The Effect Of Smoking Cessation On High Density Lipoprotein Functions And Influencing Factors Of Intention To Quit Smoking Among Male Smokers With Diabetes Mellitus

The 1st part:THE EFFECT OF SMOKING CESSATION ON HIGH DENSITY LIPOPROTEIN FUNCTIONS IN MALE SMOKERS WITH DIABETES MELLITUSObjectiveThe objective of our research is to determine whether and how the anti-inflammatory,anti-oxidation and antiapoptotic functions of functional HDL varies between male chronic smokers and ex-smokers with diabetes mellitus?DM?.Methods1.We recruited 26 male chronic smokers and 24 ex-smokers with DM,fasting blood were collected from these candidates in community physical examination and stored in-80°C for further use.2.HDL₃ was isolated by density gradient centrifugation,and its concentration was measured by bicinchonininc acid?BCA?.3.Detection of blood anti-inflammatory and anti-oxidation indices:the level of serum interleukin-6?IL-6?,tumor necrosis factor-alpha?TNF-??and malondialdehyde?MDA?,the activity of serum super oxygen dehydrogenises?SOD?and myeloperoxidase?MPO?activity were measured.4.Detection of anti-inflammatory,anti-oxidation and antiapoptotic functions of functi-onal HDL in vitro experiments:HUVECs was pretreated with HDL₃?100mg/L?for 4h,and then injuried with oxidative-low density lipoprotein ox-LDL?100mg/L?for 12h.MTT assay was used for detecting cells viability.The number of monocytes adhered to endothelial cells were quantified under high-power fields using a fluorescence microscope.The extracellular IL-6 and TNF-?level,and SOD activity were detected by ELISA.The expression level of vascular cell adhesion molecule-1?VCAM-1?and intercellularcell adhesion molecule-1?ICAM-1?was detected by western blot.Macrophage was pretreated with HDL₃ for 4h,then injuried with ox-LDLfor 12h,and stained with annexin V/PI to detected apoptotic by flow cytometry.Results1.Clinical indicators:The two groups had no statistical difference among these indices:age,duration of disease,body mass index?BMI?,blood pressure,total cholesterol?TC?,fasting plamsa glucose?FPG?,low density lipoprotein cholesterol?LDL-C?.Serum triglyceride?TG?and hemoglobin A1C?HbA1C?levels were obviously lower in ex-smokers than in chronic smokers,however,serum high-density lipoprotein cholesterol?HDL-C?level was significa-ntly higher in ex-smokers than in chronic smokers.2.Blood anti-inflammatory and anti-oxidation indices of blood:Serum IL-6,TNF-?,MDA levels and MPO activity were obviously lower in ex-smokers than in chronic smok-ers,and serum SOD activity was higher in ex-smokers than in chronic smokers.3.Functional HDL anti-inflammatory,anti-oxidation and antiapoptotic functions:HDL₃ in ex-smokers inhibited ox-LDL induced increase levels of IL-6,TNF-?,VCAM-1and ICAM-1,and inhibited the number of monocyte adhension to endothelial cells.HDL₃in ex-smokers restored ox-LDL induced decrease of SOD activity in culture medium,and inhibited ox-LDL induced cell viability decrease and apoptosis.Nevertheless,HDL₃ in chro-nic smokers have no above-mentioned functions.All these datas illustrated that smoking cessation can improve the anti-inflammatory,anti-oxidation and antiapoptotic functions of functional HDL in male patients with DM.Conclusions1.Smoking cessation could raise serum HDL-C level of male smokers with DM.2.Smoking cessation could improve functional HDL anti-inflammatory,anti-oxidati-on and antiapoptotic functions in male smokers with DM.The 2nd part: STUDY ON FACTORS INFLUENCING INTENTION TO QUIT SMOKING OF MALE SMOKERS WITH DIABETES MELLITUSObjectiveTo find factors influencing intention to smoking cessation of the male smokers with DM,and explore the associated factors and the extent of their influences on intentios to quit smoking.Provide theory foundation for developing tactic and method of smoking cesation.MethodsThrough literature analysis method to determine impact factors and measuring instruments,the research instruments included self-made Individual Information Sheet,Fagerstrom Test for Nicotine Dependence?FTND?,Medical Outcomes Study Social Support Survey?MOS-SSS?,Chinese version of the Diabetes and Smoking Beliefs Questionnaire?DSB?,smoking Self-efficacy Questionnaire.Step one:DSB was translated and adapted to Chinese according to west scale revising and evaluating procedure,this process were divided into forward-translation,back-translation,cultural adjusting and pre-research.Step two:245 hospitalized or visited in endocrinology clinic patients were investigated from January 2015 to December 2015 in a grade A tertiary hospital in taian.Firstly,testing the reliability and validity of the Chinese version of DSB after finishing the questionnaires.Secondly,Using methods of univariate analysis,Chi-Square Test,Mann-Whitney U Test and unconditional logistic regression analysis to determine the factors influencing intention to quit among the male smokers with DM,and how these factors make.Results1.Reliability and validity test of Chinese version of DSB: the Chinese version of DSB validity was 0.885,and the Confirmatory factor analysis indicated RMSEA=0.0753,NFI= 0.877,CFI=0.928,GFI=0.892.The Cronbach's ? of the total scale and its three subscales were 0.770,0.805,0.810,0.837 separately,and the test-retest reliability were 0.702,0.865,0.706,0.786.2.The distribution of intention to smoking cessation: patients with intention to stop smoking in this research accounted for 40.57%.3.Results of univariate analysis of intention to smoking cessation for the male smokers with DM.Chi-squar test found that age of regular smoking,the year duration of regular smoking,the times for quitting smoking,with regular smokers around and degree of nicotine dependence were related to intention to quit?P<0.05?.Mann-Whitney U Test showed that mean score of MOS-SSS,Smoking and Diabetes Care Subscale,Quitting and Control Subscale and smoking Self-efficacy Questionnaire have a signifycant difference between the patients with intention to stop smoking and the others?P<0.05?.4.The results of logistic regression analysis indicated that beliefs about smoking and diabetes care,beliefs about quitting and diabetes control,social support level,nicotine dependence and with regular smokers around were the main factors related to intention to quit smoking of the male smokers with DM.Their logistic coefficients were-0.293,-0.251,0.247,-0.123,-0.116 respectively.Among them,the strongest influential factor was beliefs about smoking and diabetes care.ConclusionsThe reliability and validity of Chinese version of DSB are acceptable.So it is suitable for Chinese male smokers with DM.Beliefs about smoking and diabetes care,beliefs about quitting and diabetes control,nicotine dependence level,social support level and with regular smokers around are predictors of intention to smoking cessation for male smokers with DM.What's more,our research results may provide the theory foundation for intervention studies on strengthening the level of intention to quit in patients with DM.