Strauss R S
Department of Pediatrics, UMDNJ-Robert Wood Johnson School of Medicine, New Brunswick, New Jersey 08903-0019, USA.
Pediatrics. 2001 Mar;107(3):540-2. doi: 10.1542/peds.107.3.540.
High levels of free radicals in tobacco smoke are thought to be responsible for decreased levels of serum ascorbic acid in smokers and adults exposed to environmental tobacco smoke (ETS). The association of ETS to serum ascorbic acid in children is unknown.
Data were analyzed from the Third National Health and Nutrition Examination Survey, a nationally representative sample of children and adolescents (n = 2968). Comprehensive data including serum cotinine levels and family smoking patterns allowed for analysis of relationship of ETS to serum ascorbic acid levels. Data from 24-hour dietary recall also allowed for the control of vitamin C intake. Children were divided into categories of low and high ETS exposure based on levels of serum cotinine above or below 2 ng/mL. Smokers were defined by either self-report or serum cotinine >15 ng/mL.
Although there was a trend for lower levels of vitamin C intake in children with higher levels of ETS exposure, this trend did not reach statistical significance. Among all children, serum ascorbic acid levels were linearly related to serum cotinine levels (r = 0.19). In addition, a dose-response relationship was observed between levels of tobacco exposure and serum ascorbic acid levels. After adjusting for age, gender, vitamin C intake, and multivitamin use, environmental tobacco exposure remained significantly associated with lower levels of serum ascorbic acid in children who were exposed to both high and low levels of ETS.
Exposure of children to ETS leads to significant alterations in serum ascorbic acid levels. Therefore, this study further highlights the potential dangers of ETS to children.
烟草烟雾中的高自由基水平被认为是导致吸烟者和接触环境烟草烟雾（ETS）的成年人血清抗坏血酸水平降低的原因。ETS与儿童血清抗坏血酸之间的关联尚不清楚。
对第三次全国健康与营养检查调查的数据进行分析，该调查是一个具有全国代表性的儿童和青少年样本（n = 2968）。包括血清可替宁水平和家庭吸烟模式在内的综合数据有助于分析ETS与血清抗坏血酸水平之间的关系。24小时饮食回忆的数据也有助于控制维生素C的摄入量。根据血清可替宁水平高于或低于2 ng/mL，将儿童分为ETS低暴露组和高暴露组。吸烟者通过自我报告或血清可替宁>15 ng/mL来定义。
尽管ETS暴露水平较高的儿童维生素C摄入量有降低的趋势，但这一趋势未达到统计学显著性。在所有儿童中，血清抗坏血酸水平与血清可替宁水平呈线性相关（r = 0.19）。此外，观察到烟草暴露水平与血清抗坏血酸水平之间存在剂量反应关系。在调整年龄、性别、维生素C摄入量和复合维生素使用情况后，环境烟草暴露在ETS高暴露和低暴露的儿童中仍与较低的血清抗坏血酸水平显著相关。
儿童接触ETS会导致血清抗坏血酸水平发生显著变化。因此，本研究进一步强调了ETS对儿童的潜在危害。
