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Association of Serum Cotinine with Hyperuricemia in American Adolescents: A Cross-Sectional Study

Document Type : Original Article(s)

Authors

1 Department of Clinical Laboratory Medicine, Sir Run Run Shaw Hospital Xiasha Campus, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, 310018, China

2 Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China

3 Center for Reproductive Medicine, Department of Pediatrics, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang Province, 310018, China

10.30476/ijms.2025.107138.4148

Abstract

Background: Cotinine is a known harmful toxicant, while its relationship with hyperuricemia in adolescents remains unclear. This study aimed to analyze the relationship between serum cotinine concentration and hyperuricemia among US adolescents aged 12-19 years. 
Methods: This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. Eligible participants were adolescents (12-19 years) with complete data for serum cotinine and uric acid. Out of 61,125 total participants during the study period, 6,831 participants were included in the analysis. The independent variable was serum cotinine, and the outcome was hyperuricemia. Multiple logistic regression analyses were performed to assess the relationship between serum cotinine and hyperuricemia, and sensitivity analyses were performed from multiple perspectives. 
Results: The study population comprised 6,831 individuals. The mean age of the participants was 15.5±2.3 years, 52.3% were men, and 28.6% were non-Hispanic white. Participants with hyperuricemia were more likely to be older (15.9±2.3 years vs. 15.1±2.2 years), male (56.9% vs. 43.1%), and non-Hispanic white (32.8%). The adjusted odds ratio of hyperuricemia associated with a unit increase in serum cotinine was 1.07 (95% CI: 1.01-1.13). This association remained consistent across subgroups and sensitivity analyses.
Conclusion: This study suggested an association between serum cotinine concentration and hyperuricemia in American adolescents. This modifiable risk factor warrants further investigation as a potential target for mitigating hyperuricemia in this population.

Highlights

Han Wu (Google Scholar) 

Fang Gu (Google Scholar) 

Keywords

References
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Iranian Journal of Medical Sciences
Volume 51, Issue 4
April 2026
Pages 256-265
Files
History
  • Received: 19 May 2025
  • Revised: 21 August 2025
  • Accepted: 06 October 2025
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