Analysis between Cigarette and Shisha Smokers for Early Atherogenesis: A Cardiovascular Disease

Aims: Tobacco smoking is a major health issue in Saudi Arabia, particularly among the student population. Smoking is one of the major risk factors in the genesis of coronary atherosclerosis and the development of coronary heart disease. This study aimed to evaluate the effect of cigarette and shisha smoking on atherogenic indexes, lipid profile and hematological parameters of undergraduate smokers at Majmaah University.

Methodology: This cross-sectional study was conducted between November 2019 and March 2020, at the Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Majmaah University, Al-Majmaah, enrolling 100 undergraduate students (35 cigarette smokers, 30 shisha smokers, 35 non-smokers). The subjects were asked to fast overnight and early morning blood samples were collected and analyzed to measure lipid parameters, complete blood cell count and LDH. Lipid parameters were used to calculate lipid indexes and atherogenic indexes.

Results: Compared with non-smokers, cigarette and shisha smokers had significantly higher levels of TC, TG, LDL-C and VLDL-C, but significantly lower levels of HDL-C. The values of comprehensive lipid indexes, including non-HDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, atherogenic index (AI), lipoprotein combine index (LCI), and atherogenic index of plasma (AIP) were all significantly higher in cigarette and shisha smokers. Hematological parameters were found to be within normal reference range, however when compared with non-smokers, cigarette and shisha smokers has significantly higher values of complete blood cell count, except for lymphocytes and mean corpuscular hemoglobin concentration (MCHC) which were significantly lower. LDH was also found to be elevated in cigarette and shisha smokers.

Conclusion: The findings of this study shows that, both cigarette and shisha smokers have abnormal lipid profile suggesting dyslipidemia. Prediction of early atherosclerosis through the atherogenic indexes was observed to be significantly higher in shisha smokers than in cigarette smokers. Therefore, shisha smoking has more adverse effects on the health status of adult smokers. This study adds to the accumulating evidence on the harmful effects of shisha smoking, which is a growing epidemic among young smokers, and calls for the awareness of the possible consequences of developing early atherogenesis.