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Childhood smoke exposure could initiate atherosclerosis early on in life
By Anita Wilkinson
05 June 2009
Eur Heart J 2009; Advance access publication

MedWire News: Children exposed to cigarette smoke have a low-grade inflammatory response and altered markers of lipid metabolism that may initiate atherosclerosis early on in life, a German study suggests.

Environmental tobacco exposure was associated with unfavourable levels of several cardiometabolic biomarkers in 10-year-olds, which the researchers say suggests an adverse effect on the vascular wall very early in life.

They add: “Most importantly from a public health perspective, avoidance of environmental tobacco smoke exposure during childhood may reduce risk for cardiometabolic diseases in later life.”

Gabriele Nagel (Ulm University) and colleagues studied 383 children in Baden-Wuerttemberg, of whom 127 (33.2%) were exposed to smoking according to the answers of a parental questionnaire.

Linear and logistic regression models were applied using the 90th percentile as a cut-off point for the biomarkers leptin, C-reactive protein (CRP), fibrinogen, interleukin (IL)-6, lipoprotein-associated phospholipase A2 (Lp-PLA2), and apolipoprotein (apo)B, but not for adiponectin and apoA-I, for which the 10th percentile was used.

In linear models, exposure to environmental tobacco smoke was significantly associated with increasing plasma concentrations of leptin, CRP, fibrinogen, IL-6, and Lp-PLA2.

Being exposed to smoke from more than 10 cigarettes a day was associated with elevated concentrations of leptin compared with no exposure (odds ratio [OR]=6.40), as well as elevations in CRP (OR=3.17) and Lp-PLA2 (OR=2.97), and low adiponectin (OR=2.69), and apoA-I (OR=4.48).

The number of abnormal cardiometabolic markers rose with the dose of environmental tobacco smoke.

Approximately half the children exposed to between one and 10 cigarettes a day had at least one abnormal marker, while this was true for around 70% of those exposed to greater levels of smoking.

Reporting in the European Heart Journal, the researchers conclude: “Our observations indicate a link between exposure to environmental tobacco smoke and unfavorable concentrations of cardiometabolic biomarkers in 10-year-old children, which may contribute to cardiovascular-disease risk in later life.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

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