Evidence map›Paper›PMID 41987245›Full record

ArticleEnvironmental health : a global access science source2026

Serum cotinine-assessed tobacco exposure, cadmium co-exposure, and childhood obesity: a cross-sectional study.

Fanjia Guo, Changming Ding, Simeng Gu, Wanying Shi, Xinhan Zhang, Yingli Qu, Peiwei Xu, Zhe Mo, Xiaofeng Wang, Sujun Yan and 7 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Environmental health : a global access science source, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Fanjia Guo *Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Changming Ding *China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China.
Simeng Gu *Department of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Wanying Shi *China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China.
Xinhan ZhangDepartment of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Yingli QuChina CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China.
Peiwei XuDepartment of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Zhe MoDepartment of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Xiaofeng WangDepartment of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Sujun YanDepartment of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Peijie SunChina CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China.
Feng ZhaoChina CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China.
Ying ZhuChina CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China.
Yuebin LvChina CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China.
Zhijian ChenDepartment of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China.
Xiaoming ShiChina CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing , 100021, China. shixm@chinacdc.cn.
Xiaoming LouDepartment of Environmental Health, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou , 310051, China. xmlou@cdc.zj.cn.

Funding

National Natural Science Foundation of China 32400980
6 · The paper itself

Abstract

backgroundThe association between tobacco exposure and obesity remains controversial, with the potential modifying role of cadmium (Cd) unclear. Childhood population provide a critical window to assess low-dose tobacco effects. This study aimed to investigate the association between serum cotinine-assessed tobacco exposure and childhood obesity, and further evaluate whether Cd exposure acts as a potential effect modifier in this association.

methodsThis nationwide cross-sectional study investigated 5,595 school-aged children from 2017 to 2018 China National Human Biomonitoring. Serum cotinine levels were measured to assess tobacco exposure. General obesity was determined using BMI Z-score, and central obesity was assessed via waist circumference, waist-to-height ratio, and body roundness index. Weighted regression and restricted cubic splines (RCS) assessed associations between cotinine and obesity, with interaction analyses for Cd exposure.

resultsCompared to the lowest cotinine tertile, individuals with the highest tertile had higher odds of general obesity (OR = 1.485; 95% CI: 1.096, 2.011) and central obesity (OR = 1.333; 95% CI: 1.030, 1.723). RCS models indicated linear and positive associations. Cd exposure significantly attenuated the association between cotinine levels and general obesity (Pinteraction = 0.002), with stronger effects observed in low Cd subgroups (OR = 1.279; 95% CI: 1.133, 1.444).

conclusionsThese results indicate positive associations of tobacco exposure with general and central obesity among nonsmoking children, and Cd acted as an effect modifier. This study suggested that environmental tobacco reduction and considering Cd co-exposure could have implications for obesity in children and adolescents.

Indexed as

CadmiumCotinineEnvironmental ExposurePediatric ObesityTobacco Smoke PollutionAdolescentChildChinaCross-Sectional StudiesFemaleHumansMaleCadmiumCotinineTobacco Smoke PollutionCadmiumCentral obesityGeneral obesityNational human biomonitoring.Tobacco exposure

Identifiers

PMID41987245
PMCPMC13085269

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.