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J Clin Lipidol. 2017 May - Jun;11(3):638-645.e2. doi: 10.1016/j.jacl.2017.03.011. Epub 2017 Mar 29.

Relationship of cotinine-verified and self-reported smoking status with metabolic syndrome in 116,094 Korean adults.

Author information

1
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: bjjake.kim@samsung.com.
2
Division of Cardiology, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
3
Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Seoul, Republic of Korea.
4
Divison of Endocrinology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Abstract

BACKGROUND:

No study has reported the relationship between cotinine-verified and self-reported smoking status with metabolic syndrome (MetS).

OBJECTIVE:

This study was performed to evaluate the relationship between urinary cotinine-verified and self-reported smoking status with MetS and determine the effects of unobserved smokers on MetS in Korean adults.

METHODS:

A total of 116,094 individuals (66,875 men and 49,219 women) with mean age of 36.7 ± 6.8 years included in Kangbuk Samsung Health Study and Kangbuk Samsung Cohort Study between 2011 and 2013 who had urinary cotinine measurements were enrolled. Cotinine-verified current smoking was defined as urinary cotinine level of above 50 ng/mL. Unobserved smoking was defined as urinary cotinine level of above 50 ng/mL in self-reported never smokers.

RESULTS:

The overall prevalence rates of cotinine-verified current smokers and MetS were 22.9% and 10.5%, respectively. The misclassification rate to cotinine-verified current smokers among self-reported never smokers was 1.7%. A multivariate logistic regression model adjusted for variables with univariate relationship (model 1) showed that cotinine-verified current smokers significantly increased the odds ratio for MetS compared with cotinine-verified never smokers (odds ratio [95% confidence interval], 1.30 [1.23, 1.37]). Log-transformed cotinine levels were also associated with MetS (1.04 [1.03, 1.05]). However, the association was not significant in the previously mentioned model including the traditional 5 components of MetS (model 2). Unobserved smokers significantly increased the ORs for MetS in both model 1 (1.43 [1.23, 1.67]) and model 2 (1.57 [1.06, 2.33]).

CONCLUSION:

This study shows that unobserved smoking and cotinine-verified current smoking are associated with MetS but urinary cotinine could be 1 conditional factor that interacts with traditional MetS components.

KEYWORDS:

Cigarette smoke; Cotinine; Dyslipidemia; Hypertension; Metabolic syndrome; Secondhand smoke; Smoking

PMID:
28431854
DOI:
10.1016/j.jacl.2017.03.011
[Indexed for MEDLINE]

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