title: Secondhand smoke exposure and endothelial stress in children and adolescents.
abstract: OBJECTIVE
  Links between secondhand smoke exposure and cardiovascular disease in adults are well established. Little is known about the impact of this exposure on cardiovascular status during childhood. The purpose of this study was to investigate relationships between secondhand smoke exposure in children and adolescents and cardiovascular disease risk--systemic inflammation, endothelial stress, and endothelial repair.
  
  
  METHODS
  A total of 145 subjects, aged 9 to 18 years, were studied. Tobacco smoke exposure was determined by hair nicotine level. Cardiovascular risk was assessed by markers of systemic inflammation (C-reactive protein [CRP] and adiponectin); by soluble intercellular adhesion molecule 1 (s-ICAM1), which measures endothelial activation after surface vascular injury; and by endothelial repair. This was measured by prevalence of endothelial progenitor cells (EPCs), which are bone marrow-derived cells that home preferentially to sites of vascular damage.
  
  
  RESULTS
  Hair nicotine was directly correlated with s-ICAM1 (r = 0.4090, P < .0001) and negatively correlated with EPC prevalence (r = -0.2002, P = .0195). There was no relationship between hair nicotine and CRP, and a trend toward a weak relationship with adiponectin. Hair nicotine and body mass index were independent variables in a multivariate model predicting s-ICAM1; hair nicotine was the only significant variable in a model predicting EPC prevalence.
  
  
  CONCLUSIONS
  Secondhand smoke exposure during childhood and adolescence is detrimental to vascular health because s-ICAM1 is a marker for endothelial activation and stress after vascular surface injury, and EPCs contribute to vascular repair. The fact that body mass index is also a factor in the model predicting s-ICAM1 is concerning, in that 2 risk factors may both contribute to endothelial stress.
authors.affiliation: AAP Julius B. Richmond Center of Excellence, Elk Grove Village, Ill; Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio. Electronic address: Judith.groner@nationwidechildrens.org.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Groner
authors.affiliation: AAP Julius B. Richmond Center of Excellence, Elk Grove Village, Ill; University of Kentucky, Department of Pediatrics, Lexington, Ky.
authors.forename: Hong
authors.initials: H
authors.lastname: Huang
authors.affiliation: Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, Ohio.
authors.forename: Haikady
authors.initials: H
authors.lastname: Nagaraja
authors.affiliation: Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kuck
authors.affiliation: AAP Julius B. Richmond Center of Excellence, Elk Grove Village, Ill; University of Kentucky, Department of Pediatrics, Lexington, Ky.
authors.forename: John Anthony
authors.initials: JA
authors.lastname: Bauer
mesh_terms: D052242:Adiponectin / Q000378:metabolism*; D000293:Adolescent; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D066026:Endothelial Progenitor Cells / Q000166:cytology*; D004730:Endothelium, Vascular / Q000378:metabolism*; D005260:Female; D006197:Hair / Q000737:chemistry*; D006801:Humans; D007249:Inflammation; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism*; D008297:Male; D009538:Nicotine / Q000032:analysis*; D014028:Tobacco Smoke Pollution
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; C573420:ICAM1 protein, human; D014028:Tobacco Smoke Pollution; D018799:Intercellular Adhesion Molecule-1; D009538:Nicotine; D002097:C-Reactive Protein
keywords: child hair nicotine; endothelial stress; secondhand smoke exposure; tobacco smoke exposure