Introduction: This study investigated the systemic response of serum bone alkaline phosphatase (SBAP) and urinary N-telopeptide (UNTX) to tobacco exposure and environmental tobacco smoke (ETS) and the possible effect modification (and variability) of this response by racial/ethnic origin.

Methods: Data (n = 5411) were obtained from the National Health and Nutrition Examination Survey, with data analysis done on adults aged ≥ 20 years. Outcome variables were SBAP and UNTX. Independent variable was tobacco exposure measured using serum cotinine levels and adjusted for covariates. Generalized linear models were used to explore associations.

Results: A percentage increase in log transformed serum cotinine was associated with a 0.005 percentage increase in log transformed SBAP (CI: 0.002, 0.008) and 0.02 percentage increase in log transformed UNTX (CI: −0.01, 0.04) with interaction between cotinine and race/ethnicity (p = 0.01). Stratifying by race/ethnicity, tobacco exposure was associated with significant decreases in UNTX among non-Hispanic Whites – 0.008(−0.014, −0.002) and Mexican Americans −0.014 (−0.025, −0.002) only. Categories of serum cotinine were associated with a monotonic increase in SBAP (p for trend <0.001) and monotonic non-linear decrease in UNTX (p for trend > 0.05).

Conclusions: Tobacco and environmental tobacco exposure are associated with SBAP and increased bone formation. The response of UNTX to these exposures is modified by race/ethnicity with non-Hispanic Whites and Mexican-Americans less sensitive to the resorptive effects of tobacco exposure on bone.

简介：本研究调查了血清骨碱性磷酸酶 (SBAP) 和尿 N-端肽 (UNTX) 对烟草暴露和环境烟草烟雾 (ETS) 的全身反应，以及种族/民族对这种反应的可能影响修正（和变异性）起源。

方法：数据（n = 5411）来自全国健康与营养调查，对20岁以上成年人进行数据分析 年。结果变量是 SBAP 和 UNTX。自变量是使用血清可替宁水平测量的烟草暴露并针对协变量进行调整。使用广义线性模型来探索关联。

结果： log 转化血清可替宁百分比增加与 log 转化 SBAP 0.005 百分比增加（CI：0.002，0.008）和 log 转化 UNTX 0.02 百分比增加（CI：-0.01，0.04）相关，与可替宁和种族之间的相互作用有关/种族 ( p = 0.01）。按种族/族裔分层，烟草暴露与非西班牙裔白人的 UNTX 显着下降相关 - 仅 0.008（−0.014，−0.002）和墨西哥裔美国人 -0.014（−0.025，−0.002）。血清可替宁的类别与 SBAP 的单调增加相关（ p表示趋势 <0 id=59>p 表示趋势 > 0.05）。

结论：烟草和环境烟草暴露与 SBAP 和骨形成增加有关。 UNTX 对这些暴露的反应因种族/民族而改变，非西班牙裔白人和墨西哥裔美国人对烟草暴露对骨骼的再吸收影响不太敏感。