European Heart Journal Advance Access originally published online on May 24, 2009
European Heart Journal 2009 30(15):1885-1893; doi:10.1093/eurheartj/ehp180
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Environmental tobacco smoke and cardiometabolic risk in young children: results from a survey in south-west Germany
1 Institute of Epidemiology, Ulm University, Helmholtzstr.22, 89081 Ulm, Germany
2 Institute of Informatics (Medical Documentation and Statistics), Ulm University of Applied Sciences, Ulm, Germany
3 Baden-Württemberg State Health Office, Stuttgart, Germany
4 Department of Internal Medicine II–Cardiology, Ulm University Medical Center, Ulm, Germany
Received 22 October 2008; revised 20 March 2009; accepted 21 April 2009; online publish-ahead-of-print 24 May 2009.
* Corresponding author. Tel: +49 731 50 31073, Fax: +49 731 50 31069, Email: gabriele.nagel{at}uni-ulm.de
Aims: We explored the association between exposure to environmental tobacco smoke (ETS) and various cardiometabolic biomarkers in 10-year-old children.
Methods and results: A population-based cross-sectional study was carried out. Data on ETS exposure and potential confounders were collected by parental questionnaire. Adiponectin, leptin, markers of inflammation, apolipoproteins (apo) AI and B, and lipoprotein-associated phospholipase A2 (Lp-PLA2) were measured. Linear and logistic regression models were applied using the 90th percentile as a cut-off point except for adiponectin and apoAI (10th percentile). In linear models, ETS exposure was significantly associated with increasing plasma concentrations of leptin, C-reactive protein, fibrinogen, interleukin (IL)-6, and Lp-PLA2. When compared with none, ETS exposure of more than 10 cigarettes per day was associated with elevated concentrations of leptin (OR 6.40; 95% CI, 2.67–15.39), C-reactive protein (OR 3.17; 95% CI, 1.31–7.68), Lp-PLA2 (OR 2.97 95% CI, 1.32–6.68), low adiponectin (OR 2.69; 95% CI, 1.10–6.57), and low apoAI (OR 4.48; 95% CI, 2.16–10.85). Increasing dose of ETS exposure was related to an increasing number of abnormal cardiometabolic markers.
Conclusion: Among children, ETS exposure was associated with a low-grade inflammatory response and altered markers of lipid metabolism, which may initiate atherosclerosis in early life. However, longitudinal studies are necessary to determine the potential causal relevance of these associations.
Key Words: Leptin • Adiponectin • Apolipoproteins • Inflammation • Environmental tobacco smoke • Children