Fu Yi-Cheng, Xu Zhi-Liang, Zhao Ming-Yi, Xu Ke
Department of Paediatrics, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China.
Department of Paediatrics, The Third Xiangya Hospital, Central South University, Changsha, China.
Front Med (Lausanne). 2022 Jun 3;9:870278. doi: 10.3389/fmed.2022.870278. eCollection 2022.
Many conclusions have been reached in renal function studies in direct smokers.
This study aimed to determine the relationship between smoking and decreased renal function to ensure that reduced chronic kidney disease incidence can be achieved by limiting smoking, we assessed the relationship between cigarette smoking and renal function.
We recruited 10,267 people from the National Health and Nutrition Program Testing Survey (NHANES) aged over 20 years from 2013 to 2018 to assess smoking exposure by serum cotinine. We estimated the glomerular filtration rate (eGFR) and used multivariate linear regression models and smooth curve fittings to assess the relationship between smoking and renal function.
We found an inverse relationship between serum cotinine and the eGFR. In a subgroup analysis, we found a non-linear relationship between serum cotinine and the eGFR in different ethnic groups or in different sexes. In a subgroup analysis of sex, we found inflection points between men and women for the relationship between serum cotinine and the eGFR (men 183 ng/ml and 465 ng/ml; women 227 ng/ml and 412 ng/ml). However, in a subgroup analysis by age, we found that serum cotinine showed a clear negative correlation with the eGFR in people aged 20-39 years, but in people older than 40 years, a weak correlation was shown. In stratified analysis by ethnicity, we found significant negative associations in Mexican American and Other Hispanic individuals and weaker associations in Non-Hispanic White and Non-Hispanic Black individuals.
Through the negative correlation between serum cotinine and the eGFR, we can conclude that as the smoking quantity increases, smoking leads to a decrease in renal function. The results of the subgroup analysis indicate that in young people, by advocating smoking cessation early, we can very effectively prevent kidney disease in this population and thus reduce the incidence of chronic kidney disease. Smoking should be included as an independent risk factor for chronic kidney disease.
在直接吸烟者的肾功能研究中已经得出了许多结论。
本研究旨在确定吸烟与肾功能下降之间的关系，以确保通过限制吸烟可降低慢性肾病的发病率，我们评估了吸烟与肾功能之间的关系。
我们从2013年至2018年的国家健康与营养检查调查（NHANES）中招募了10267名年龄超过20岁的人，通过血清可替宁评估吸烟暴露情况。我们估算了肾小球滤过率（eGFR），并使用多元线性回归模型和平滑曲线拟合来评估吸烟与肾功能之间的关系。
我们发现血清可替宁与eGFR之间呈负相关。在亚组分析中，我们发现在不同种族或不同性别中，血清可替宁与eGFR之间存在非线性关系。在性别亚组分析中，我们发现血清可替宁与eGFR之间的关系在男性和女性中有拐点（男性为183 ng/ml和465 ng/ml；女性为227 ng/ml和412 ng/ml）。然而，在按年龄进行的亚组分析中，我们发现血清可替宁在20至39岁的人群中与eGFR呈明显负相关，但在40岁以上的人群中，相关性较弱。在按种族进行的分层分析中，我们发现墨西哥裔美国人和其他西班牙裔个体中存在显著的负相关，而非西班牙裔白人和非西班牙裔黑人个体中的相关性较弱。
通过血清可替宁与eGFR之间的负相关，我们可以得出结论，随着吸烟量的增加，吸烟会导致肾功能下降。亚组分析结果表明，在年轻人中，通过尽早倡导戒烟，我们可以非常有效地预防该人群中的肾病，从而降低慢性肾病的发病率。吸烟应被列为慢性肾病的独立危险因素。
