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Department of Health Risk Analysis and Toxicology, University of Maastricht, 6200 MD Maastricht [R. W. L. G., D. E. M. F., P. J. A. B., F-J. V. S.], and Department of Pulmonology, Academic Hospital Maastricht, 6202 AZ Maastricht [E. F. M. W.], the Netherlands
Smokers with a low body mass index (BMI; weight/height2) have a higher risk for developing lung malignancies as compared with smokers of average weight, but there is no mechanistic explanation for this observation. Carcinogens in cigarette smoke are thought to elicit cancer by the formation of DNA adducts, which give the opportunity to additionally investigate the biological link between BMI and lung cancer. DNA adduct levels in peripheral blood lymphocytes of 24 healthy smoking volunteers (0.76 ± 0.41 adducts per 108 nucleotides) positively correlated with cigarette consumption (r = 0.51; P = 0.01) and were inversely related with BMI (r = -0.48; P = 0.02). A significant overall relationship was observed when both parameters were included in multiple regression analysis (r = 0.63; P = 0.007). Moreover, body composition may affect DNA adduct persistence, because lipophilic tobacco smoke-derived carcinogens accumulate in adipose tissue and can be mobilized once exposure ceases. Therefore, DNA adduct levels and BMI were reassessed in all of the subjects after a nonsmoking period of 22 weeks. Adduct levels declined to 0.44 ± 0.23 per 108 nucleotides (P = 0.002), and the estimated half-life was 11 weeks on the basis of exponential decay to background levels in never-smoking controls (0.33 ± 0.18 per 108 nucleotides). Overweight subjects (BMI >25) with little weight gain after smoking cessation (<median weight gain of 6%) had more persistent adduct levels as compared with those with lower BMI and higher weight gain (P = 0.06). Overall, these results suggest that leanness is a host susceptibility factor that affects DNA adduct formation, which could underlie the observed relationship between BMI and lung cancer risk.
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