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청소년의 흡연자 선별을 위한 소변 중 코티닌 절사점 결정: 제3기 국민환경보건 기초조사(2015~2017)

Determination of Urinary Cotinine Cut-Off Point for Discriminating Smokers and Non-Smokers among Adolescents: The Third Cycle of the Korean National Environmental Health Survey (2015~2017)

박상신|정선경
한국환경보건학회 (Korean Society of Environmental Health)|2021.08|한국환경보건학회지 (JOURNAL OF ENVIRONMENTAL HEALTH SCIENCES)|제47권 제4호|pp. 320-329|DOI 10.5668/JEHS.2021.47.4.320

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키워드

Adolescentscut-off pointROC curvecotininesmoking exposure

초록

Background: Smoking exposure may be objectively assessed through specific biomarkers. The most common biomarker for smoking is cotinine concentration in urine, and setting an optimal cut-off point can accurately classify smoking status. Such a cut-off point for Korean adolescents has never been studied. Objectives: The aim of this study was to determine a cut-off point for urinary cotinine concentration for the discrimination of smoking in adolescents. Methods: Participants were adolescents aged 13~18 years who participated in the third cycle of the Korean National Environmental Health Survey. We used urine samples to confirm the level of cotinine concentrations. Smoking status was determined by self-reported questionnaire. We identified the optimal cotinine cut-off point for discriminating smoking status using receiver operating characteristic curve analysis. Results: Of the 904 participants, 28 (3.1%) were smokers, among whom 20 (71.4%) were male. The median urinary cotinine concentrations in smokers was 218 μg/L (male: 215 μg/L, female: 303 μg/L), and that in non-smokers was 1.31 μg/L (male: 1.46 μg/L, female: 1.18 μg/L). We found significant differences in urinary cotinine concentration according to smoking status and sex (p<0.001). Urinary cotinine concentrations performed well for identifying smoking adolescents [area under the curve: 0.954 (male: 0.963, female: 0.908)]. The cut-off that optimally distinguished smokers from non-smokers was 39.85 μg/L (sensitivity: 89.3%, specificity: 97.4%). Male [39.85 μg/L (sensitivity: 90.0%, specificity: 94.9%)] had a different optimal cut-off point than female [26.26 μg/L (sensitivity: 87.5%, specificity: 99.6%)]. Conclusions: This study determined a cut-off point for urinary cotinine of 39.85 μg/L (male: 39.85 μg/L, female: 26.26 μg/L) to distinguish smokers from non-smokers in adolescents.

Abstract

Background: Smoking exposure may be objectively assessed through specific biomarkers. The most common biomarker for smoking is cotinine concentration in urine, and setting an optimal cut-off point can accurately classify smoking status. Such a cut-off point for Korean adolescents has never been studied. Objectives: The aim of this study was to determine a cut-off point for urinary cotinine concentration for the discrimination of smoking in adolescents. Methods: Participants were adolescents aged 13~18 years who participated in the third cycle of the Korean National Environmental Health Survey. We used urine samples to confirm the level of cotinine concentrations. Smoking status was determined by self-reported questionnaire. We identified the optimal cotinine cut-off point for discriminating smoking status using receiver operating characteristic curve analysis. Results: Of the 904 participants, 28 (3.1%) were smokers, among whom 20 (71.4%) were male. The median urinary cotinine concentrations in smokers was 218 μg/L (male: 215 μg/L, female: 303 μg/L), and that in non-smokers was 1.31 μg/L (male: 1.46 μg/L, female: 1.18 μg/L). We found significant differences in urinary cotinine concentration according to smoking status and sex (p<0.001). Urinary cotinine concentrations performed well for identifying smoking adolescents [area under the curve: 0.954 (male: 0.963, female: 0.908)]. The cut-off that optimally distinguished smokers from non-smokers was 39.85 μg/L (sensitivity: 89.3%, specificity: 97.4%). Male [39.85 μg/L (sensitivity: 90.0%, specificity: 94.9%)] had a different optimal cut-off point than female [26.26 μg/L (sensitivity: 87.5%, specificity: 99.6%)]. Conclusions: This study determined a cut-off point for urinary cotinine of 39.85 μg/L (male: 39.85 μg/L, female: 26.26 μg/L) to distinguish smokers from non-smokers in adolescents.

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관련 논문AI추천

소변 중 코티닌 농도에 따른 청소년의 자가보고 흡연 상태의 정확도 및 관련요인 분석: 제3기(2015~2017) 국민환경보건 기초조사박상신, 정선경한국환경보건학회 · 한국환경보건학회지2022 · 제48권 제4호간접흡연에 노출된 청소년의 요 코티닌 배설량김규남, 김봉성, 김자형, 김현근, 김효빈, 성문우, 유선미, 유장석, 이도훈, 이선영, 이소연, 이혜령, 홍수종대한가정의학회 · Korean Journal of Family Medicine2009 · 제30권 제1호타액 중 코티닌 검출을 이용한 청소년 흡연 자가 보고의 타당도목예진, 바이사, 설재웅, 오희철, 지선하, 최문영한국보건정보통계학회 · 보건정보통계학회지2010 · 제35권 제1호청소년에서 흡연자 선별을 위한 요중 코티닌 검사의 유용성강윤희, 공선영, 윤영호, 이도훈, 이영준대한진단검사의학회 · Annals of Laboratory Medicine2004 · 제24권 제3호우리나라 성인 중 비흡연자에 대한 코티닌 노출수준 및 영향요인 분석 - 국민환경보건 기초조사(2009-2017) 결과 -권영민, 유승도, 유지영, 이철우, 전혜리, 정선경, 주영경, 홍수연한국환경보건학회 · 한국환경보건학회지2020 · 제46권 제2호Validity of Self-reported Smoking Using Urinary Cotinine among Vocational High School Students김종연, 박순우대한예방의학회 · 예방의학회지2009 · 제42권 제4호

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