Association of the Extent of Exposure to Environmental Tobacco Smoke With Exhaled Nitric Oxide and Eosinophils: A Cross-Sectional Study Based on the NHANES 2007–2012 Database

IF 2.2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of Clinical Practice Pub Date : 2025-02-14 DOI:10.1155/ijcp/3384282

Xingfang Hou, Shufen Hou, Chenggong Hou, Xuelian Chen, Yuling Tang

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引用次数: 0

Abstract

Background: Previous studies have demonstrated that exposure to environmental tobacco smoke is associated with a reduction in fractional exhaled nitric oxide (FeNO) levels, elevation in eosinophil (EOS) counts and alterations in airway inflammation patterns, influencing the efficacy of glucocorticoid therapy for TH2 inflammation. No previous study has investigated the association of the extent of exposure to environmental tobacco smoke with FeNO levels. This study aimed to investigate the association of the extent of exposure to environmental tobacco smoke with FeNO level and EOS count.

Methods: In this retrospective cohort study, we included 12,766 individuals from the National Health and Nutrition Examination Survey 2007–2012. The extent of exposure to environmental tobacco smoke was assessed by measuring serum cotinine levels. Participants were categorised into quintiles based on their cotinine levels. Logistic regression models were developed to evaluate the association of serum cotinine levels with FeNO levels and EOS count.

Findings: In the unadjusted and adjusted models, the highest quintile of serum cotinine levels (> 105 ng/mL) was significantly negatively associated with FeNO levels. However, low-to-moderate quintiles of serum cotinine levels were not significantly associated with FeNO levels. Based on sensitivity analyses, the negative associations between the highest quintile of serum cotinine levels and FeNO levels remained consistent among participants with asthma, chronic bronchitis and respiratory symptoms within 7 days. Increased serum cotinine levels were significantly associated with increased EOS counts, which in turn were significantly associated with increased FeNO levels. EOS significantly mediated 7.59% of cotinine-associated reductions in FeNO levels.

Conclusions: Our findings indicated that high levels of tobacco smoke exposure are associated with a decrease in FeNO levels and an increase in EOS count. The smoking status should be considered when evaluating type 2 airway inflammation based on FeNO levels and EOS count.

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环境烟草烟雾暴露程度与呼出一氧化氮和嗜酸性粒细胞的关系：基于NHANES 2007-2012数据库的横断面研究

背景：先前的研究表明，暴露于环境烟草烟雾与呼出一氧化氮（FeNO）分数水平降低、嗜酸性粒细胞（EOS）计数升高和气道炎症模式改变有关，影响糖皮质激素治疗TH2炎症的疗效。以前没有研究调查过接触环境烟草烟雾的程度与FeNO水平之间的关系。本研究旨在探讨环境烟草烟雾暴露程度与FeNO水平和EOS计数的关系。方法：在这项回顾性队列研究中，我们纳入了2007-2012年国家健康与营养检查调查的12,766名个体。通过测定血清可替宁水平来评估接触环境烟草烟雾的程度。参与者根据他们的可替宁水平被分成五分之一。建立了Logistic回归模型来评估血清可替宁水平与FeNO水平和EOS计数的关系。结果：在未调整和调整的模型中，血清可替宁水平的最高五分位数(>；105 ng/mL)与FeNO水平呈显著负相关。然而，低至中等五分位数的血清可替宁水平与FeNO水平无显著相关性。根据敏感性分析，在7天内出现哮喘、慢性支气管炎和呼吸道症状的参与者中，血清可替宁水平最高五分位数与FeNO水平之间的负相关保持一致。血清可替宁水平升高与EOS计数升高显著相关，而EOS计数又与FeNO水平升高显著相关。EOS显著介导了7.59%的可替宁相关的FeNO水平降低。结论：我们的研究结果表明，高水平的烟草烟雾暴露与FeNO水平的降低和EOS计数的增加有关。基于FeNO水平和EOS计数评估2型气道炎症时应考虑吸烟状况。

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来源期刊

International Journal of Clinical Practice 医学-医学：内科

CiteScore

5.30

自引率

0.00%

发文量

274

审稿时长

3-8 weeks

期刊介绍： IJCP is a general medical journal. IJCP gives special priority to work that has international appeal. IJCP publishes: Editorials. IJCP Editorials are commissioned. [Peer reviewed at the editor''s discretion] Perspectives. Most IJCP Perspectives are commissioned. Example. [Peer reviewed at the editor''s discretion] Study design and interpretation. Example. [Always peer reviewed] Original data from clinical investigations. In particular: Primary research papers from RCTs, observational studies, epidemiological studies; pre-specified sub-analyses; pooled analyses. [Always peer reviewed] Meta-analyses. [Always peer reviewed] Systematic reviews. From October 2009, special priority will be given to systematic reviews. [Always peer reviewed] Non-systematic/narrative reviews. From October 2009, reviews that are not systematic will be considered only if they include a discrete Methods section that must explicitly describe the authors'' approach. Special priority will, however, be given to systematic reviews. [Always peer reviewed] ''How to…'' papers. Example. [Always peer reviewed] Consensus statements. [Always peer reviewed] Short reports. [Always peer reviewed] Letters. [Peer reviewed at the editor''s discretion] International scope IJCP publishes work from investigators globally. Around 30% of IJCP articles list an author from the UK. Around 30% of IJCP articles list an author from the USA or Canada. Around 45% of IJCP articles list an author from a European country that is not the UK. Around 15% of articles published in IJCP list an author from a country in the Asia-Pacific region.