目标:最近,吸烟对肌肉代谢的有害影响备受关注,但是吸烟和肌肉质量之间的关系知之甚少。因此,这项研究调查了暴露于香烟烟雾之间的关联,根据血清可替宁定义,和美国人口的肌肉质量。
方法:我们利用2011年至2018年的国家健康和营养调查(NHANES)数据进行分析。血清可替宁的数据,肌肉质量(通过四肢骨骼肌质量指数量化,ASMI),和协变量进行了提取和分析。采用加权多元线性回归分析和平滑曲线拟合研究血清可替宁与ASMI的关系。亚组分析按性别分层,种族和吸烟状况。当检测到非线性时,阈值效应采用两分段线性回归模型进行分析.
结果:总计,8004名参与者被纳入分析。在完全调整模型中,可替宁的血清水平与ASMI呈负相关。此外,比较最高与最高的参与者血清可替宁的最低三分位数,我们发现ASMI降低了0.135Kg/m2。在按性别和种族分层的亚组分析中,血清可替宁和ASMI之间的关联在所有性别和种族中仍然显著.此外,该协会在当前和以前的吸烟者中仍然很重要,但不是那些从不吸烟的人。平滑曲线拟合显示血清可替宁与ASMI之间存在非线性关系,拐点为356ng/mL。
结论:我们的研究显示血清可替宁与肌肉质量呈负相关。这一发现提高了我们对吸烟对肌肉质量的有害影响的理解,并强调了戒烟对肌肉健康的重要性。
OBJECTIVE: Recently, the detrimental effect of cigarette smoking on muscle metabolism has attracted much attention, but the relationship between cigarette smoking and muscle mass is poorly understood. Thus, this study investigated the association between exposure to cigarette smoke, defined based on serum cotinine, and muscle mass in the US population.
METHODS: We utilized National Health and Nutrition Examination Survey (NHANES) data between 2011 and 2018 for analysis. Data on serum cotinine, muscle mass (quantified by appendicular skeletal muscle mass index, ASMI), and covariates were extracted and analyzed. Weighted multivariate linear regression analyses and smooth curve fittings were performed to investigate the association between serum cotinine and ASMI. Subgroup analyses were stratified by gender, race and smoking status. When nonlinearity was detected, the threshold effects were analyzed using a two-piecewise linear regression model.
RESULTS: In total, 8004 participants were included for analysis. The serum level of cotinine was negatively associated with ASMI in the fully adjusted model. Furthermore, comparing participants in the highest vs. the lowest tertile of serum cotinine, we found that ASMI decreased by 0.135 Kg/m2. In subgroup analysis stratified by gender and race, the association between serum cotinine and ASMI remained significant in all genders and races. In addition, the association remained significant among current and former smokers, but not among those who never smoked. Smooth curve fittings showed nonlinear relationships between serum cotinine and ASMI, with the inflection points identified at 356 ng/mL.
CONCLUSIONS: Our study revealed that serum cotinine was negatively related to muscle mass. This finding improves our understanding of the deleterious effects of cigarette smoking on muscle mass and highlights the importance of smoking cessation for muscle health.