Ahmet ÖKSÜZ, Ruhuşen KUTLU, İsmail REİSLİ, İbrahim KILINÇ

İdrar kotinin ve kotinin/kreatinin oranının çevresel tütün dumanı maruziyetinin bir biyolojik belirteci olarak kullanımı

Amaç: Çevresel Tütün Dumanına (ÇTD) maruz kalma, dünya çapında bir halk sağlığı sorunu olmaya devam etmektedir. Bu çalışmada, çocuklarda idrar kotinin düzeyleri ve kotinin/kreatinin oranlarını ölçerek ebeveynlerin evde sigara içme alışkanlıkları ile çocukların çevresel tütün dumanına maruz kalmaları arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve Yöntem: Vaka-kontrol tipindeki analitik çalışma 0-18 yaş grubundan 357 çocuk ile yapılmıştır. Olgu grubunu çevresel sigara dumanına maruz kalan 180 çocuk oluşturdu. Kontrol grubunu herhangi bir sağlık sorunu olmayan ve çevresel sigara dumanına maruz kalmayan 177 çocuk oluşturuldu. Spot idrardaki kotinin ve kreatinin seviyeleri her iki grupta da analiz edildi. Bulgular: Ebeveynleri sigara içenlerde, kadın cinsiyette, eğitim düzeyi düşük babalarda ve evde 3 veya daha az oda bulunan çocukların idrar kotinin düzeyi istatistiksel olarak daha yüksek bulundu. Çocukların idrar kotinin/kreatinin oranı, ebeveynleri sigara içenlerde (15.91 pg/mg (1.54-147.54) - 7.90 pg/mg (1.29-68.52)), kadın cinsiyette (13.19 pg/mg (1.79-115.07) - 10.45 pg/mg (1.29-147.54)) istatistiksel olarak daha yüksek bulundu. ÇTD'ye maruz kalan gruptaki idrar kotinin seviyeleri, ÇTD'ye maruz kalan gruptan 1042 kat daha fazla etkilenmiştir [OR:1042,462, %95 GA (139.821.839-7772.246)]. Sonuç: Çalışmamızda ÇTD’ye maruz kalan çocuklarda idrar kotinin düzeyleri, ÇTD’ye maruz kalmayan çocuklara göre daha yüksek bulundu. Bu sonuçların ışığında, çocuklarda ÇTD'ye maruziyeti değerlendirmek için idrar kotinin düzeyi noninvaziv bir belirteç olarak kullanılabilir. Ebeveynler için eğitim müdahaleleri, ÇTD’ye maruz kalma konusundaki farkındalıklarını artırmak ve özellikle ev ortamında çocukların sağlığını korumak için doğru davranışları öğretmek için gereklidir.

Use of urinary cotinine and cotinine/creatinine ratio as a biomarker of environmental tobacco exposure

Purpose: Exposure to Environmental Tobacco Smoke (ETS) remains a worldwide public health problem. The purpose of this study was to investigate the relationship between parents' smoking habits at home and children's exposure to environmental tobacco smoke by measuring urinary cotinine levels and urine cotinine/creatinine ratios in children. Materials and Methods: This case-control typed analytical study was conducted with 357 children in the 0-18 age group. The case group consisted of 180 children exposed to environmental cigarette smoke. As the control group, it consisted of 177 healthy children and non-smoking in their family. The levels of cotinine and creatinine in spot urinary were analyzed in both groups. Results: The urinary cotinine level of the children was found to be statistically higher in those whose parents were smokers, female gender, fathers with a low educational level, and those with 3 or fewer rooms in the house. The urinary cotinine/creatinine ratio of the children was found to be statistically higher in those whose parents were smokers (15.91 pg/mg (1.54-147.54) vs 7.90 pg/mg (1.29-68.52)), female gender (13.19 pg/mg (1.79-115.07) vs 10.45 pg/mg (1.29-147.54)). Urinary cotinine levels in the ETS exposed group were affected 1042 times more than in the ETS unexposed group [OR:1042,462, 95% CI (139.821.839-7772.246)]. Conclusion: In the present study, urinary cotinine levels were found to be higher in children exposed to tobacco smoke than in children not exposed to tobacco smoke. In the light of these results, urinary cotinine can be used as a biomarker to evaluate exposure to ETS in children. Educating parents is essential to raising their awareness of exposure to ETS and teaching the right behaviors to protect children's health, especially in the home environment.

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