Introduction: This study aimed to examine the association of smoking status with homocysteine levels and to determine whether the association is modified by oestradiol or cholesterol.

Methods: Data (N = 4580) were obtained from National Health and Nutrition Examination Survey 2003–2004 with analysis done in 2018 on adults aged ≥20 years. The outcome was homocysteine; smoking status was the exposure variable and categorized as current, former or never smoker. Generalized linear models were used to examine the associations between smoking status and homocysteine levels, while assessing the impact of oestradiol and cholesterol.

Results: After adjusting for age, sex, ethnicity, education and income level, homocysteine levels did differ by smoking status ((current smokers versus never smokers: β: 0.18 CI: 0.00, 0.36), (former smokers: β: 0.10 CI: –0.09, 0.28)). The addition of oestradiol as an interaction term in adjusted models was associated with a 16.6% increase in homocysteine levels when compared to models without the interaction term. Oestradiol but not cholesterol did moderate the association between smoking status and homocysteine levels.

Discussion and conclusions: Homocysteine levels did differ across smoking status after adjusting for confounders. Oestradiol did moderate the relationship between homocysteine and smoking status.

简介：本研究旨在检查吸烟状态与同型半胱氨酸水平之间的关系，并确定该关系是否被雌二醇或胆固醇所修饰。

方法：数据（N  = 4580）来自2003-2004年美国国家健康和营养调查，并于2018年对20岁以上的成年人进行了分析。结果是同型半胱氨酸；吸烟状况是暴露变量，分类为现在，以前或从不吸烟。使用广义线性模型检查吸烟状态与同型半胱氨酸水平之间的关联，同时评估雌二醇和胆固醇的影响。

结果：在调整了年龄，性别，种族，文化程度和收入水平之后，高半胱氨酸水平的确因吸烟状况而有所不同（（当前吸烟者与从不吸烟者：β：0.18 CI：0.00，0.36）；（前吸烟者：β：0.10 CI： –0.09，0.28））。与没有相互作用项的模型相比，在调整模型中添加雌二醇作为相互作用项与高半胱氨酸水平增加了16.6％。雌二醇而非胆固醇确实减轻了吸烟状况与同型半胱氨酸水平之间的联系。

讨论与结论：调整混杂因素后，同型半胱氨酸水平在吸烟状态之间确实存在差异。雌二醇确实减轻了同型半胱氨酸与吸烟状况之间的关系。