groups

P*: Kruskal-Wallis test, P**: Bonferroni/Dunn post-hoc test.

0.657

0.252

0.003

P** (low vs moderate physical activity groups)

0.343

P** (moderate vs high physical activity groups)

0.253

P** (low vs high physical activity groups)

0.011

**Table 3.** Univariate Analysis for Maximum IMT With Each Factor in Three Smoking Status Groups
	Current smoker	Former smoker	Never smoker
Spearman correlation test except Mann-Whitney analysis for gender †. IMT: intima-media thickness; HDL cholesterol: high-density-lipoprotein cholesterol.
Variables	ρ	P	ρ	P	ρ	P
Physical activity	-0.053	0.403	-0.025	0.695	-0.136*	0.001
Age	0.435	< 0.0001	0.313	< 0.0001	0.474	< 0.0001
Coexisting disease	0.284	< 0.0001	0.215	0.001	0.272	< 0.0001
Alcohol drinking	0.050	0.389	0.033	0.602	-0.020	0.634
Family history	-0.007	0.916	0.066	0.171	-0.016	0.689
Present symptom	0.013	0.835	0.088	0.299	-0.060	0.144
Body mass index	0.022	0.728	0.048	0.451	0.108	0.009
Systolic blood pressure	0.146	0.021	0.299	< 0.0001	0.255	< 0.0001
Diastolic blood pressure	-0.061	0.334	0.212	0.001	0.179	< 0.0001
Blood Sugar	0.065	0.302	0.127	0.047	0.192	< 0.0001
Total cholesterol	0.108	0.089	0.034	0.592	0.181	0.013
HDL cholesterol	-0.033	0.598	-0.057	0.376	-0.127	0.002
Triglyceride	-0.109	0.083	0.040	0.531	0.181	< 0.0001
Bathel index	0.365	< 0.0001	-	-	-	-
Periods since ceasing smoking	-	-	-0.161	0.012	-	-
Male sex †	-	0.071	-	0.007	-	0.001

Table 3. Univariate Analysis for Maximum IMT With Each Factor in Three Smoking Status Groups

Current smoker

Former smoker

Never smoker

Spearman correlation test except Mann-Whitney analysis for gender †. IMT: intima-media thickness; HDL cholesterol: high-density-lipoprotein cholesterol.

Variables

Physical activity

-0.053

0.403

-0.025

0.695

-0.136*

0.001

Age

0.435

< 0.0001

0.313

< 0.0001

0.474

< 0.0001

Coexisting disease

0.284

< 0.0001

0.215

0.001

0.272

< 0.0001

Alcohol drinking

0.050

0.389

0.033

0.602

-0.020

0.634

Family history

-0.007

0.916

0.066

0.171

-0.016

0.689

Present symptom

0.013

0.835

0.088

0.299

-0.060

0.144

Body mass index

0.022

0.728

0.048

0.451

0.108

0.009

Systolic blood pressure

0.146

0.021

0.299

< 0.0001

0.255

< 0.0001

Diastolic blood pressure

-0.061

0.334

0.212

0.001

0.179

< 0.0001

Blood Sugar

0.065

0.302

0.127

0.047

0.192

< 0.0001

Total cholesterol

0.108

0.089

0.034

0.592

0.181

0.013

HDL cholesterol

-0.033

0.598

-0.057

0.376

-0.127

0.002

Triglyceride

-0.109

0.083

0.040

0.531

0.181

< 0.0001

Bathel index

0.365

< 0.0001

Periods since ceasing smoking

-0.161

0.012

Male sex †

0.071

0.007

0.001

**Table 4.** Age-Specific Multiple Regression Analysis for Maximum IMT With Each Factor in Three Smoking Status Groups
Age (y/o)	≤ 49	50 - 59	60 ≤
Listed dependent variables are selected by cluster analysis. HDL cholesterol: high-density-lipoprotein cholesterol.
	Variables	F	P value	R-square	Variables	F	P value	R-square	Variables	F	P value	R-square
Current smoker	Physical activity	1.024	0.315		Physical activity	0.125	0.724		Physical activity	0.284	0.596
	Male sex	0.442	0.508		Age	7.219	0.009		Age	2.466	0.122
	Blood sugar	9.150	0.003		Present symptom	5.135	0.026		Present symptom	0.595	0.444
	Alcohol drinking	0.000	0.990		Body mass index	2.555	0.113		Blood sugar	0.056	0.814
	Coexisting disease	6.701	0.012		Male sex	0.970	0.327		HDL-cholesterol	2.811	0.099
	Total cholesterol	3.500	0.065		Alcohol drinking	15.046	0.0002		Body mass index	1.823	0.182
	Family history	1.078	0.303		HDL-cholesterol	1.348	0.249		Triglyceride	0.581	0.449
	HDL-cholesterol	2.200	0.142		Systolic blood pressure	0.762	0.385		Alcohol drinking	0.445	0.507
	Systolic blood pressure	0.650	0.423		Total cholesterol	1.442	0.233		Diastolic blood pressure	0.052	0.820
				0.276				0.271				0.115

Former smoker	Physical activity	0.968	0.334		Physical activity	0.939	0.335		Physical activity	0.259	0.612
	Age	0.861	0.362		Age	0.043	0.836		Age	3.339	0.071
	Systolic blood pressure	4.598	0.041		Present symptom	0.126	0.724		Body mass index	0.376	0.541
	Family history	1.295	0.265		Triglyceride	1.453	0.231		Total cholesterol	0.268	0.606
	Body mass index	2.363	0.136		Periods since quitting smoking	2.308	0.132		Systolic blood pressure	0.052	0.819
	Periods since quitting smoking	0.560	0.460		Alcohol drinking	3.487	0.065		Male sex	0.339	0.562
	Alcohol drinking	0.018	0.896		Blood sugar	0.145	0.705		Alcohol drinking	0.006	0.939
	Coexisting disease	23.626	< 0.0001		Coexisting disease	1.693	0.196		Coexisting disease	1.992	0.162
	Present symptom	1.855	0.184		Systolic blood pressure	1.101	0.296		Present symptom	3.603	0.061
				0.636				0.107				0.120

Never smoker	Physical activity	0.308	0.580		Physical activity	2.566	0.111		Physical activity	0.082	0.776
	Age	1.609	0.206		Age	5.630	0.019		Age	6.562	0.011
	Coexisting disease	1.658	1.995		Family history	0.078	0.781		Body mass index	0.026	0.873
	HDL-cholesterol	3.248	0.073		Diastolic blood pressure	0.606	0.437		Systolic blood pressure	0.066	0.798
	Family history	0.551	0.459		Male sex	0.255	0.614		Male sex	2.202	0.140
	Total cholesterol	2.916	0.089		Triglyceride	2.651	0.105		Blood sugar	0.001	0.976
	Alcohol drinking	1.444	0.231		Blood sugar	0.036	0.850		Family history	0.192	0.662
	Body mass index	0.399	0.529		Present symptom	0.026	0.872		Present symptom	0.856	0.356
	Systolic blood pressure	0.052	0.820		HDL-cholesterol	2.594	0.109		Total cholesterol	1.935	0.166
				0.078				0.089				0.104

Table 4. Age-Specific Multiple Regression Analysis for Maximum IMT With Each Factor in Three Smoking Status Groups

Age (y/o)

≤ 49

50 - 59

60 ≤

Listed dependent variables are selected by cluster analysis. HDL cholesterol: high-density-lipoprotein cholesterol.

Variables

P value

R-square

Variables

P value

R-square

Variables

P value

R-square

Current smoker

Physical activity

1.024

0.315

Physical activity

0.125

0.724

Physical activity

0.284

0.596

Male sex

0.442

0.508

Age

7.219

0.009

Age

2.466

0.122

Blood sugar

9.150

0.003

Present symptom

5.135

0.026

Present symptom

0.595

0.444

Alcohol drinking

0.000

0.990

Body mass index

2.555

0.113

Blood sugar

0.056

0.814

Coexisting disease

6.701

0.012

Male sex

0.970

0.327

HDL-cholesterol

2.811

0.099

Total cholesterol

3.500

0.065

Alcohol drinking

15.046

0.0002

Body mass index

1.823

0.182

Family history

1.078

0.303

HDL-cholesterol

1.348

0.249

Triglyceride

0.581

0.449

HDL-cholesterol

2.200

0.142

Systolic blood pressure

0.762

0.385

Alcohol drinking

0.445

0.507

Systolic blood pressure

0.650

0.423

Total cholesterol

1.442

0.233

Diastolic blood pressure

0.052

0.820

0.276

0.271

0.115

Former smoker

Physical activity

0.968

0.334

Physical activity

0.939

0.335

Physical activity

0.259

0.612

Age

0.861

0.362

Age

0.043

0.836

Age

3.339

0.071

Systolic blood pressure

4.598

0.041

Present symptom

0.126

0.724

Body mass index

0.376

0.541

Family history

1.295

0.265

Triglyceride

1.453

0.231

Total cholesterol

0.268

0.606

Body mass index

2.363

0.136

Periods since quitting smoking

2.308

0.132

Systolic blood pressure

0.052

0.819

Periods since quitting smoking

0.560

0.460

Alcohol drinking

3.487

0.065

Male sex

0.339

0.562

Alcohol drinking

0.018

0.896

Blood sugar

0.145

0.705

Alcohol drinking

0.006

0.939

Coexisting disease

23.626

< 0.0001

Coexisting disease

1.693

0.196

Coexisting disease

1.992

0.162

Present symptom

1.855

0.184

Systolic blood pressure

1.101

0.296

Present symptom

3.603

0.061

0.636

0.107

0.120

Never smoker

Physical activity

0.308

0.580

Physical activity

2.566

0.111

Physical activity

0.082

0.776

Age

1.609

0.206

Age

5.630

0.019

Age

6.562

0.011

Coexisting disease

1.658

1.995

Family history

0.078

0.781

Body mass index

0.026

0.873

HDL-cholesterol

3.248

0.073

Diastolic blood pressure

0.606

0.437

Systolic blood pressure

0.066

0.798

Family history

0.551

0.459

Male sex

0.255

0.614

Male sex

2.202

0.140

Total cholesterol

2.916

0.089

Triglyceride

2.651

0.105

Blood sugar

0.001

0.976

Alcohol drinking

1.444

0.231

Blood sugar

0.036

0.850

Family history

0.192

0.662

Body mass index

0.399

0.529

Present symptom

0.026

0.872

Present symptom

0.856

0.356

Systolic blood pressure

0.052

0.820

HDL-cholesterol

2.594

0.109

Total cholesterol

1.935

0.166

0.078

0.089

0.104