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The Effect of Cigarette Smoking on Serum Liver Enzymes in Baghdad 

  

Wasan Qasim Turki 

wasan.turki@almustafafauniversity.edu.iq  
Department of Medical Laboratory Techniques, Al-Mustafa University College, Baghdad, Iraq. 

 

 
Abstract   

Smoking is the most noticeably horrible human conduct; it is rehearsed by individuals 

dependent on nicotine numerous hurtful sicknesses, for example, cancer and liver disorder are 

brought about by smoking cigarettes. So this study aimed to study some of the liver function 

represented by the enzymes aspartate aminotransferase (AST or GOT) and alanine 

aminotransferase (ALT or GPT) in smokers and non-smokers for 50 persons in a group 

consists of 25 smokers and 25 non-smokers of different ages and to study the effectiveness of 

cigarette smoking on liver enzymes by checking the secretion of (AST) (35.84± 4.1)U/ 1 

(ALT)(51.08±7.286 ) U/1(p<0.05) relative to non-smokers were significantly correlated with 

heavy cigarette smoking. 

Keywords: Smokers, Liver enzyme, Cigarette, Tobacco. 
 

1. Introduction 
Many diseases are caused by Smoking, and because of the risk of smoking, one person 

dies in the world per six minutes [1]. More than 4000 chemicals are present in tobacco smoke 

[2] and various hazardous substances like nicotine, free extremists, carbon monoxide, and 

other gaseous materials are submitted to a cigarette smoker [3]. That can lead to various 

degenerative pulmonary cardiovascular diseases and cancer. Cigarette smoking has been 

embroiled as a huge danger factor for the tobacco smoke contains various mixes, huge 

numbers of which are oxidants and favorable to oxidants fit for creating free extremists and 

improving the oxidative stress in vivo [4] (Preston, 1991). The liver, which has several duties, 

is an essential organ. The liver is responsible, among other things, for removing narcotics, 

alcohol, and other toxins from the body to remove them. The liver is one of the organs that are 

not directly affected by smoking so Heavy smoking creates toxins that stimulate 

necroinflammation and rise the dangerousness of hepatic lesions (fibrosis and activity scores) 

that related to hepatitis C virus (HCV) or hepatitis B virus (HBV) infection [5, 6]. Three main 

adverse effects on the liver are caused by smoking: direct or indirect harmful impact, 

immunological effects, and tumorigenesis effects. Smoking can cause a Direct toxic effect 

when produced chemicals with the potential for cytotoxicity [7]. Some Chemicals caused by 

smoking lead to oxidative stress linked to lipid peroxidation [8, 9]. Where it stimulates the 

production of stellar cells and the growth of fibrosis. Cigarette smoke also helps in the 

production of pro-inflammatory cytokines that are related to liver cell damage (IL-1, IL-6, and 

TNF-alpha) [10]. Heavy cigarettes are related to carboxyhaemoglobin and lowered ability of 

red blood cells (RBC) to carrying oxygen, contributing to tissue hypoxia. Hypoxia promotes 

the development of erythropoietin, which causes bone marrow hyperplasia. This leads to the 

production of secondary polycythemia, which in turn increases the mass and turnover of red 

cells. This enhances catabolic iron resulting from both old red blood cells and iron produced 

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Special Issue                                                                                 1220 ICPASIH 
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from elevated red cell destruction associated with polycythemia [11, 12]. In addition, 

erythropoietin promotes iron absorption from the intestine. Both elevated catabolic iron and 

high iron absorption lead to its concentration in macrophages over time and then in 

hepatocytes, inducing oxidative stress in hepatocytes [13]. Subsequently, the reason for this 

examination is to inspect the differences of liver enzymes among smokers than non-smokers 

in males and clarify the negative impacts of tobacco when smoking for long periods and the 

extent of its impact on the liver.  

 

2.  Materials Method 

     Blood samples are taken during February from (50) healthy male subjects in Baghdad, Al-

Rusafa whose ages ranged from 20 to 55 years of age and divided into two groups, with 25 

smoking persons and 25 non-smoking persons with varying smoking durations in the second 

group. We had to make sure that the volunteer had no illness before taking the sample to 

prevent cases that could rise liver enzyme secretion and interfere with the results of our study. 

The two groups (smoking persons and non-smoking persons) were chosen at close ages to be 

appropriate for the statistical study. People under the test are divided into smokers (who are 

smoking more than (20) cigarette daily) (n=25) and non-smokers (n=25). 5.0 ml of blood 

were taken from each participant, and this 5.0 ml of venous blood were drowning by 

venipuncture using antiseptic for the skin (70%alcohol), and then the samples placed in a 

heparinized tube, after that we made centrifugation to the blood samples at about three 

thousand, then the enzymes AST and ALT were estimated. In current experiments used 

ABBOTT C4000 Chemistry Analyzer to detect AST and ALT. To determine substantial 

differences and all the differences, the statistical assessment was carried out by statistical 

package for social sciences (spss) 26.0 and found the significant differences between the 

values (Mean± SEM) of the test and the control groups, t-test (at p<0.05) was applied. 

 

3.  Results and Discussion 

The results showed that high concentrations of aspartate aminotransferase (AST or GOT) 

and alanine aminotransferase (ALT or GPT) compared to non-smokers p<0.05 (Table 1) were 

significantly associated with heavy cigarette smoking (ALT). 

 

Table 1. Concentrations AST and ALT enzymes of smokers compared with non-smoker. 

Significant 

p<0.05 

P-value Non-smoking 

N= 25 

Smoking 

N= 25 

Parameters 

S* 0.006 19.20±1.534 35.84±4.1 AST or GOT (U/I ) 

S* 0.001 25.72±1.837 51.08±7.286 ALT or GPT (U/I ) 

*S= Significant 

 

Figure (1) and Figure (2) show that both AST and ALT have a higher level in smokers if we 

compare them with non-smokers where (p<0.05). According to the results in Figure (1). 

Height of the concentrations of aspartate aminotransferase (AST or GOT) and alanine 

aminotransferase (ALT or GPT) because of the intensity of tobacco smoke and its harmful 

substance affected on liver cells, prompting the emission of liver enzyme (AST) and (ALT)  

through inflammatory pathways or exacerbating the pathogenic effects of other compounds on 

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the liver [14]. Furthermore, that may occur due to nitrosative stress, which is a disorder that 

arises when the processing of chemicals containing highly reactive, such as nitrous oxide, 

exceeds the human body`s capacity to neutralize and remove them. Nitrosative stress able to 

run the reactions that convert the structure of proteins so interfere with normal body functions 

[15, 16]. Cigarette smoke contains a large number of hepatotoxic chemicals, like nicotine [7].  

 

 
Figure 1. Concentrations (AST or GOT) enzymes of smokers compared with non-smoker. 

 
Figure 2. Concentrations (ALT or GPT) enzymes of smokers compared with a non-smoker. 

 

Important changes in the activity concentrations of AST and ALT liver enzymes in 

smokers relative to non-smokers, and increases in proportion to the duration of smoking. So 

the liver enzymes AST and ALT in which increased due to exposure to smoke or duo to 

release a high level of the cellular oxidative radicals as reported in [17, 18]. The enzyme that 

is important for producing energy is alanine aminotransferase (ALT or GPT), this enzyme is 

found in the liver and other tissues besides the liver but in fewer concentrations than its 

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concentration in the liver, it is found for example in the heart and the skeletal muscles. In 

comparison to other liver enzymes can be used to diagnose liver diseases, such as in the 

diagnosis of hepatitis and cirrhosis [19].   

4. Conclusion 

The results show that cigarette smoking has an effect on the liver function that is 

expressed in the amount of liver enzyme secretion in the blood serum, so smoking can affect 

liver functions by affecting the secretion of AST and ALT liver enzymes, causing liver injury 

in the community of smokers compared to non-smokers. shows that the level of AST and 

ALT enzymes are higher in cigarette smokers when we compare them with non-smokers, and 

this may be related to the effect of smoking on the liver.  

 

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