Pérez-Stable E J, Benowitz N L, Marín G
Department of Medicine, San Francisco General Hospital Medical Center, 94143-0320, USA.
Prev Med. 1995 Mar;24(2):171-9. doi: 10.1006/pmed.1995.1031.
To address the question of whether serum cotinine is a better measure of cigarette smoking than self-reported behavior by examining the relation of biochemical, physical examination, and depression assessments to self-reported cigarette consumption and serum cotinine in a population-based sample.
Serum from 743 Mexican American participants in the Hispanic Health and Nutrition Examination Survey (HHANES) categorized by sex and number of cigarettes smoked per day (0, 1 to 9, 10 to 19, > or = 20) was analyzed for cotinine. HHANES results from hematocrit, hemoglobin, red blood cells (RBCs), white blood cells (WBCs), mean corpuscular volume (MCV), iron, transferrin, lead, erythrocyte protoporphyrin (EPP), vitamin E, vitamin A, cholesterol, body mass index (BMI), pulse rate, systolic and diastolic blood pressure (DBP), Center for Epidemiological Depression Scale (CES-D), and Diagnostic Interview Schedule (DIS) depression diagnosis were compared by category of cigarettes smoked per day and serum cotinine.
Among women significant correlations were found between cigarettes per day and cotinine, respectively, and hematocrit (r = 0.148, r = 0.338), hemoglobin (r = 0.152, r = 0.342), WBCs (r = 0.160, r = 0.272), and BMI (r = -0.124, r = -0.164). Among men significant correlations were found between cigarettes per day and cotinine, respectively, and WBCs (r = 0.176, r = 0.296), MCV (r = 0.310, r = 0.264), lead (r = 0.105, r = 0.177), and BMI (r = -0.110, r = -0.192). Cotinine, but not cigarettes per day, was significantly correlated with hemoglobin (r = 0.179) and DBP (r = -0.146) in men and EPP (r = -0.135) and cholesterol (r = 0.105) in women. Mean CES-D score was correlated with cigarettes per day for both men (r = 0.106) and women (r = 0.158) but not with cotinine. CES-D caseness (score > or = 16) and a positive diagnosis of depression by DIS was not related to smoking behavior measures among men. Women smokers compared to nonsmokers had higher levels of depression. Multivariate regression models controlling for sex, age, and education indicated that serum cotinine was a significant predictor of hematocrit, hemoglobin, RBCs, WBCs, lead, and DBP; self-reported cigarettes was significant only for MCV.
Serum cotinine may be a better method of quantifying risks from cigarette use in epidemiological studies.
通过在一个基于人群的样本中研究生化、体格检查和抑郁评估与自我报告的香烟消费量及血清可替宁之间的关系，探讨血清可替宁在衡量吸烟情况方面是否比自我报告行为更有效。
对西班牙裔健康与营养检查调查（HHANES）中743名墨西哥裔美国参与者的血清进行分析，根据性别和每日吸烟量（0、1至9、10至19、≥20）对血清可替宁进行分类。比较HHANES中血细胞比容、血红蛋白、红细胞（RBC）、白细胞（WBC）、平均红细胞体积（MCV）、铁、转铁蛋白、铅、红细胞原卟啉（EPP）、维生素E、维生素A、胆固醇、体重指数（BMI）、脉搏率、收缩压和舒张压（DBP）、流行病学抑郁量表中心（CES-D）以及诊断访谈表（DIS）抑郁诊断结果，按每日吸烟量类别和血清可替宁进行比较。
在女性中，每日吸烟量分别与可替宁以及血细胞比容（r = 0.148，r = 0.338）、血红蛋白（r = 0.152，r = 0.342）、白细胞（r = 0.160，r = 0.272）和体重指数（r = -0.124，r = -0.164）之间存在显著相关性。在男性中，每日吸烟量分别与可替宁以及白细胞（r = 0.176，r = 0.296）、平均红细胞体积（r = 0.310，r = 0.264）、铅（r = 0.105，r = 0.177）和体重指数（r = -0.110，r = -0.192）之间存在显著相关性。在男性中，可替宁而非每日吸烟量与血红蛋白（r = 方程0.179）和舒张压（r = -0.146）显著相关，在女性中与红细胞原卟啉（r = -0.135）和胆固醇（r = 0.105）显著相关。平均CES-D评分在男性（r = 0.106）和女性（r = 0.158）中均与每日吸烟量相关，但与可替宁无关。CES-D病例（评分≥16）以及DIS对抑郁的阳性诊断与男性的吸烟行为指标无关。与不吸烟者相比，女性吸烟者的抑郁水平更高。控制性别、年龄和教育程度的多变量回归模型表明，血清可替宁是血细胞比容、血红蛋白、红细胞、白细胞、铅和舒张压的显著预测指标；自我报告的吸烟量仅对平均红细胞体积有显著意义。
在流行病学研究中，血清可替宁可能是一种更好的量化吸烟风险的方法。
