Plasma Cotinine Is Positively Associated with Homocysteine in Smokers but Not in Users of Smokeless Tobacco

Elisabet Söderström, Torbjörn K. Nilsson, Jörn Schneede, Per-Magne Ueland, Øivind Midttun, Björn Gylling, Ingegerd Johansson and Johan Hultdin
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Elisabet Söderström: Department of Medical Biosciences, Clinical Chemistry, Norrbotten County Council, Sunderby Hospital, Umeå University, SE 90187 Umeå, Sweden
Torbjörn K. Nilsson: Department of Medical Biosciences, Clinical Chemistry, Umeå University, SE 90187 Umeå, Sweden
Jörn Schneede: Department of Pharmacology and Clinical Neuroscience, Clinical Pharmacology, Umeå University, SE 90187 Umeå, Sweden
Per-Magne Ueland: Department of Clinical Science, University of Bergen and Laboratory of Clinical Biochemistry, Haukeland University Hospital, N 5021 Bergen, Norway
Øivind Midttun: Bevital AS, N 5021 Bergen, Norway
Björn Gylling: Department of Medical Biosciences, Pathology, Umeå University, SE 90187 Umeå, Sweden
Ingegerd Johansson: Department of Odontology/Section of Cariology, Umeå University, SE 90187 Umeå, Sweden
Johan Hultdin: Department of Medical Biosciences, Clinical Chemistry, Umeå University, SE 90187 Umeå, Sweden

IJERPH, 2021, vol. 18, issue 21, 1-9

Abstract: Plasma total homocysteine (tHcy) is a risk marker, and smoking is an established risk factor for cardiovascular disease. It is unclear if the effect of smoked tobacco on homocysteine is mediated by nicotine or other combustion products in smoked tobacco. Snus (moist smokeless tobacco) is high nicotine-containing tobacco, and little is known about the effect of snus on plasma homocysteine. Therefore, we studied, in a cross-section of subjects (n = 1375) from the Northern Sweden Health and Disease Study, with strictly defined current smokers (n = 194) and snus users (n = 47), the impact of tobacco exposure on tHcy, assessed by self-reported tobacco habits and plasma cotinine concentrations. The snus users had higher cotinine concentrations than the smokers. Cotinine, creatinine, methylmalonic acid, and the methylenetetrahydrofolate reductase genotype ( MTHFR ) T allele were positively associated with tHcy among the smokers, but not among the snus users. No association was observed between tHcy and the number of cigarettes/day. There was a positive association between cotinine and tHcy in the smokers, but not among the snus users. This indicates that substances other than nicotine in tobacco smoke could be responsible for the differential effects on homocysteine status. Self-reported smoking should be complemented by a cotinine assay whenever possible.

Keywords: cotinine; nicotine; homocysteine; tobacco (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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