Urine Cotinine Underestimates Exposure to the Tobacco-Derived Lung Carcinogen 4-(Methylnitrosamino)-1-(3-Pyridyl)-1-Butanone in Passive Compared with Active Smokers

作者：Benowitz Neal^*; Goniewicz Maciej Lukasz; Eisner Mark D; Lazcano Ponce Eduardo; Zielinska Danch Wioleta; Koszowski Bartosz; Sobczak Andrzej; Havel Christopher; Jacob Peyton III

来源：Cancer Epidemiology Biomarkers & Prevention, 2010, 19(11): 2795-2800.

DOI：10.1158/1055-9965.EPI-10-0497

Objectives: Cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) are widely used biomarkers for tobacco-derived nicotine and the lung carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), respectively. The discrepancy between cotinine levels in relation to disease risk comparing active versus passive smoking suggests a nonlinear tobacco smoke dose-response and/or that cotinine is not providing an accurate measure of exposure to the toxic constituents of secondhand tobacco smoke.
Methods: Cotinine and NNAL were measured in the urine of 373 active smokers and 228 passive smokers.
Results: Average cotinine levels were 1,155 (interquartile range, 703-2,715) for active smokers and 1.82 (0.45-7.33) ng/mg creatinine for passive smokers. Average NNAL levels were 183 (103-393) and 5.19 (2.04-11.6) pg/mg creatinine, respectively. NNAL/cotinine ratio in urine was significantly higher for passive smokers when compared with active smokers (2.85 x 10(3) versus 0.16 x 10(3), P < 0.0001).
Conclusions: Passive smoking is associated with a much higher ratio of NNAL/cotinine in the urine compared with active smoking.
Impact: Cotinine measurement leads to an underestimation of exposure to the carcinogen NNK from secondhand smoke when compared with active smoking. Cancer Epidemiol Biomarkers Prev; 19(11); 2795-800.

• 出版日期2010-11