Waterpipe smoking (WPS) is increasingly popular worldwide and is believed to be less harmful than cigarette smoking (CS), despite evidence of its negative impact on multiple organs. The kidneys and liver are key organs affected by toxic compounds in WPS; however, limited research has explored their effects on related biochemical markers and novel biomarkers, such as omentin-1. This study aimed to investigate the impact of WPS and its cessation on liver and kidney function tests, as well as omentin-1 levels, in adults. A cross-sectional study was conducted from November 2024 to January 2025 among 90 individuals at Zakho General Hospital in Zakho City, the Kurdistan region of Iraq. Participants were recruited using a convenience sampling method. Participants were categorized into three groups: non-smokers, waterpipe smokers, and former waterpipe smokers. Inclusion criteria included adults aged 18–40. Renal function tests, including urea, creatinine, and uric acid, and liver enzymes, including AST, ALT, ALP, GGT, total bilirubin, and FBS, were performed using a Cobas 6000 c501 autoanalyzer. The omentin-1 level was assessed by ELISA. Data were analyzed using the SPSS program version 26, with independent-sample t-tests, Mann–Whitney U tests, an ANOVA with post hoc tests, and Kruskal–Wallis tests. There were no significant differences in age and BMI among the three groups (P > 0.05). The results showed that eGFR, AST, and ALT were significantly higher in the WPS smokers’ group than the non-smokers group (P < 0.05). Both the WPS and cessation groups showed significant reductions in omentin-1 levels and DBP (P < 0.05). A longer WPS duration was associated with lower BMI, WC, ALT, and DBP (P < 0.05). Prolonged cessation reduced FBS and SBP but increased uric acid levels (P < 0.05). Omentin-1 levels were negatively correlated with FBS and oxygen levels (R2 = −0.254, P = 0.018 and R2 = −0.266, P = 0.013). These findings suggest that WPS negatively affects metabolic health by decreasing omentin-1 and increasing AST and ALT levels, while cessation improves some biochemical markers over time, leading to a significant decrease in FBS and SBP levels and a significant increase in uric acid level (P < 0.05). WPS and its cessation adversely affect metabolic health, reduce omentin-1 levels, and increase the risk of metabolic disorders. Over time, cessation improves the levels of FBS, SBP, and uric acid. The outcome is an enhancement in glycemic regulation, which is probably the result of less oxidative stress and inflammation. In addition, it increases the level of uric acid. This increase in uric acid levels is due to a reduction in oxidative stress, which occurs because smoking generates reactive oxygen species (ROS). Uric acid acts as an antioxidant, and its levels may decrease during active smoking due to increased usage. Upon cessation, oxidative stress diminishes, reducing the consumption of uric acid and allowing its levels to rise.

The Effect of Waterpipe Smoking Cessation on Kidney and Liver Functions and a Novel Biomarker Omentin-1

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发表日期：

2025年8月28日

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Hiba A. Yousif,
Mohammed A. Hami

摘要

Waterpipe smoking (WPS) is increasingly popular worldwide and is believed to be less harmful than cigarette smoking (CS), despite evidence of its negative impact on multiple organs. The kidneys and liver are key organs affected by toxic compounds in WPS; however, limited research has explored their effects on related biochemical markers and novel biomarkers, such as omentin-1. This study aimed to investigate the impact of WPS and its cessation on liver and kidney function tests, as well as omentin-1 levels, in adults. A cross-sectional study was conducted from November 2024 to January 2025 among 90 individuals at Zakho General Hospital in Zakho City, the Kurdistan region of Iraq. Participants were recruited using a convenience sampling method. Participants were categorized into three groups: non-smokers, waterpipe smokers, and former waterpipe smokers. Inclusion criteria included adults aged 18–40. Renal function tests, including urea, creatinine, and uric acid, and liver enzymes, including AST, ALT, ALP, GGT, total bilirubin, and FBS, were performed using a Cobas 6000 c501 autoanalyzer. The omentin-1 level was assessed by ELISA. Data were analyzed using the SPSS program version 26, with independent-sample t-tests, Mann–Whitney U tests, an ANOVA with post hoc tests, and Kruskal–Wallis tests. There were no significant differences in age and BMI among the three groups (P > 0.05). The results showed that eGFR, AST, and ALT were significantly higher in the WPS smokers’ group than the non-smokers group (P < 0.05). Both the WPS and cessation groups showed significant reductions in omentin-1 levels and DBP (P < 0.05). A longer WPS duration was associated with lower BMI, WC, ALT, and DBP (P < 0.05). Prolonged cessation reduced FBS and SBP but increased uric acid levels (P < 0.05). Omentin-1 levels were negatively correlated with FBS and oxygen levels (R² = −0.254, P = 0.018 and R² = −0.266, P = 0.013). These findings suggest that WPS negatively affects metabolic health by decreasing omentin-1 and increasing AST and ALT levels, while cessation improves some biochemical markers over time, leading to a significant decrease in FBS and SBP levels and a significant increase in uric acid level (P < 0.05). WPS and its cessation adversely affect metabolic health, reduce omentin-1 levels, and increase the risk of metabolic disorders. Over time, cessation improves the levels of FBS, SBP, and uric acid. The outcome is an enhancement in glycemic regulation, which is probably the result of less oxidative stress and inflammation. In addition, it increases the level of uric acid. This increase in uric acid levels is due to a reduction in oxidative stress, which occurs because smoking generates reactive oxygen species (ROS). Uric acid acts as an antioxidant, and its levels may decrease during active smoking due to increased usage. Upon cessation, oxidative stress diminishes, reducing the consumption of uric acid and allowing its levels to rise.