Impact of Vitamin B6 Status on the Relationship Between Tobacco Exposure and Central Obesity in Children and Adolescents: A Cross-Sectional Study

Background: The purpose of this research is to explore the relationship between vitamin B6 status (measured by pyridoxal-5′-phosphate, PLP levels) and central obesity in children and adolescents. Additionally, the study seeks to examine how this relationship might influence the link between exposure to tobacco and central obesity in this age group. Methods: This cross-sectional study utilized data from the National Health and Nutrition Examination Survey spanning 2005 to 2010. Central obesity was identified by waist circumference measurements that were equal to or exceeded the 90th percentile, with adjustments made for age and gender. To assess the relationship between tobacco exposure and central obesity, both weighted univariate and multivariate logistic regression analyses were applied. An analysis was performed using PLP concentration categories (PLP ≥ 53.74 nmol/L and PLP < 53.74 nmol/L) to determine the impact of tobacco exposure on central obesity in each respective PLP group. Results: The final sample included 5,865 participants. Higher tobacco exposure [odds ratio (OR): 1.25, 95% confidence interval (CI): 1.03-1.53, P =0.027] and lower PLP levels (OR: 1.28, 95% CI: 1.05-1.57, P =0.016) were each independently linked to an increased risk of central obesity in children and adolescents. Among children and adolescents with lower PLP levels, cotinine exposure was related to an increased risk of central obesity (OR: 1.36, 95% CI: 1.05-1.76, P =0.022), particularly in specific subgroups: individuals under the age of 12 years, males, and those with six hours or less of daily screen time. Conclusion: Our results underscore the critical role of nutritional status, specifically vitamin B6 levels, in modulating the relationship between environmental exposures and obesity risk. Future initiatives aimed at primary prevention could be enhanced by recognizing the link between central obesity and adjustable lifestyle elements.