Physical Activity Mitigates Negative Effects of Serum Cotinine Induced by Tobacco on the Risk of Metabolic Syndrome

Abstract Introduction/Objective: This study aims to assess the complex interactions between tobacco exposure, confirmed through serum cotinine (SC) levels, physical activity (PA), and the likelihood of developing metabolic syndrome (MetS). Methods This study involved 8,423 adults from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2007 to 2018. The logistic regression and quantile regression analyses were conducted to estimate the associations among SC, PA and the risk of MetS with its components. We also investigated the sex differences on these outcome variables via the analysis of variance (ANOVA) and the Chi-square test. Results The covariate-adjusted logistic regression analysis results suggest that SC concentration (unit: ng/mL) was significantly and positively associated with MetS (OR: 6.41, 95%CI: 5.81–7.08), abdominal obesity (OR: 1.92, 95%CI: 1.75–2.11), hypertension (OR: 2.70, 95%CI: 2.46–2.96), hyperglycemia (OR: 12.50, 95%CI: 10.63–14.71), hypertriglyceridemia (OR: 2.10, 95%CI: 1.90–2.33), and low HDL-C (OR: 1.61, 95%CI: 1.46–1.77). PA energy consumption (unit: MET*h/wk) was significantly and negatively associated with MetS (OR: 0.56, 95%CI: 0.51–0.61), abdominal obesity (OR: 0.71, 95%CI: 0.65–0.78), hypertension (OR: 0.55, 95%CI: 0.50–0.60), hyperglycemia (OR: 0.59, 95%CI: 0.52–0.67), and hypertriglyceridemia (OR: 0.84, 95%CI: 0.76–0.93). For males, an increase of 6 MET*h/wk in PA energy consumption compensated for the risk impact of 1 ng/mL SC on MetS. Similarly, for females, an increase of 7 MET*h/wk in PA energy consumption compensated for the risk impact of 1 ng/mL SC on MetS. Conclusions This study indicates a positive correlation between SC concentration and a higher risk of MetS, while energy expenditure through PA was inversely related to the increased risk of MetS. Additionally, there appears to be a compensatory effect between PA energy expenditure and SC levels on the risk of developing MetS.