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Association Between Urine Cotinine Levels and Bone Mineral Density in Lumbar Spine and Femoral Neck Among Adult Males

 Sungkyu Lee  ;  Do Heum Yoon  ;  Keung Nyun Kim  ;  Dong Ah Shin  ;  Yoon Ha 
 SPINE, Vol.39(4) : 311-317, 2014 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Bone Density/physiology* ; Cotinine/urine* ; Cross-Sectional Studies ; Femur Neck/diagnostic imaging* ; Humans ; Lumbar Vertebrae/diagnostic imaging* ; Male ; Middle Aged ; Nutrition Surveys ; Radiography ; Republic of Korea ; Risk Factors
smoking ; urine cotinine ; femoral neck ; lumbar spine ; bone mineral density
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To investigate an association between tobacco exposure as determined by urine cotinine and bone mineral density (BMD) in femoral neck and lumbar spine. SUMMARY OF BACKGROUND DATA: Loss of BMD is 1 of the major causes of spine and femoral neck fractures in the elderly population. There is limited literature on risk factors to loss of BMD, in particular, among males. METHODS: We analyzed data of 770 males older than 30 years, which were collected from the cross-sectional Fifth Korea National Health and Nutrition Examination Survey, with t tests, analysis of variance, and multiple linear regressions. RESULTS: The means of femoral neck BMD (T score) significantly decreased with increasing age, -0.08, -0.63, and -1.49 in males aged 30 to 40 years, 50 to 69 years, and 70 to 95 years, respectively (P < 0.001). The same trend was observed in lumbar spine BMD. Although education (P < 0.001) and income (P = 0.021) were associated with femoral neck T score, only education (P = 0.034) was associated with lumbar spine T score. The group who had urine cotinine level of more than 10 μg/mL (active smokers or nonsmokers who were exposed to second-hand smoking) had lower femoral neck T score (-0.43 ± 0.98) than the group who had cotinine level of 10 μg/mL or less (-0.33 ± 0.89) (P = 0.114). In the multiple linear regressions, age, urine cotinine level, and body mass index were statistically related to femoral neck and lumbar spine T score. CONCLUSION: Our findings suggest that tobacco exposure by active or passive smoking and lower body mass index seem to exert a negative effect on femoral neck and lumbar spine BMD.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Yoon, Do Heum(윤도흠) ORCID logo https://orcid.org/0000-0003-1452-5724
Ha, Yoon(하윤)
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