Difference in nicotine metabolism as a potential factor causing disparities in tobacco consumption estimates by wastewater-based epidemiology

Min-Tz Weng , Kathryn J Steadman , Kelly Zhong , Maryam Al-Gharibeh , Qiuda Zheng , Phong K Thai
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Abstract

Wastewater-based epidemiology (WBE) can be used for estimating tobacco consumption at a population level. It involves analysing wastewater for the nicotine biomarkers cotinine (COT) and 3-hydroxycotinine (3HC). However, large discrepancies between WBE estimates for tobacco consumption compared to surveys and sales data have been reported. We hypothesise it could be partly related to genetic differences in CYP2A6 enzyme activity affecting COT and 3HC excretion. To review the use of COT and 3HC excretion factors within WBE calculations of tobacco consumption, a literature search for relevant articles was conducted using PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, and Medline. A total of 34 papers were identified across the Americas, Oceania, Asian and European regions. In contrast to the other regions, 100 % of WBE cases involving East and Southeast Asian populations exhibited an underestimation of tobacco use when compared to surveys or sales data. The excretion factors used across all 34 papers had been derived from urine samples from predominantly White populations. People of Asian descent tend to have lower urinary concentrations of COT and 3HC than White populations due to slower CYP2A6 enzyme activity diverting nicotine metabolism towards non-CYP2A6 pathways. We show that using excretion factors that better represent Asian populations in WBE calculations can result in more accurate estimates of tobacco use. Measurement and use of excretion factors tailored to specific ethnic backgrounds can be expected to enhance the precision of WBE analysis.
基于废水流行病学的烟草消费估算差异的潜在因素是尼古丁代谢差异
基于废水的流行病学(WBE)可用于估计人口水平上的烟草消费。它包括分析废水中尼古丁生物标志物可替宁(COT)和3-羟基可替宁(3HC)。然而,与调查和销售数据相比,世界卫生组织对烟草消费的估计存在很大差异。我们假设这可能部分与影响COT和3HC排泄的CYP2A6酶活性的遗传差异有关。为了回顾烟草消费WBE计算中COT和3HC排泄因子的使用情况,我们使用PubMed、EMBASE、CINAHL、PsycINFO、Web of Science和Medline进行相关文献检索。在美洲、大洋洲、亚洲和欧洲地区共鉴定出34篇论文。与其他区域相比,与调查或销售数据相比,涉及东亚和东南亚人口的WBE病例100%表现出对烟草使用的低估。所有34篇论文中使用的排泄因子均来自以白人为主的人群的尿液样本。由于CYP2A6酶活性较慢,将尼古丁代谢转向非CYP2A6途径,亚洲人的尿COT和3HC浓度往往低于白人。我们表明,在WBE计算中使用更好地代表亚洲人群的排泄因子可以更准确地估计烟草使用情况。测量和使用针对特定种族背景的排泄因子有望提高WBE分析的精度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Health sciences review (Oxford, England)
Health sciences review (Oxford, England) Medicine and Dentistry (General)
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