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Metabolic syndrome was defined based on the modified Third National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (NCEP-ATP III) criteria 20 along with the abdominal obesity criteria from the Korean Society for the Study of Obesity 21

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Elevated carboxy-haemoglobin can lead to hypoxia, sub- endothelial edema as it affects vascular permeability and cause lipid deposition while Free radicals and peroxides involved with prostaglandins and thromboxane synthesis, and in pathogenesis of different diseases as atherosclerosis, carcinoma, and inammatory processes.14 Haematologically continuous cigarette smoking raises RBC count, hemoglobin concentration, packed cell volume, white blood cell count, mean corpuscular volume and mean corpuscular haemoglobin concentration, all of which may increase atherosclerosis risk.14 Furthermore, leukocyte recruitment mediated by endothelial adhesion molecules J Coloproctol Vol