Objective: Links between secondhand smoke (SHS) exposure and cardiovascular disease in adults are well established but seldom reported during childhood. Although rates of smoking have decreased, young children from low-income backgrounds remain likely to be exposed to SHS. The purpose of this study was to investigate relationships between SHS exposure in young children and several preclinical markers of cardiovascular risk that have been established as relevant to adult populations.

Methods: 139 children, 2–5 years of age, were enrolled in a cross-sectional study. SHS exposure was objectively determined by hair nicotine level; a comprehensive panel of clinical markers (AM blood pressure, fasting glucose & insulin, lipid profiles, inflammation) and research markers (markers of oxidation, endothelial stress, and endothelial repair) of cardiovascular risk status were assessed. Univariate and multivariate linear regression were used to evaluate relationships between SHS exposure and cardiovascular risk markers.

Results: Hair nicotine levels were directly correlated with blood pressure and serum CRP, and inversely correlated with serum HDL and endothelial cell progenitor cell prevalence. In multivariate analyses, these relationships remained when controlled for age, sex, BMI z-score, maternal education, and method of payment. Additionally, in multivariate analyses, hair nicotine level was significantly negatively correlated with total anti-oxidant capacity.

Conclusions: These results support the view that SHS exposure in the very young has a detectable relationship with several markers of cardiovascular risk, long before the emergence of clinical disease. Further studies to define mechanisms and strategies to prevent and mitigate these risks early in life are warranted.

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Notes/Citation Information

Published in The Journal of Pediatrics, v. 189, p. 155-161.

© 2017 Elsevier Inc. All rights reserved.

This manuscript version is made available under the CC‐BY‐NC‐ND 4.0 license https://creativecommons.org/licenses/by-nc-nd/4.0/.

The document available for download is the author's post-peer-review final draft of the article.

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Funding Information

The research was supported by the American Academy of Pediatrics Julius B. Richmond Center of Excellence, (Co-PIs Judith A. Groner and John A. Bauer), which is funded by grants from the Flight Attendant Medical Research Institute and Legacy.

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