Differential Effect of Smoking On HDL Levels in Afro-Caribbean Diabetics Compared to Non-Diabetics

Objective:Afro-Caribbean people are known to have low rates of smoking and heart disease. Llittle is known about the relative effect of smoking on the serum lipid profile of Afro Caribbeans with and without diabetes.  This study examined whether smoking has a differential effect on serum lipids associated with increased CVD risks in diabetic and non-diabetic Afro-Caribbean persons living in the U.S. Virgin Islands.

Methods:Serum levels of Triglycerides, HDL, LDL and Total Cholesterol were determined for population-based samples of 127 Afro Caribbean diabetics and 626 Afro Caribbean non-diabetics without diagnosed heart disease on the island of St. Croix, U.S. Virgin Islands. Age and sex adjusted mean lipid values were compared for smokers and non-smokers with and without diabetes. Statistical analyses were performed using Statistical Analysis Software (SAS).

Results:The frequency of smoking  was similar among diabetics and non-diabetics (5.51% vs 5.75%, respectively). There was no difference in mean values for total cholesterol and LDL between smokers and non-smokers in either study group. Among non-diabetics and diabetics, Triglyceride values appeared higher for smokers than non smokers, although the differences were not statistically significant. However, HDL values were significantly lower among smokers than non smokers in the diabetic group, while no significant difference in HDL values were observed between smokers and non-smokers in the non-diabetic group.      

Conclusion:Reduced levels of HDL cholesterol are associated with smoking in Afro Caribbean diabetics compared to non-diabetics. In a population with very low smoking prevalence, increased effort to curb smoking in diabetic patients is warranted.