Accuracy of cotinine serum test to detect the smoking habit and its association with periodontal disease in a multicenter study

Abstract

BackgroundThe validity of the surveys on self-reported smoking status is often questioned because smokers underestimate cigarette use and deny the habit. It has been suggested that self-report should be accompanied by cotinine test. This report evaluates the usefulness of serum cotinine test to assess the association between smoking and periodontal status in a study with a large sample population to be used in studies with other serum markers in epidemiologic and periodontal medicine researches.Material and Methods578 patients who were part of a multicenter study on blood biomarkers were evaluated about smoking and its relation to periodontal disease. Severity of periodontal disease was determinate using clinical attachment loss (CAL). Smoking was assessed by a questionnaire and a blood sample drawn for serum cotinine determination.ResultsThe optimal cut-off point for serum cotinine was 10 ng/ml. Serum cotinine showed greater association with severity of CAL than self-report for mild-moderate CAL [OR 2.03 (CI95% 1.16-3.53) vs. OR 1.08 (CI95% 0.62-1.87) ] advanced periodontitis [OR 2.36 (CI95% 1.30- 4.31) vs. OR 2.06 (CI95% 0.97-4.38) ] and extension of CAL > 3 mm [ OR 1.78 (CI95% 1.16-1.71) vs. 1.37 (CI95% 0.89-2.11)]. When the two tests were evaluated together were not shown to be better than serum cotinine test.ConclusionsSelf-reported smoking and serum cotinine test ≥ 10ng/ml are accurate, complementary and more reliable methods to assess the patient’s smoking status and could be used in studies evaluating serum samples in large population and multicenter studies. Clinical Relevance: The serum cotinine level is more reliable to make associations with the patient’s periodontal status than self-report questionnaire and could be used in multicenter and periodontal medicine studies. Key words:Biological markers, serum, cotinine, periodontitis, smoking.

Effect of tobacco on periodontal disease and oral cancer

“…Nicotine possesses a very short half-life in the blood, approximately 2 h, while cotinine, a major metabolite of nicotine with a longer half-life (17 h vs 30 min), may be a more useful biochemical marker of smoking status 107 . Cotinine has been widely used as a stable biomarker of tobacco exposure and has been used to correlate its levels with periodontal disease severity 108,109 .…”

Periodontal Disease Status among Adults from South Africa—Prevalence and Effect of Smoking

“…Though cotinine can be measured in samples of saliva, urine and serum, the latter presents the longest half-life [8]. Cotinine serum levels between 10 and 20 ng/mL are compatible with smoking and have been associated with an increased severity of periodontitis in a variety of studies [9,10,11,12]. The cut-off value of 15 ng/mL was used in the current study to differentiate between smokers and non-smokers based on previous studies on serum cotinine and periodontal disease [8,9].…”

Interaction between beta‐3 adrenergic receptor genotype and environmental factors on periodontal progression

“…According to these results, we may infer that ADRB3 genotype among smokers is a more important factor involved in periodontal disease progression. Previous reports indicated a significant association between smoking and periodontal disease progression (Duque et al, ; Johnson, ; Radvar, Shafaee, Mohtasham, Shiezadeh, & Zamanpour, ). Nicotine is a major harmful substance found in tobacco, and nicotine derivatives are vasoconstrictive on peripheral, coronary, placental and gingival blood vessels.…”