title: Are active and passive smoking associated with cardiometabolic risk factors in adolescents? The CASPIAN-III Study.
abstract: Smoking is an important risky behavior in adolescents worldwide. Active and passive smoking have adverse health effects at public and individual levels.
  
  
  
  This study aimed to evaluate the association of active and passive smoking with cardiometabolic risk factors in a national sample of Iranian adolescents.
  
  
  
  Participants consisted of 5625 students, aged 10-18 years, studied in the third survey of a national school-based surveillance system. Participants were classified into three groups based on smoking pattern: active smoker, passive smoker, and exposure to smoke (active or passive or both of them). Considering the Adult Treatment Panel III criteria modified for the paediatric age group, metabolic syndrome (MetS) was defined as the co-existence of three out of five components of abdominal obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and depressed high-density cholesterol (HDL-C) levels.
  
  
  
  The mean (SD) age of participants was 14.7 (2.4) years. Mean level of HDL-C was significantly lower in all types of smoking compared to non-smokers. Low HDL-C and MetS had significant association with active smoking (OR 2.10, 95% CI 1.33-3.31 and OR 5.24, 95% CI 2.41-11.37), passive smoking (OR 1.19, 95% CI 1.01-1.43 and OR 1.79, 95% CI 1.09-2.96), and smoking exposure (OR 1.20, 95% CI 1.01-1.43 and OR 2.02, 95% CI 1.22-3.31), respectively.
  
  
  
  This study confirms that both smoking and exposure to smoke are associated with an increased risk of MetS and some of the cardiometabolic risk factors in adolescents. Preventive measures against passive smoking should be considered as a health priority in the paediatric age groups.
authors.affiliation: a Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease , Isfahan University of Medical Sciences , Isfahan.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.affiliation: b Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute , Tehran University of Medical Sciences.
authors.forename: Atefeh
authors.initials: A
authors.lastname: Noori
authors.affiliation: c Department of Community Medicine , Alborz University of Medical Sciences , Karaj.|d Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute , Tehran University of Medical Sciences , Tehran.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
authors.affiliation: b Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute , Tehran University of Medical Sciences.
authors.forename: Shadi
authors.initials: S
authors.lastname: Rahimzadeh
authors.affiliation: b Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute , Tehran University of Medical Sciences.|e Development of Research and Technology Center, Deputy of Research and Technology , Ministry of Health and Medical Education , Tehran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Djalalinia
authors.affiliation: d Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute , Tehran University of Medical Sciences , Tehran.
authors.forename: Gita
authors.initials: G
authors.lastname: Shafiee
authors.affiliation: f Pediatrics Department , Ahvaz University of Medical Sciences.
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: a Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease , Isfahan University of Medical Sciences , Isfahan.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: g Health Promotion Research Center , Zahedan University of Medical Sciences.
authors.forename: Hossein
authors.initials: H
authors.lastname: Ansari
authors.affiliation: h Department of Medical Emergencies , Qom University of Medical Sciences , Qom , Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Asayesh
authors.affiliation: d Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute , Tehran University of Medical Sciences , Tehran.
authors.forename: Zeinab
authors.initials: Z
authors.lastname: Ahadi
authors.affiliation: d Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Endocrinology and Metabolism Research Institute , Tehran University of Medical Sciences , Tehran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D002648:Child; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*
chemical_list: D001786:Blood Glucose; D008055:Lipids; D014028:Tobacco Smoke Pollution
keywords: Adolescents; Cardiometabolic risk factors; Smoking