Kim K Y, Myong J-P, Kim H-R, Lee H E, Jang T-W, Koo J-W, Park C Y
Department of Occupational & Environmental Medicine, Korea Medical Institute, Seoul, Republic of Korea.
Department of Occupational & Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Int J Tuberc Lung Dis. 2014 May;18(5):622-7. doi: 10.5588/ijtld.13.0677.
Country-wide general population in South Korea.
The dose-response relationship between smoking and pulmonary function in women may have been significantly over-estimated by studies that employed a self-reporting questionnaire.
To evaluate whether this relationship was still observed among Korean women when smoking levels were determined by urinary cotinine measurements.
A total of 4584 Korean women from the spirometry data set of the Korean National Health and Nutrition Examination Surveys IV and V (2008-2010) were included. Analysis of covariance was performed to estimate the dose-related effect of urinary cotinine levels on pulmonary function after adjusting for covariates in this country-wide cross-sectional study.
Compared to urinary cotinine levels (cut-off 50 ng/ml), the false-positive rate of self-reported smoking was 53.2%. After the smokers were divided into deciles, the regression coefficients for percentage forced expiratory volume in 1 second (FEV₁%) and percentage forced expiratory volume/forced volume capacity (FEV₁/FVC) ratio (FEV1/FVC%) were -0.2903 and -0.2680 (%/decile), respectively (both P < 0.001).
It is necessary to use objective methods when determining the smoking status of Korean women. Even after reducing information bias, smoking affected pulmonary function in a dose-dependent manner.
韩国全国范围内的普通人群。
采用自我报告问卷的研究可能显著高估了女性吸烟与肺功能之间的剂量反应关系。
当通过尿可替宁测量确定吸烟水平时，评估韩国女性中是否仍存在这种关系。
纳入了韩国国家健康与营养检查调查IV和V（2008 - 2010年）肺活量测定数据集中的4584名韩国女性。在这项全国性横断面研究中，进行协方差分析以估计尿可替宁水平在调整协变量后对肺功能的剂量相关影响。
与尿可替宁水平（临界值50 ng/ml）相比，自我报告吸烟的假阳性率为53.2%。将吸烟者分为十分位数后，第1秒用力呼气容积百分比（FEV₁%）和用力呼气容积/用力肺活量比值百分比（FEV₁/FVC%）的回归系数分别为-0.2903和-0.2680（%/十分位数）（均P < 0.001）。
确定韩国女性吸烟状况时，有必要使用客观方法。即使减少信息偏倚后，吸烟仍以剂量依赖方式影响肺功能。
