Hart C L, Smith G Davey, Hole D J, Hawthorne V M
University of Glasgow, Glasgow, UK.
Heart. 2006 Mar;92(3):321-4. doi: 10.1136/hrt.2005.065185. Epub 2005 Jun 6.
To investigate how carboxyhaemoglobin concentration is related to smoking habit and to assess whether carboxyhaemoglobin concentration is related to mortality.
Prospective cohort study.
Residents of the towns of Renfrew and Paisley in Scotland.
The whole Renfrew/Paisley study, conducted between 1972 and 1976, consisted of 7048 men and 8354 women aged 45-64 years. This study was based on 3372 men and 4192 women who were screened after the measurement of carboxyhaemoglobin concentration was introduced about halfway through the study.
Deaths from coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD), lung cancer, and all causes in 25 years after screening.
Carboxyhaemoglobin concentration was related to self reported smoking and for each smoking category was higher in participants who reported inhaling than in those who reported not inhaling. Carboxyhaemoglobin concentration was positively related to all causes of mortality analysed (relative rates associated with a 1 SD (2.93) increase in carboxyhaemoglobin for all causes, CHD, stroke, COPD, and lung cancer were 1.26 (95% confidence interval (CI) 1.19 to 1.34), 1.19 (95% CI 1.13 to 1.26), 1.19 (95% CI 1.13 to 1.26), 1.64 (95% CI 1.47 to 1.84), and 1.69 (95% CI 1.60 to 1.79), respectively). Adjustment for self reported cigarette smoking attenuated the associations but they remained relatively strong.
Self reported smoking data were validated by the objective measure of carboxyhaemoglobin concentration. Since carboxyhaemoglobin concentration remained associated with mortality after adjustment for smoking, carboxyhaemoglobin seems to capture more of the risk associated with smoking tobacco than does self reported tobacco consumption alone. Analysing mortality by self reported cigarette smoking underestimates the strength of association between smoking and mortality.
研究碳氧血红蛋白浓度与吸烟习惯的关系，并评估碳氧血红蛋白浓度与死亡率是否相关。
前瞻性队列研究。
苏格兰伦弗鲁和佩斯利镇的居民。
1972年至1976年间开展的整个伦弗鲁/佩斯利研究，包括7048名男性和8354名年龄在45 - 64岁的女性。本研究基于3372名男性和4192名女性，这些人是在研究进行到大约一半时引入碳氧血红蛋白浓度测量后进行筛查的。
筛查后25年内冠心病（CHD）、中风、慢性阻塞性肺疾病（COPD）、肺癌及所有原因导致的死亡。
碳氧血红蛋白浓度与自我报告的吸烟情况相关，对于每个吸烟类别，报告有吸入行为的参与者的碳氧血红蛋白浓度高于报告无吸入行为的参与者。碳氧血红蛋白浓度与分析的所有死亡原因均呈正相关（碳氧血红蛋白浓度每增加1个标准差（2.93），所有原因、冠心病、中风、慢性阻塞性肺疾病和肺癌的相对风险分别为1.26（95%置信区间（CI）1.19至1.34）、1.19（95%CI 1.13至1.26）、1.19（95%CI 1.13至1.26）、1.64（95%CI 1.47至1.84）和1.69（95%CI 1.60至1.79））。对自我报告的吸烟情况进行调整后，关联有所减弱，但仍然相对较强。
自我报告的吸烟数据通过碳氧血红蛋白浓度这一客观测量得到了验证。由于在对吸烟进行调整后，碳氧血红蛋白浓度仍与死亡率相关，因此碳氧血红蛋白似乎比单纯的自我报告烟草消费量更能反映与吸烟相关的风险。通过自我报告的吸烟情况分析死亡率会低估吸烟与死亡率之间关联的强度。
