Published online January 26, 2009
PEDIATRICS Vol. 123 No. 2 February 2009, pp. e267-e273 (doi:10.1542/peds.2008-2659)
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ARTICLE

Decreased Aortic Elasticity in Healthy 11-Year-Old Children Exposed to Tobacco Smoke

Katariina Kallio, MDa, Eero Jokinen, MD, PhDb, Mauri Hämäläinen, PhDc, Maiju Saarinen, MSSca, Iina Volanen, MD, PhDa, Tuuli Kaitosaari, MD, PhDa, Jorma Viikari, MD, PhDd, Tapani Rönnemaa, MD, PhDd, Olli Simell, MD, PhDe and Olli T. Raitakari, MD, PhDf

a Research Centre of Applied and Preventive Cardiovascular Medicine
c Joint Clinical Biochemistry Laboratory of University of Turku, Turku University Central Hospital, and Wallac
d Departments of Medicine
e Pediatrics
f Clinical Physiology, University of Turku, Turku, Finland
b Department of Pediatrics, University of Helsinki, Helsinki, Finland

OBJECTIVE. The goal was to assess the relationship between passive smoking and arterial elasticity in children.

METHODS. Healthy 11-year-old children (N = 386) from an atherosclerosis prevention trial (Special Turku Coronary Risk Factor Intervention Project for Children) were studied. Aortic and carotid elasticities were determined by using M-mode ultrasound imaging based on measurements of blood pressure and arterial diameter changes during the cardiac cycle. The aortic stiffness index, Young's elastic modulus, and distensibility and the respective indices for the carotid artery were calculated. Exposure to tobacco smoke was measured by using serum cotinine concentrations, and children were classified into 3 groups, that is, the noncotinine group (n = 220; undetectable cotinine levels), the low-cotinine group (n = 127; cotinine levels of 0.2–1.6 ng/mL), and the top-decile cotinine group (n = 39; cotinine levels of ≥1.7 ng/mL).

RESULTS. Higher cotinine concentrations were associated with increased aortic stiffness index values. An increase in aortic Young's elastic modulus and a decrease in aortic distensibility were observed across the cotinine groups. In multivariate regression models, the cotinine level remained a significant explanatory variable regarding all aortic elasticity indices. Carotid elasticity indices showed no differences across the cotinine groups.

CONCLUSIONS. Childhood exposure to tobacco smoke (verified with serum cotinine levels) decreases aortic elastic properties in healthy children.

Key Words: passive smoking • elasticity • children • ultrasonography • atherosclerosis

Abbreviations: hsCRP—high-sensitivity C-reactive protein • FMD—flow-mediated dilation • aSI—aortic stiffness index • aYEM—aortic Young's elastic modulus • cSI—carotid stiffness index • cYEM—carotid Young's elastic modulus • CV—coefficient of variation • STRIP—Special Turku Coronary Risk Factor Intervention Project for Children

Accepted Oct 17, 2008.


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