Wang Xiaona, Su Shanshan
Department of Nephrology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
Front Endocrinol (Lausanne). 2024 Sep 17;15:1424068. doi: 10.3389/fendo.2024.1424068. eCollection 2024.
The effects of nicotine metabolism on the kidneys of healthy individuals have not been determined. The nicotine metabolite ratio (NMR) indicates the rate of nicotine metabolism and is linked to smoking behaviors and responses to tobacco treatments. We conducted this study in order to investigated the relationship between nicotine metabolite ratio (NMR) and kidney function.
An analysis of cross-sectional data of adults was conducted using a population survey dataset (National Health and Nutrition Examination Survey Data 2013/2018 of the United States). A weighted multivariate regression analysis was conducted to estimate the correlation between NMR and kidney function. Furthermore, we apply fitting smooth curves to make the relationship between NMR and estimated glomerular filtration rate (eGFR) more visualized.
The research included a total of 16153 participants. Weighted multivariate regression analyses adjusted for possible variables showed a negative relationship between NMR and estimated glomerular filtration rate (eGFR).The β (95%CI) of the regression equation between NMR and eGFR was -2.24 (-2.92, -1.55), the trend testing showed consistent results. NMR is positively correlated with urinary albumin creatinine ratio (uACR), but it is not statistically significant. A stratified analysis found a negative correlation between NMR and eGFR in all age, gender and diabetes subgroups, the results were not statistically significant among Mexican Americans and other races. Notably, each unit rise in NMR corresponded to a 4.54 ml/min·1.73m² lower eGFR in diabetic participants and a 6.04 ml/min·1.73m² lower eGFR in those aged 60 and above.
Our study shows that nicotine metabolite ratio is negatively associated with kidney function among most adults. It will be necessary to conduct more well-designed prospective clinical trials in order to determine the exact causal interactions between NMR and kidney function. Specific mechanisms also need to be further explored in basic experiments.
尼古丁代谢对健康个体肾脏的影响尚未明确。尼古丁代谢物比率（NMR）可指示尼古丁代谢速率，并与吸烟行为及对烟草治疗的反应相关。我们开展本研究以调查尼古丁代谢物比率（NMR）与肾功能之间的关系。
使用一项人口调查数据集（美国2013/2018年国家健康与营养检查调查数据）对成年人的横断面数据进行分析。进行加权多变量回归分析以估计NMR与肾功能之间的相关性。此外，我们应用拟合平滑曲线以使NMR与估计肾小球滤过率（eGFR）之间的关系更直观。
该研究共纳入16153名参与者。对可能变量进行校正后的加权多变量回归分析显示，NMR与估计肾小球滤过率（eGFR）之间呈负相关。NMR与eGFR之间回归方程的β（95%CI）为-2.24（-2.92，-1.55），趋势检验显示结果一致。NMR与尿白蛋白肌酐比值（uACR）呈正相关，但无统计学意义。分层分析发现，在所有年龄、性别和糖尿病亚组中，NMR与eGFR之间均呈负相关，在墨西哥裔美国人和其他种族中结果无统计学意义。值得注意的是，在糖尿病参与者中，NMR每升高一个单位，eGFR降低4.54 ml/min·1.73m²；在60岁及以上人群中，eGFR降低6.04 ml/min·1.73m²。
我们的研究表明，在大多数成年人中，尼古丁代谢物比率与肾功能呈负相关。有必要开展更多设计良好的前瞻性临床试验，以确定NMR与肾功能之间的确切因果关系。具体机制也需要在基础实验中进一步探索。
