title: The mediating effect of body mass index on the relationship between cigarette smoking and atopic sensitization in Chinese adults.
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.
  
  
  CONCLUSIONS
  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.
authors: Public Health College, Harbin Medical University, No.157, Baojian Road, Harbin City, Heilongjiang Province 150081, China. lxlx1218@163.com.
authors: Xiao
authors: X
authors: Luo
authors: Public Health College, Harbin Medical University, No.157, Baojian Road, Harbin City, Heilongjiang Province 150081, China. 007@163.com.
authors: Yupeng
authors: Y
authors: Wang
authors: School of Medicine, The University of Queensland, Health Sciences Building, Royal Brisbane & Women's Hospital, Herston, QLD 4029, Australia. z.wang@uq.edu.au.
authors: Zhiqiang
authors: Z
authors: Wang
authors: Public Health College, Harbin Medical University, No.157, Baojian Road, Harbin City, Heilongjiang Province 150081, China. caifuwen920@163.com.
authors: Fuwen
authors: F
authors: Cai
authors: Public Health College, Harbin Medical University, No.157, Baojian Road, Harbin City, Heilongjiang Province 150081, China. xiexiexiebiaobiao@163.com.
authors: Biao
authors: B
authors: Xie
authors: Public Health College, Harbin Medical University, No.157, Baojian Road, Harbin City, Heilongjiang Province 150081, China. qmiss1224@163.com.
authors: Siyang
authors: S
authors: Qu
authors: Public Health College, Harbin Medical University, No.157, Baojian Road, Harbin City, Heilongjiang Province 150081, China. liumeina369@163.com.
authors: Meina
authors: M
authors: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016022:Case-Control Studies; D002681:China; D003430:Cross-Sectional Studies; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000276:immunology; D055815:Young Adult