美国青少年的吸烟暴露与呼出气一氧化氮水平。
Tobacco smoke exposure and fractional exhaled nitric oxide levels among U.S. adolescents.
机构信息
School of Human Services, University of Cincinnati, Cincinnati, OH, USA.
Division of Biostatistics and Bioinformatics, Department of Environmental and Public Health Sciences, College of Medicine, University of Cincinnati, 162 Kettering Lab Building, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA.
出版信息
Nitric Oxide. 2021 Dec 1;117:53-59. doi: 10.1016/j.niox.2021.10.004. Epub 2021 Oct 21.
BACKGROUND
Fractional exhaled nitric oxide (FeNO) can objectively guide clinical practice in the assessment, diagnosis, and treatment of eosinophilic airway inflammation. FeNO values may be affected by current smoking, but the role of tobacco smoke exposure (TSE) is understudied.
OBJECTIVE
This study investigated the associations between biochemically validated and self-reported TSE and FeNO levels among U.S. nonsmoking adolescents without asthma.
METHODS
National Health and Nutrition Examination Survey 2007-2012 data were used. TSE was assessed via serum cotinine and self-reported measures. We assessed FeNO continuously and using cutpoints of >35 ppb and >50 ppb to indicate likely eosinophilic inflammation in children and adults, respectively. We conducted linear and logistic regression adjusting for potential covariates.
RESULTS
Overall, 34.0% of adolescents had low cotinine (0.05-2.99 ng/ml), 6.2% had high cotinine (≥3.00 ng/ml), and 11.9% had home TSE. Compared to adolescents with no/minimal cotinine, adolescents with high cotinine were at reduced odds to have FeNO >35 ppb (adjusted odds ratio [aOR] = 0.54, 95%CI = 0.43,0.69). Adolescents with low cotinine had lower FeNO values (β = -2.05, 95%CI = -3.61,-0.49), and were also at decreased odds to have FeNO >35 ppb (aOR = 0.74, 95%CI = 0.66,0.83) and FeNO >50 ppb (aOR = 0.62, 95%CI = 0.53,0.72). Adolescents with home TSE were at reduced odds to have FeNO >50 ppb (aOR = 0.72, 95%CI = 0.57,0.91) than adolescents without home TSE. Adolescents with a higher number of cigarettes/day smoked inside their home were at reduced odds to have FeNO >35 ppb (OR = 0.98, 95%CI = 0.97,0.99) and FeNO >50 ppb (OR = 0.98, 95%CI = 0.96,0.99).
CONCLUSIONS
TSE was associated with decreased FeNO levels. The addition of TSE may be clinically important when interpreting thresholds for FeNO.
背景
呼出气一氧化氮分数（FeNO）可客观指导临床评估、诊断和治疗嗜酸性气道炎症。FeNO 值可能受到当前吸烟的影响，但烟草烟雾暴露（TSE）的作用尚未得到充分研究。
目的
本研究旨在调查美国非哮喘青少年中，经生物化学验证的 TSE 和自我报告的 TSE 与 FeNO 水平之间的关联。
方法
利用 2007-2012 年国家健康和营养调查数据。通过血清可替宁和自我报告的措施评估 TSE。我们连续评估 FeNO，并分别使用>35 ppb 和>50 ppb 的切点来表示儿童和成人中可能的嗜酸性炎症。我们通过调整潜在协变量进行线性和逻辑回归。
结果
总体而言，34.0%的青少年可替宁水平较低（0.05-2.99ng/ml），6.2%的青少年可替宁水平较高（≥3.00ng/ml），11.9%的青少年有家庭 TSE。与可替宁水平较低（<0.05ng/ml）的青少年相比，可替宁水平较高的青少年 FeNO >35 ppb 的可能性较低（调整后的比值比[aOR] = 0.54，95%CI = 0.43,0.69）。可替宁水平较低的青少年 FeNO 值较低（β=-2.05，95%CI = -3.61,-0.49），且 FeNO >35 ppb（aOR = 0.74，95%CI = 0.66,0.83）和 FeNO >50 ppb（aOR = 0.62，95%CI = 0.53,0.72）的可能性也较低。有家庭 TSE 的青少年 FeNO >50 ppb 的可能性低于无家庭 TSE 的青少年（aOR = 0.72，95%CI = 0.57,0.91）。在家中吸烟的青少年每天吸烟的数量越多，FeNO >35 ppb（OR = 0.98，95%CI = 0.97,0.99）和 FeNO >50 ppb（OR = 0.98，95%CI = 0.96,0.99）的可能性越低。
结论
TSE 与 FeNO 水平降低有关。在解释 FeNO 阈值时，增加 TSE 可能具有重要的临床意义。
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