Interaction between serum cotinine and body mass index on asthma in the children: a cross-sectional study

Abstract

Background The purpose of this study was to explore the interaction between serum cotinine (a marker of environmental tobacco smoke exposure) and body mass index (BMI) on asthma in children. Methods This cross-sectional study relied on representative samples of American children included in the National Health and Nutrition Examination Survey in 1999–2018. Multivariate logistic regression analyses were to evaluate the association between serum cotinine level, BMI z-score and asthma. Serum cotinine was dichotomized at 0.0436 ng/mL. Interactions were examined by the estimated joint effect of BMI and serum cotinine levels. We also performed interaction analyses in age and ethnicity subgroups. Results Among the 11,504 children aged 3 to 12 years included in the analysis, 15.86% (n = 1852) had childhood asthma, 15.68% (n = 1837) were overweight, and 17.31% (n = 2258) were obese. Compared to low serum cotinine, high serum cotinine was significantly associated with asthma [odds ratio (OR) = 1.190, 95% confidence interval (CI): 1.004–1.410]. Overweight (OR = 1.275, 95%CI: 1.079–1.506) and obesity (OR = 1.636, 95%CI: 1.354–1.977) were significantly associated with asthma compared with normal weight. The adjusted attributable proportion of interaction = 0.206 (95%CI: 0.075–0.337) and the adjusted synergy index = 1.617 (95%CI: 1.126–2.098) indicated that there was a significant synergistic effect of serum cotinine levels and BMI on asthma. In males, females, non-Hispanic White and other Hispanic, there were synergistic interactions between serum cotinine levels and BMI on asthma. Conclusion A synergistic interaction between serum cotinine and overweight/obesity on childhood asthma was found. For children with asthma, both intensive weight interventions in overweight or obese children and intensive passive smoking interventions in children exposed to the environment may be important.

Interaction between Serum Cotinine and Magnesium Intake with Childhood Asthma: A Cross-Sectional Study

“…Cotinine is an important indicator of ETS, and serum cotinine levels are thought to reflect passive exposure to cigarettes in children [7]. Several studies have illustrated that high-level serum cotinine is now considered to be an associated risk factor for childhood asthma [9,21], which is consistent with our results. The mitigation of ETS is advantageous for enhancing the health status of children.…”

“…In this analysis, tobacco exposure was assessed by serum cotinine concentration. For participants in the NHANES database, serum cotinine was measured by an isotope dilution-high performance liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometry [9]. Serum cotinine levels were stratified based on the lower quartile (cutoff = 0.2089 ng/mL), with ≤0.2089 ng/mL defined as low-level serum cotinine and >0.2089 ng/mL as high-level serum cotinine.…”

“…Cotinine, a marker of ETS, is the main metabolite of nicotine and is also considered a biomarker of smoking [7]. Extensive research has shown a relationship between cotinine level in serum and the risk of childhood asthma [8, 9]. A cross-sectional study reported that high-level serum cotinine was significantly related to childhood asthma compared to low-level serum cotinine [9].…”

“…Extensive research has shown a relationship between cotinine level in serum and the risk of childhood asthma [8, 9]. A cross-sectional study reported that high-level serum cotinine was significantly related to childhood asthma compared to low-level serum cotinine [9]. The intake of dietary antioxidants was also thought to be associated with an increased risk of allergic diseases such as asthma in recent years [10].…”

“…Previous research has primarily focused on the association between individual risk factors and outcomes, with limited exploration of potential interactions among these factors [9, 13]. A recent study found that the quality of diet may affect the relationship between indoor pollution and childhood asthma [14].…”