Toenail nicotine levels as predictors of coronary heart disease among women
Toenail nicotine levels as predictors of coronary heart disease among women
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DOI：
10.1093/aje/kwn061
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发表时间：
2008-06-01
影响因子：
5
通讯作者：
Willett, Walter C.
中科院分区：
文献类型：
--
作者：
Al-Delaimy, Wael K.;Stampfer, Meir J.;Willett, Walter C.
作者评估了趾甲尼古丁水平作为一种生物标志物预测冠心病（CHD）发生的能力。在护士健康研究队列中，对1982年提供趾甲剪样的62641名年龄在36 - 61岁的女性进行了一项巢式病例对照研究。在1984年至1998年期间，诊断出905例冠心病新发病例，并根据年龄和趾甲采集日期与两名对照进行匹配。通过多变量逻辑回归分析，作者发现趾甲尼古丁水平升高与冠心病风险之间存在具有统计学意义的剂量 - 反应关联（趋势p < 0.0001）；处于最高五分位数的女性与处于最低五分位数的女性相比，相对风险为3.44（95%置信区间（CI）：2.56，4.62）。随着连续趾甲尼古丁水平的对数转换单位每增加一个，冠心病的风险增加42%（相对风险 = 1.42，95% CI：1.33，1.52）。当把吸烟数量和被动吸烟作为协变量纳入时，这种关联仍然显著（相对风险 = 1.12，95% CI：1.01，1.24）。总之，趾甲尼古丁水平可预测女性的冠心病，且独立于其他风险因素，即使在对吸烟史进行调整后，这种关联仍然显著。
The authors assess the ability of toenail nicotine levels as a biomarker to predict incident coronary heart disease (CHD). A nested case-control study was carried out among 62,641 women aged 36-61 years in the Nurses' Health Study cohort who provided toenail clippings in 1982. Between 1984 and 1998, 905 incident CHD cases were diagnosed and matched with two controls by age and date of toenail collection. Using multivariate logistic regression analyses, the authors found a statistically significant dose-response association between increasing toenail nicotine levels and risk of CHD (p(trend) < 0.0001); women in the highest quintile had a relative risk of 3.44 (95% confidence interval (CI): 2.56, 4.62) compared with women in the lowest quintile. With each increase in the log-transformed unit of continuous toenail nicotine levels, there was a 42% increase in the risk of CHD (relative risk = 1.42, 95% CI: 1.33, 1.52). The association remained significant when the number of cigarettes smoked and passive smoking were included as covariates (relative risk = 1.12, 95% CI: 1.01, 1.24). In conclusion, toenail nicotine levels are predictive of CHD among women independent of other risk factors and remained significant even after adjustment for history of cigarette smoking.