Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, 030000, China.
Department of Orthopedics, Yangquan Coal Group General Hospital, Yangquan, 045000, China.
Sci Rep. 2024 May 14;14(1):11061. doi: 10.1038/s41598-024-61950-2.
While smoking is widely acknowledged as a risk factor for rheumatoid arthritis (RA), the connection between secondhand smoke (SHS) exposure and RA in never-smoking adults remains limited and inconsistent. This study aims to explore and quantify this association using serum cotinine levels. We conducted a cross-sectional study with 14,940 adults who self-report as never smokers, using National Health and Nutrition Examination Survey data from 1999 to 2018. Based on previous literature, SHS exposure was categorized into four groups according to serum cotinine levels. Compared to individuals in the unexposed group (serum cotinine < 0.05 ng/mL), the adjusted odds ratio (OR) for RA was 1.37 (95% CI 1.14-1.64, p = 0.001) in the low exposure group (serum cotinine at 0.05 to 0.99 ng/mL) after adjusting for covariates. However, no significant association was found in the moderate exposure group (serum cotinine at 1 to 10 ng/mL) or the heavy exposure group (serum cotinine ≥ 10 ng/mL). Furthermore, we detected a non-linear, positively saturated correlation between the cotinine levels after log2 transformation and RA, with a turning point at approximately - 2.756 ng/mL (OR = 1.163, 95% CI 1.073-1.261, p = 0.0002). The stability of the results was confirmed by subgroup analysis.
虽然吸烟被广泛认为是类风湿关节炎（RA）的一个风险因素，但二手烟（SHS）暴露与从不吸烟成年人 RA 之间的联系仍然有限且不一致。本研究旨在通过血清可替宁水平来探讨和量化这种关联。我们使用 1999 年至 2018 年国家健康和营养调查的数据，进行了一项横断面研究，纳入了 14940 名自我报告为从不吸烟者的成年人。根据之前的文献，根据血清可替宁水平，将 SHS 暴露分为四组。与未暴露组（血清可替宁<0.05ng/mL）相比，在调整了协变量后，低暴露组（血清可替宁在 0.05 至 0.99ng/mL 之间）患 RA 的调整比值比（OR）为 1.37（95%CI 1.14-1.64，p=0.001）。然而，在中度暴露组（血清可替宁在 1 至 10ng/mL 之间）或重度暴露组（血清可替宁≥10ng/mL）中，没有发现显著的关联。此外，我们在对可替宁水平进行对数转换后，检测到 RA 与可替宁水平之间存在非线性、正饱和相关关系，转折点约为-2.756ng/mL（OR=1.163，95%CI 1.073-1.261，p=0.0002）。亚组分析证实了结果的稳定性。
