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Arterial intima-media thickness, endothelial function, and apolipoproteins in adolescents frequently exposed to tobacco smoke.

Abstract：

BACKGROUND:Exposure to tobacco smoke is associated with markers of preclinical atherosclerosis in adults, but its effect on arterial structure in adolescents is unknown. METHODS AND RESULTS:Healthy 13-year-old adolescents from the atherosclerosis prevention trial STRIP were studied. Maximum carotid and aortic intima-media thickness and brachial artery flow-mediated dilation were measured in 494 adolescents using high-resolution ultrasound. Serum lipid, lipoprotein, and apolipoprotein (Apo) A-I and B concentrations were determined using standard methods. Exposure to tobacco smoke was measured annually between ages 8 and 13 years using serum cotinine concentrations, analyzed with gas chromatography. To define longitudinal exposure, cotinine values of children having serum cotinine measured 2 to 6 times during follow-up were averaged and divided into tertiles (exposure groups): low (n=160), intermediate (n=171), and high (n=163). Adolescents with higher longitudinal exposure to tobacco smoke had increased carotid intima-media thickness (exposure groups [mean+/-SD]: low, 0.502+/-0.079 mm; intermediate, 0.525+/-0.070 mm; high, 0.535+/-0.066 mm; P<0.001) and increased aortic intima-media thickness (exposure groups: low, 0.527+/-0.113 mm; intermediate, 0.563+/-0.139 mm; high, 0.567+/-0.126 mm; P=0.008). The flow-mediated dilation decreased when cotinine level increased (exposure groups: low, 10.43+/-4.34%; intermediate, 9.78+/-4.38%; high, 8.82+/-4.14%; P=0.004). Moreover, ApoB (P=0.014) and ApoB/ApoA-I ratio (P=0.045) increased with increase in cotinine level. The associations between tobacco smoke exposure and ultrasound variables were unchanged after adjusting for traditional atherosclerosis risk factors and for ApoB. CONCLUSIONS:Frequent exposure to tobacco smoke is independently associated with arterial changes of preclinical atherosclerosis and increased ApoB levels among healthy adolescents. Clinical Trial Registration- clinicaltrials.gov. Identifier: NCT00223600.

journal_name

Circ Cardiovasc Qual Outcomes

journal_title

Circulation. Cardiovascular quality and outcomes

authors

Kallio K,Jokinen E,Saarinen M,Hämäläinen M,Volanen I,Kaitosaari T,Rönnemaa T,Viikari J,Raitakari OT,Simell O

doi

10.1161/CIRCOUTCOMES.109.857771

subject

Has Abstract

pub_date

2010-03-01 00:00:00

pages

196-203

issue

eissn

1941-7713

issn

1941-7705

pii

CIRCOUTCOMES.109.857771

journal_volume

pub_type

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Arterial intima-media thickness, endothelial function, and apolipoproteins in adolescents frequently exposed to tobacco smoke.