Association between serum cotinine concentrations on red blood cell folate concentrations in pregnant women and the mediating role of lymphocytes: an NHANES Study

The relationship began approaching significance between the second and third inflection points (1.24 to 2.91 ng/mL) [-0.238 (-0.555, 0.079); p = 0.134], ultimately achieving significance following the third inflection point (ln-transformed cotinine ≥ 2.91 ng/mL), with a significant decrease in ln-transformed RBC folate levels [-0.198 (-0.303, -0.093); p = 0.002].

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A nonsignificant trend towards a relationship between serum ln-transformed cotinine levels in the 1.24–2.91 ng/mL range and ln-transformed RBC folate levels was detected [-0.238 (-0.555, 0.079); p = 0.134], suggesting that other factors may play a predominant role in modulating this relationship within this range.

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