Kim Byung Jin, Han Ji Min, Kang Jung Gyu, Kim Bum Soo, Kang Jin Ho
Department of Medicine, Division of Cardiology.
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Coron Artery Dis. 2018 May;29(3):254-261. doi: 10.1097/MCA.0000000000000568.
There are no data comparing the relationship between coronary artery calcification and self-reported and cotinine-verified smoking. This study was carried out to evaluate the relationship between coronary artery calcium (CAC) and urinary cotinine or self-reported smoking status in Korean adults.
Study participants included 22 797 individuals (19 181 men; mean age±SD 39.2±7.1 years) who were enrolled in the Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study between 2011 and 2013, and who had urinary cotinine and CAC measurements. Cotinine-verified current smokers were defined as having a urinary cotinine level of above 50 ng/ml.
The prevalence of never smokers, former smokers, and current smokers according to the self-reported questionnaires was 44.6, 24.2, and 31.2%, respectively, and that of cotinine-verified current smokers was 30.2%. The prevalence of the presence of CAC in self-reported current smokers was higher than that in self-reported never/former smokers (13.7 vs. 10.2%, P<0.001), and that in cotinine-verified current smokers was higher than that in cotinine-verified never smokers (14.0 vs. 10.2%, P<0.001). A multivariate logistic regression model adjusted for the variables with univariate relationships showed that self-reported former smokers and current smokers had significantly increased odds ratio (OR) for the presence of CAC compared with self-reported never smokers [OR (95% confidence interval): 1.20 (1.03-1.40) in former smokers and 1.29 (1.11-1.50) in current smokers]. Cotinine-verified current smokers also showed a significant association with the presence of CAC [1.23 (1.12-1.35)]. Furthermore, log-transformed cotinine levels increased the OR for the presence of CAC [1.03 (1.01-1.05)].
This study is the first large cohort study to show that both self-reported and cotinine-verified smoking is associated independently with the presence of CAC in Korean adults.
目前尚无关于冠状动脉钙化与自我报告吸烟及可替宁验证吸烟之间关系的比较数据。本研究旨在评估韩国成年人冠状动脉钙化（CAC）与尿可替宁或自我报告吸烟状况之间的关系。
研究参与者包括2011年至2013年间纳入江北三星健康研究和江北三星队列研究的22797人（19181名男性；平均年龄±标准差39.2±7.1岁），这些人进行了尿可替宁和CAC测量。可替宁验证的当前吸烟者定义为尿可替宁水平高于50 ng/ml。
根据自我报告问卷，从不吸烟者、既往吸烟者和当前吸烟者的患病率分别为44.6%、24.2%和31.2%，可替宁验证的当前吸烟者患病率为30.2%。自我报告的当前吸烟者中CAC存在的患病率高于自我报告的从不/既往吸烟者（13.7%对10.2%，P<0.001），可替宁验证的当前吸烟者中CAC存在的患病率高于可替宁验证的从不吸烟者（14.0%对10.2%，P<0.001）。对具有单变量关系的变量进行调整的多变量逻辑回归模型显示，与自我报告的从不吸烟者相比，自我报告的既往吸烟者和当前吸烟者CAC存在的优势比（OR）显著增加[OR（95%置信区间）：既往吸烟者为1.20（1.03 - 1.40），当前吸烟者为1.29（1.11 - 1.50）]。可替宁验证的当前吸烟者也显示出与CAC存在显著关联[1.23（1.12 - 1.35）]。此外，对数转换后的可替宁水平增加了CAC存在的OR[1.03（1.01 - 1.05）]。
本研究是第一项大型队列研究，表明自我报告吸烟和可替宁验证吸烟均独立与韩国成年人CAC的存在相关。
