Department of Geriatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Nephrology, Tongren Hospital of Wuhan University (Wuhan Third Hospital), Wuhan University, Wuhan, P.R. China.
Ren Fail. 2024 Dec;46(1):2356024. doi: 10.1080/0886022X.2024.2356024. Epub 2024 Jun 4.
Smoking has been suggested as a modifiable and cardiovascular risk factor for chronic kidney disease (CKD). Although long-term smoking has been associated with CKD, the potential relationship between its metabolite hydroxycotinine and CKD has not been clarified.
A total of 8,544 participants aged 20 years and above from the National Health and Nutrition Examination Survey (NHANES) 2017 - March 2020 were enrolled in our study. CKD was defined by estimated glomerular filtration rate (eGFR) < 60 mL/(min*1.73 m). Serum hydroxycotinine was measured by an isotope-dilution high-performance liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometric (ID HPLC-APCI MS/MS) method with a lower limit of detections (LLOD) at 0.015 ng/mL. The non-linear relationship was explored with restricted cubic splines (RCS). Pearson's correlation coefficient and a multivariate logistic regression model were used for correlation analysis.
Serum hydroxycotinine and eGFR were negatively correlated in both non-CKD group (r= -0.05, < 0.001) and CKD group (r= -0.04, < 0.001). After serum hydoxycotinine dichotominzed with LLOD, serum hydroxycotinine ≥ 0.015 ng/mL was negatively correlated with eGFR not only in non-CKD group (r = -0.05, < 0.001) but also in CKD group (r = -0.09, < 0.001). After adjusting for comprehensive confounders, results from the multivariate logistic regression analysis showed that participants with serum hydroxycotinine ≥ 0.015 ng/mL had increased odds of CKD (OR = 1.505, < 0.001).
Serum hydroxycotinine might be positively associated with CKD. Further study is warranted to find the right concentration of hydroxycotinine to measure the CKD.
吸烟被认为是慢性肾脏病（CKD）的可改变心血管危险因素。尽管长期吸烟与 CKD 有关，但羟可替宁与其的潜在关系尚未阐明。
本研究共纳入了 2017 年至 2020 年 3 月期间参加美国国家健康和营养调查（NHANES）的 8544 名年龄在 20 岁及以上的参与者。CKD 的定义为估算肾小球滤过率（eGFR）<60ml/（min*1.73 m）。血清羟可替宁采用同位素稀释高效液相色谱/大气压化学电离串联质谱法（ID HPLC-APCI MS/MS）检测，检测下限为 0.015ng/ml。采用限制性立方样条（RCS）探索非线性关系。采用 Pearson 相关系数和多变量 logistic 回归模型进行相关性分析。
在非 CKD 组（r= -0.05，<0.001）和 CKD 组（r= -0.04，<0.001）中，血清羟可替宁与 eGFR 呈负相关。将血清羟可替宁分为 LLOD 后，血清羟可替宁≥0.015ng/ml 与非 CKD 组（r=-0.05，<0.001）和 CKD 组（r=-0.09，<0.001）的 eGFR 均呈负相关。在调整了综合混杂因素后，多变量 logistic 回归分析结果显示，血清羟可替宁≥0.015ng/ml 的参与者发生 CKD 的几率增加（OR=1.505，<0.001）。
血清羟可替宁与 CKD 呈正相关。需要进一步研究以确定合适的羟可替宁浓度来测量 CKD。
