Association between Serum Cotinine Levels and Bone Mineral Density: An Analysis of the National Health and Nutrition Examination Survey (NHANES)

Fang, Jianguo; Wang, Duojun; Yang, Hao-Yu; Zhang, Hui; Tong, J; Lin, Zaijun

doi:10.1155/2022/6830705

Cited by 3 publications

(1 citation statement)

References 29 publications

(33 reference statements)

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“…Serum cotinine and the frequency of bone diseases were positively and nonlinearly correlated. Fang, et al also reported that high serum cotinine levels significantly reduced lumbar BMD participants aged 30 years or older [30].…”

Section: Spine) (Fig 1)mentioning

confidence: 92%

Association between cadmium and lead in active and passive cigarette smokers with bone mass: a retrospective study

Hussein¹,

El‐Metwally²,

Abo-Elfotoh³

et al. 2023

BCHD

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Objective: Cigarette smoking harms all body systems, and its effects are primarily related to nicotine. However, the heavy metal content (mainly lead and cadmium) could add to nicotine's hazardous effects. Thus, the current study aimed to investigate the effect of cigarette smoking content of cadmium and lead on bone mineral density. Subjects and Methods: A retrospective analysis of data from active, passive, and non-smokers (every 70 subjects) was analyzed for patient demographics, laboratory investigation, serum cotinine (as a confirmatory marker of smoking, bone mineral density (BMD), blood and urinary levels of cadmium and lead). Results: Hemoglobin concentrations and red blood cell count were significantly reduced, while erythrocyte sedimentation rate and liver enzymes were significantly increased in active and passive smokers than non-smokers. Serum cadmium, lead, and cotinine were raised considerably in passive and active than non-smokers (0.47±0.05, 21.94±3.99, 5.35±0.90 in active, 0.32±0.09, 18.91±3.30, and 4.35±0.89 in passive, versus 0.09±0.06, 9.84±2.63, and 1.28±0.21 in the control group, successively). Bone mineral density was reduced in active and passive than non-smokers at the radial shaft, femoral neck, and spine. Cotinine was significantly and proportionately correlated with serum cadmium and lead and inversely correlated with bone mineral density. Furthermore, cadmium and lead were inversely correlated with BMD. Conclusion: Cigarettesmoke was associated with higher concentrations of cadmium, and lead may directly and indirectly share in the harmful effects of smoking on BMD. Keywords: Bone Mineral Density, Cotinine, Toxic Heavy Metals, Smoking

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Section: Spine) (Fig 1)mentioning

confidence: 92%

Association between cadmium and lead in active and passive cigarette smokers with bone mass: a retrospective study

Hussein¹,

El‐Metwally²,

Abo-Elfotoh³

et al. 2023

BCHD

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Comprehensive evaluation of serum cotinine on human health: Novel evidence for the systemic toxicity of tobacco smoke in the US general population

Lei

Zhu

et al. 2023

Science of The Total Environment

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Associations between smoke exposure and osteoporosis or osteopenia in a US NHANES population of elderly individuals

et al. 2023

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BackgroundTobacco exposure is considered to be a risk factor for reduced bone mineral density (BMD), which may result in osteopenia. Cotinine, a metabolite of nicotine, is commonly utilized as a marker of tobacco exposure. Nevertheless, there are limited clinical data on the associations between osteoporosis (OP) or osteopenia and smoking status or serum cotinine level.MethodsWe thoroughly examined the NHANES cross-sectional data from 2005 to 2010, 2013 to 2014, and 2017 to 2018. Multivariate logistic regression models were applied to assess the associations among smoking status and serum cotinine levels as well as OP and osteopenia. The relationships between serum cotinine level and OP and osteopenia were also assessed using the restricted cubic spline (RCS) method.ResultsA total of 10,564 participants were included in this cross-sectional study. The mean age of the study population was 64.85 ± 9.54 years, and the patients were predominantly male (51.9%). We found that the relationships between higher serum cotinine levels (≥3 ng/ml) and the prevalence of osteoporosis (Model 1: OR=2.27 [1.91-2.69]; Model 2: OR=2.03 [1.70-2.43]; Model 3: OR=2.04 [1.70-2.45]; all p for trend <0.001) remained significant after adjustment for covariates by applying the lowest serum cotinine levels (<0.05 ng/ml) as the reference. Similar results were observed for current smokers, who were more likely to develop OP compared with nonsmokers (Model 1: OR=2.30 [1.90-2.79]; Model 2: OR=2.16 [1.77-2.64]; Model 3: OR=2.16 [1.77-2.65]). Moreover, higher serum cotinine levels were found to be strongly and positively correlated with the prevalence of osteopenia (OR=1.60 [1.42-1.80]). A similar relationship was observed between current smokers and the prevalence of osteopenia compared with nonsmokers (OR=1.70 [1.49-1.94]). RCS regression also showed that serum cotinine levels were nonlinearly and positively correlated with OP and osteopenia, with inflection points of 5.82 ng/ml and 3.26 ng/ml, respectively.ConclusionThis study showed that being a smoker was associated with the prevalence of OP or osteopenia compared with being a nonsmoker and that there was a strong nonlinear positive dose−response relationship between serum cotinine levels and OP and osteopenia.

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Association between Serum Cotinine Levels and Bone Mineral Density: An Analysis of the National Health and Nutrition Examination Survey (NHANES)

Cited by 3 publications

References 29 publications

Association between cadmium and lead in active and passive cigarette smokers with bone mass: a retrospective study

Association between cadmium and lead in active and passive cigarette smokers with bone mass: a retrospective study

Comprehensive evaluation of serum cotinine on human health: Novel evidence for the systemic toxicity of tobacco smoke in the US general population

Associations between smoke exposure and osteoporosis or osteopenia in a US NHANES population of elderly individuals

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