title: Prenatal and postnatal tobacco smoke exposure and development of insulin resistance in 10 year old children.
abstract: In this study, we evaluated the association between prenatal and postnatal exposure to environmental tobacco smoke and the development of insulin resistance in 10 year old children. Fasting blood samples were collected from 470 children participating in two prospective birth cohorts. Of those 276 were selected population based and enriched with 194 children exceeding the 85th percentile of body mass index in this age group. Children already having diabetes type 1 or 2 at the age of 10 years were excluded. Fasting blood insulin and glucose levels and calculated HOMA index for insulin resistance assessment were analysed using generalised additive models. Potential confounders were adjusted for. Insulin resistance was increased by 24% in children frequently exposed to environmental tobacco smoke during childhood (MR(adj) = 1.24, p = 0.001), while glucose levels were not. Exclusion of prenatally exposed children did not attenuate the association (MR(adj) = 1.25, p = 0.006). After stratification, the effect sizes were identical within overweight children and the population based sample of children. Insulin resistance and fasting insulin levels were increasing with increasing numbers of cigarettes smoked in children's home. Maternal smoking during the third trimester of pregnancy increased children's insulin levels (MR(adj) = 1.19, p = 0.037), and even more so, if children were exclusively breastfed after birth (MR(adj) = 1.31, p = 0.016). Increased mean ratios were found for smoking of a third person in addition to maternal smoking. Positive dose-dependent associations and independent effects of postnatal exposure suggest involvement of environmental tobacco smoke in the risk for development of insulin resistance in children.
authors.affiliation: Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Thiering
authors.forename: Irene
authors.initials: I
authors.lastname: Brüske
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kratzsch
authors.forename: Joachim
authors.initials: J
authors.lastname: Thiery
authors.forename: Stefanie
authors.initials: S
authors.lastname: Sausenthaler
authors.forename: Christa
authors.initials: C
authors.lastname: Meisinger
authors.forename: Sibylle
authors.initials: S
authors.lastname: Koletzko
authors.forename: Carl-Peter
authors.initials: CP
authors.lastname: Bauer
authors.forename: Beate
authors.initials: B
authors.lastname: Schaaf
authors.forename: Andrea
authors.initials: A
authors.lastname: von Berg
authors.forename: Dietrich
authors.initials: D
authors.lastname: Berdel
authors.forename: Irina
authors.initials: I
authors.lastname: Lehmann
authors.forename: Olf
authors.initials: O
authors.lastname: Herbarth
authors.forename: Ursula
authors.initials: U
authors.lastname: Krämer
authors.forename: H Erich
authors.initials: HE
authors.lastname: Wichmann
authors.forename: Joachim
authors.initials: J
authors.lastname: Heinrich
mesh_terms: D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D001942:Breast Feeding; D002648:Child; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D050177:Overweight / Q000503:physiopathology; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D011297:Prenatal Exposure Delayed Effects; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D001786:Blood Glucose; D014028:Tobacco Smoke Pollution