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Tobacco smoke exposure increases risk of metabolic syndrome in teens

Study links obesity, smoking to insulin resistance

Wednesday, August 03, 2005

A study published in August’s Circulation: The Journal of the American Heart Association has found that children -- particularly overweight teens -- exposed to tobacco smoke have an increased risk for the metabolic syndrome.

The study, led by Michael Weitzman, M.D., executive director of the American Academy of Pediatrics Center for Child Health Research and professor and associate chair at the University of Rochester School of Medicine and Dentistry’s Golisano Children’s Hospital, both in Rochester, NY, is the first to make the link between tobacco smoke exposure and the metabolic syndrome in children.

The metabolic syndrome is a cluster of conditions that increase cardiovascular problems. It often develops in childhood and is associated with insulin resistance, which means the body can’t use insulin efficiently. It is a predictor of early death. The risk of metabolic syndrome increases up to five-fold for overweight adolescents exposed to tobacco smoke.

“Tobacco and obesity are the two leading causes of preventable death in the United States, so our findings may have profound implications for the future health of the public,” Weitzman said.

The researchers studied children between the ages of 12 and 19 from the Center for Disease Control’s National Health and Nutrition Examination Survey (NHANES III 1988 to 1994). The teens and their parents were asked whether they or anyone in the household smoked, and the teens received physical exams with laboratory blood and urine testing.

This is the first study in any age group to use along with self-reported tobacco exposure measurements of cotinine, a biomarker of nicotine breakdown in the liver. Two-thirds of the teens who abstained from smoking had cotinine levels between .05 and 15 nanograms per milliliter, indicating exposure to secondhand smoke.

“All things equal, you are almost five times more likely to develop the metabolic syndrome if you are exposed to secondhand smoke,” Weitzman said. “Active smoking increases the risk to at least six times that of a non-exposed individual.”

An even more dramatic effect was found in overweight teens and teens at risk for being overweight. Higher risks were also found for males and Mexican Americans.

Weitzman said the study points out the need to reduce or eliminate tobacco smoke exposure of teens, with particular emphasis on overweight teens or teens at-risk of being overweight.

“The war on tobacco is not over.”

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