Associations between smoke exposure and kidney stones: results from the NHANES (2007-2018) and Mendelian randomization analysis

作者全名："Huang, Yong; Wang, Hexi; Xu, Chengwei; Zhou, Fulin; Su, Huiyi; Zhang, Yao"

作者地址："[Huang, Yong; Wang, Hexi; Xu, Chengwei; Zhou, Fulin; Zhang, Yao] Chongqing Med Univ, Affiliated Hosp 1, Dept Urol, Chongqing, Peoples R China; [Su, Huiyi] Chongqing Med Univ, Dept Resp Med, Childrens Hosp, Chongqing, Peoples R China"

通信作者："Zhang, Y (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Urol, Chongqing, Peoples R China."

来源：FRONTIERS IN MEDICINE

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001053828700001

JCR分区：Q1

影响因子：3.1

年份：2023

卷号：10

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：smoking status; serum cotinine; kidney stone; NHANES; Mendelian randomization

摘要："Purpose It is currently controversial whether smoke exposure is associated with the risk of kidney stones. Herein, publicly available databases were combined to explore relationships with the risk of nephrolithiasis in terms of smoking status and serum cotinine concentrations.Materials and methods First, we conducted an observational study using data from 2007 to 2018, based on the National Health and Nutrition Examination Survey (NHANES) database. Univariate analysis, multivariate logistic regression, trend testing, restricted cubic spline (RCS), and multiple imputation (MI) were the main analytical methods of our study. Then, A Mendelian randomization (MR) analysis was performed to explore the causal relationship between serum cotinine and nephrolithiasis. Genetic instruments for serum cotinine and pooled data for kidney stones were derived from publicly available large-scale genome-wide association studies (GWAS). Inverse-variance weighting (IVW) was the primary method for our MR analysis.Results A total of 34,657 and 31,352 participants were included in the observational study based on smoking status and serum cotinine concentrations, respectively. Under full adjustment of covariates, current smokers had an increased risk of kidney stones compared to non-smokers [OR = 1.17 (1.04-1.31), P = 0.009, P for trend = 0.010]. Compared with serum cotinine of <0.05 ng/ml, serum cotinine levels of 0.05-2.99 ng/ml [OR = 1.15 (1.03-1.29), P = 0.013] and & GE;3.00 ng/ml [OR = 1.22 (1.10-1.37), P < 0.001] were observed to have a higher risk of nephrolithiasis (P for trend < 0.001). In addition, a non-linear relationship between log2-transformed serum cotinine and the risk of nephrolithiasis was found (P for non-linearity = 0.028). Similar results were found when serum cotinine (log2 transformation) was used as a continuous variable [OR = 1.02 (1.01-1.03), P < 0.001] or complete data was used to analyze after MI. In the MR analysis, genetically predicted high serum cotinine was causally related to the high risk of nephrolithiasis [IVW: OR = 1.09 (1.00-1.19), P = 0.044].Conclusion Current smoking and high serum cotinine concentrations may be associated with an increased risk of kidney stones. Further research is needed to validate this relationship and explore its underlying mechanisms."

基金机构："We thank all participants, staff, and institutions that have contributed to the NHANES database and the publicly available GWAS database."

基金资助正文："We thank all participants, staff, and institutions that have contributed to the NHANES database and the publicly available GWAS database."