二手烟暴露与从不吸烟成年人严重头痛或偏头痛之间的关联。

Association between secondhand smoke exposure and severe headaches or migraine in never-smoking adults.

机构信息

Department of Anesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou, China.

出版信息

Headache. 2023 Nov-Dec;63(10):1341-1350. doi: 10.1111/head.14640. Epub 2023 Nov 8.

DOI:10.1111/head.14640

PMID:37938023

Abstract

OBJECTIVE

The study aimed to examine the relationship between secondhand smoke (SHS) exposure and severe headaches or migraine in never-smoking adults verified by serum cotinine.

BACKGROUND

Current evidence about the association between self-reported SHS exposure and headaches or migraine is limited and contradictory. An important issue lies in the lack of actual SHS exposure assessment through biomarkers.

METHODS

We conducted a cross-sectional study on 4560 never-smoking adults from the National Health and Nutrition Examination Survey (NHANES), 1999-2004. The SHS exposure was evaluated by measuring serum cotinine concentrations. The information regarding severe headaches or migraine was based on self-reporting.

RESULTS

The overall prevalence rate of severe headaches or migraine was 20% (919/4560). After adjusting for relevant covariates, we found that heavy SHS exposure (serum cotinine at 1 to 10 ng/mL) was positively associated with severe headaches or migraine (OR: 2.02, 95% CI [1.19, 3.43]); however, no significant association was found between low SHS exposure (serum cotinine at 0.05 to 0.99 ng/mL) and severe headaches or migraine (OR: 1.15, 95% CI [0.91, 1.47]). Restricted cubic spline analysis showed that the natural logarithm of serum cotinine had a linear relationship with severe headaches or migraine (p = 0.335 for nonlinearity). Stratified analysis indicated that individuals with a BMI of <25 (p < 0.001 for interaction) and sedentary activity (p = 0.016 for interaction) modified the relationship between SHS exposure and severe headaches and migraine. Even after altering the definition of SHS exposure, excluding drugs that might affect the metabolism of serum cotinine, and multiple imputation, our sensitivity analysis results remained stable.

CONCLUSIONS

The study demonstrated that heavy SHS exposure (serum cotinine at 1 to 10 ng/mL) had a significant positive association with severe headaches or migraine in never-smoking adults. Prospective studies are necessary to verify this relationship in the future.

摘要

目的

本研究旨在通过血清可替宁检测，探讨二手烟（SHS）暴露与从不吸烟成年人重度头痛或偏头痛之间的关系。

背景

目前关于自我报告的 SHS 暴露与头痛或偏头痛之间关联的证据有限且存在矛盾。一个重要问题在于缺乏通过生物标志物进行实际的 SHS 暴露评估。

方法

我们对来自 1999-2004 年国家健康和营养调查（NHANES）的 4560 名从不吸烟的成年人进行了一项横断面研究。通过测量血清可替宁浓度评估 SHS 暴露情况。重度头痛或偏头痛的信息基于自我报告。

结果

重度头痛或偏头痛的总体患病率为 20%（4560 名中的 919 人）。在校正了相关协变量后，我们发现重度 SHS 暴露（血清可替宁浓度在 1 至 10ng/ml 之间）与重度头痛或偏头痛呈正相关（OR：2.02，95%CI[1.19，3.43]）；然而，低 SHS 暴露（血清可替宁浓度在 0.05 至 0.99ng/ml 之间）与重度头痛或偏头痛之间无显著关联（OR：1.15，95%CI[0.91，1.47]）。限制性立方样条分析显示，血清可替宁的自然对数值与重度头痛或偏头痛呈线性关系（非线性检验 p=0.335）。分层分析表明，BMI<25（交互作用检验 p<0.001）和久坐不动的活动（交互作用检验 p=0.016）的个体改变了 SHS 暴露与重度头痛和偏头痛之间的关系。即使改变了 SHS 暴露的定义、排除可能影响血清可替宁代谢的药物，以及进行多重插补，我们的敏感性分析结果仍然稳定。