Background

The present study investigated associations between urinary cotinine levels as a biomarker of secondhand smoke exposure and symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).

Methods

A total of 520 child participants (200 with ADHD, 67 with ASD, and 253 normal control subjects) were assessed using the Korean version of the ADHD rating scale (K-ARS), Autism spectrum screening questionnaire (ASSQ), and Behavioral Assessment System for Children, second edition (BASC-2). The Korean version of the computer-based continuous performance test was used to assess cognitive function. Urinary cotinine was evaluated as a biomarker of secondhand smoke exposure.

Results

Urinary cotinine levels were significantly and positively associated with K-ARS score (B = 4.00, p < 0.001), ASSQ score (B = 1.71, p = 0.030), the behavioral problem subscales of the BASC-2 (B = 1.68–3.52, p < 0.001–0.045), and omission and commission errors in the continuous performance test (B = 6.21–8.42, p < 0.001–0.019). Urinary cotinine levels were also associated with the increased odds ratio of ADHD (OR = 1.55, 95% CI 1.05–2.30, p = 0.028) and ASD (OR = 1.89, 95% CI 1.12–3.21, p = 0.018).

Conclusion

Urinary cotinine levels were associated with lower behavioral adaptation and cognitive function and increased odds ratios of ADHD and ASD, indicating a negative effect of secondhand smoke exposure on the symptomatic manifestation of ADHD and ASD.

中文翻译：

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尿可替宁与注意缺陷/多动障碍和自闭症谱系症状之间的关联

背景

本研究调查了尿可替宁水平作为二手烟暴露的生物标志物与注意缺陷/多动障碍（ADHD）和自闭症谱系障碍（ASD）症状之间的关联。

方法

使用韩语版多动症评分量表（K-ARS），自闭症谱筛查问卷（ASSQ）和行为评估系统对总共520名儿童参与者（200名患有ADHD，67名患有ASD以及253名正常对照受试者）进行了评估儿童版，第二版（BASC-2）。韩文版的基于计算机的连续性能测试用于评估认知功能。尿可替宁被评估为二手烟暴露的生物标志物。

结果

尿中可替宁水平与K-ARS评分（B = 4.00，p <0.001），ASSQ评分（B = 1.71，p = 0.030）和行为问题分量表（BASC-2）显着正相关（B = 1.68–3.52 ，p <0.001–0.045），以及连续性能测试中的遗漏和委托误差（B = 6.21–8.42，p <0.001–0.019）。尿中可替宁水平也与多动症（OR = 1.55，95％CI 1.05–2.30，p = 0.028）和ASD（OR = 1.89，95％CI 1.12–3.21，p = 0.018）的增加相关。

结论

尿可替宁水平与较低的行为适应和认知功能以及ADHD和ASD的优势比增加相关，表明二手烟暴露对ADHD和ASD的症状表现有负面影响。