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. 2015 Mar 23;12(3):3381-94.
doi: 10.3390/ijerph120303381.

The mediating effect of body mass index on the relationship between cigarette smoking and atopic sensitization in Chinese adults

Xiao Luo  1 , Yupeng Wang  2 , Zhiqiang Wang  3 , Fuwen Cai  4 , Biao Xie  5 , Siyang Qu  6 , Meina Liu  7
Affiliations

The mediating effect of body mass index on the relationship between cigarette smoking and atopic sensitization in Chinese adults

Xiao Luo et al. Int J Environ Res Public Health. .

Abstract

Background: It is unclear whether the relationship between cigarette smoking and atopy is mediated by body fat mass, such as the Body Mass Index (BMI). We assessed the mediating role of BMI on the relationship between smoking and atopy in Chinese adults.

Methods: A hospital-based case-control study of 786 atopic cases and 2771 controls was conducted in adults aged 18 years or older from March 2010 to September 2014 in Harbin, China. Mediation models were used to estimate the indirect effects of smoking on atopic sensitization through BMI.

Results: Compared to non-smokers, light smokers and moderate smokers had a lower risk of inhalant allergen sensitization. The indirect effect of smoking and sensitization to aeroallergens were only observed in light smokers (point estimate, -0.026; 95% CI, -0.062 to -0.004). The mediating roles of BMI on the relationships between smoking and other types of allergic sensitization were not statistically significant.

Conclusion: BMI appeared to partially mediate the effect of light smoking on sensitization to aeroallergens. However, considering the other harmful health effects of cigarette smoking, the effective method to lower the incidence of atopy would be to decrease body fat mass by physical exercise and employing other more healthy ways of living rather than smoking.

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Figures

Figure 1
Figure 1
Model of the potential mediating effect of BMI on the association betweensmoking categories and atopic sensitization. The figure shows how to estimate the indirect effects through the potential mediator, of one smoking category (X1, X2, X3 and X4) on atopic sensitization compared to non-smoking category. Total effects (c paths) represent the overall association of a smoking category with atopic sensitization. Mediating effect occurred when the overall association could be partially (or fully) explained by the potential mediator (BMI). Association of the potential mediator with each smoking category (a paths) and the association with atopic sensitization independent of each smoking category were estimated. The products of abs (a1b, a2b, a3b, a4b) were used for estimating the indirect effects of BMI on the association between each smoking category and atopic sensitization. The “c” paths’ represent the direct effects of each smoking category and atopic sensitization.
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