Division of Endocrinology, Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, United States of America.
Department of General Pediatrics, Children's Hospital of Richmond, Virginia Commonwealth University School of Medicine, Richmond, Virginia, United States of America.
PLoS One. 2018 Oct 8;13(10):e0205342. doi: 10.1371/journal.pone.0205342. eCollection 2018.
The role of tobacco-smoke exposure on serum vitamin D concentration in US pediatric population is not known. We hypothesized that tobacco smoke exposure would increase the prevalence of vitamin D deficiency in US children.
Representative national data were accessed from the National Health and Nutrition Examination Survey (NHANES) 2009-2010 databank on 2,263 subjects of ages 3 to 17 years. Subjects were categorized into two groups based on their age: children, if <10 years; and youth if 10 to 17 years. Descriptive and multiple logistic regression analyses were conducted to determine the effect of serum cotinine-verified tobacco smoke exposure on vitamin D status after controlling for key sociodemographic confounders. Vitamin D deficiency was defined as 25(OH)D <20 ng/mL, insufficiency as 25(OH)D of 20-29.9 ng/mL, and sufficiency as 25(OH)D of ≥30 ng/mL. Tobacco smoke exposure status was defined by serum cotinine concentration as follows: unexposed and non-smoking (<0.05 ng/mL) and exposed (passive and active smokers combined) (≥0.05ng/mL). Specifically, passive and active smoking were defined as cotinine of 0.05-10 ng/mL, and ≥10ng/mL respectively.
The prevalence of second-hand smoke exposure was 42.0% (95%CI, 36.7%-47.5%); while the prevalence of active smoking among teenagers was 9.0% (95%CI, 6.2%-12.5%). Vitamin D deficiency occurred at a frequency of 15.1% in children unexposed to tobacco smoke, 20.9% in children exposed to passive tobacco smoke, and 18.0% among actively smoking youth (p<0.001). Tobacco smoke exposure independently predicted vitamin D deficiency after controlling for age, sex, race, BMI, maternal education, and family socio-economic status (OR:1.50; 95%CI, 1.14-1.85, p = 0.002).
This analysis of a nationwide database reports that tobacco smoke exposure is an independent predictor of vitamin D deficiency in US children.
在美国儿科人群中，烟草烟雾暴露对血清维生素 D 浓度的影响尚不清楚。我们假设烟草烟雾暴露会增加美国儿童维生素 D 缺乏症的患病率。
从 2009-2010 年国家健康和营养调查（NHANES）数据库中获取了具有代表性的全国性数据，共纳入 2263 名年龄在 3 至 17 岁的受试者。根据年龄将受试者分为两组：<10 岁为儿童组，10-17 岁为青少年组。进行描述性和多因素逻辑回归分析，以确定血清可替宁证实的烟草烟雾暴露对控制关键社会人口混杂因素后的维生素 D 状态的影响。维生素 D 缺乏症定义为 25（OH）D <20ng/mL，不足为 25（OH）D 20-29.9ng/mL，充足为 25（OH）D ≥30ng/mL。根据血清可替宁浓度定义烟草烟雾暴露状态如下：未暴露且不吸烟（<0.05ng/mL）和暴露（被动和主动吸烟者合并）（≥0.05ng/mL）。具体来说，被动和主动吸烟定义为可替宁浓度 0.05-10ng/mL 和≥10ng/mL。
二手烟暴露率为 42.0%（95%CI，36.7%-47.5%）；青少年主动吸烟率为 9.0%（95%CI，6.2%-12.5%）。未接触烟草烟雾的儿童中维生素 D 缺乏的发生率为 15.1%，接触被动烟草烟雾的儿童为 20.9%，主动吸烟的青少年为 18.0%（p<0.001）。在控制年龄、性别、种族、BMI、母亲教育程度和家庭社会经济地位后，烟草烟雾暴露独立预测了维生素 D 缺乏（OR：1.50；95%CI，1.14-1.85，p=0.002）。
对全国性数据库的分析报告显示，烟草烟雾暴露是美国儿童维生素 D 缺乏的独立预测因素。
