Relation of smoking status to a panel of inflammatory markers: the framingham offspring

Atherosclerosis. 2008 Nov;201(1):217-24. doi: 10.1016/j.atherosclerosis.2007.12.058. Epub 2008 Mar 4.


Aims: We sought to investigate the hypothesis that smoking is accompanied by systemic inflammation.

Methods and results: We examined the relation of smoking to 11 systemic inflammatory markers in Framingham Study participants (n=2944, mean age 60 years, 55% women, 12% ethnic minorities) examined from 1998-2001. The cohort was divided into never (n=1149), former (n=1424), and current smokers with last cigarette >6h (n=134) or < or =6h (n=237) prior to phlebotomy. In multivariable-adjusted models there were significant overall between-smoking group differences (defined as p<0.0045 to account for multiple testing) for every inflammatory marker tested, except for serum CD40 ligand (CD40L), myeloperoxidase (MPO) and tumor necrosis factor receptor-2 (TNFR2). With multivariable-adjustment, pair-wise comparisons with never smokers revealed that former smokers had significantly lower concentrations of plasma CD40L (p<0.0001) and higher concentrations of (CRP) C-reactive protein (p=0.002).

Conclusions: As opposed to never smokers, those with acute cigarette smoke exposure (< or =6h) had significantly higher concentrations of all markers (p<0.0001) except serum CD40L, MPO, and TNFR2; plasma CD40L were significantly lower. Compared with never smokers, cigarette smokers have significantly elevated concentrations of most circulating inflammatory markers, consistent with the hypothesis that smoking is associated with a systemic inflammatory state.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute-Phase Proteins / metabolism
  • Age Factors
  • Aged
  • Biomarkers / blood
  • Biomarkers / urine
  • Body Mass Index
  • Case-Control Studies
  • Cohort Studies
  • Female
  • Humans
  • Inflammation / blood*
  • Inflammation / epidemiology
  • Inflammation / urine*
  • Inflammation Mediators / blood
  • Inflammation Mediators / urine
  • Male
  • Middle Aged
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / blood*
  • Smoking / urine*


  • Acute-Phase Proteins
  • Biomarkers
  • Inflammation Mediators