Phillipou G, James S K, Seaborn C J, Phillips P J
Endocrine Service, Queen Elizabeth Hospital, Woodville, South Australia.
Clin Chem. 1994 Jul;40(7 Pt 1):1296-8.
The performance of a colorimetric assay for nicotine metabolites to validate self-reported smoking classification (nonsmoker, ex-smoker, and smoker) was assessed in a group of diabetic patients (n = 201). Comparison of the results with those of cotinine immunoassay (ELISA), by comparing respective areas under receiver operating characteristic curves, established the superiority of the cotinine immunoassay method. Adjusting the urinary concentrations of nicotine metabolites for creatinine excretion significantly lowered test performance. The sensitivity and specificity for the assay of nicotine metabolites to discriminate smoking classification within the diabetic patients at a threshold of > or = 28 mumol/L "cotinine carboxylic acid equivalents" were 68.4% and 98.6%, respectively; the corresponding sensitivity and specificity for urinary cotinine at a cutoff of > or = 0.5 mumol/L were 94.7% and 100%. The low sensitivity of the colorimetric urinary nicotine metabolites assay precludes its application as an objective assessment of smoking status in our patient population.
在一组糖尿病患者（n = 201）中评估了一种用于尼古丁代谢物的比色测定法，以验证自我报告的吸烟分类（非吸烟者、既往吸烟者和吸烟者）。通过比较各自的受试者工作特征曲线下面积，将结果与可替宁免疫测定法（ELISA）的结果进行比较，确定了可替宁免疫测定法的优越性。根据肌酐排泄量调整尼古丁代谢物的尿液浓度会显著降低检测性能。在糖尿病患者中，以≥28 μmol/L“可替宁羧酸当量”为阈值时，用于区分吸烟分类的尼古丁代谢物测定法的灵敏度和特异性分别为68.4%和98.6%；以≥0.5 μmol/L为临界值时，尿可替宁的相应灵敏度和特异性分别为94.7%和100%。比色法测定尿尼古丁代谢物的低灵敏度使其无法作为我们患者群体吸烟状况的客观评估方法。
