Coronary heart disease risk factors in male adolescents, with particular reference to smoking and blood lipids

Effect of smoking on vital hemodynamic parameters and lipid profile of young smokers

Background and objectives: Tobacco use is associated with cardiovascular, respiratory and peripheral vascular diseases. The short term effects of tobacco smoking on vital hemodynamic parameters and lipid profile of young smoker with increased quantity of smoking is still debatable. The objective of this study was to evaluate the effect of smoking on vital hemodynamic parameters and lipid profile of young smokers. Materials and methods: The current study was an observational cross sectional study conducted in a tertiary care hospital over a period of 18 months and included smokers and non-smokers. Data on vital hemodynamic parameters like blood pressure, heart rate, oxygen saturation (SPO2) and lipid profile were collected. Chi-square and analysis of variance (ANOVA) tests were used to analyze the data. Results: A total of 80 smokers and 80 non-smokers were enrolled in the study. Blood pressure, heart rate and mean SpO2 were significantly (p<0.001) lower in non-smokers compared to smokers. Breath holding time (BHT) and single breath count (SBC) were higher in non-smokers. Mean values of total cholesterol (T-chol), low density lipoprotein (LDL) and triglyceride (TG) were significantly (p<0.001) higher in smokers than non-smokers, while high density lipoprotein (HDL) was significantly low in smokers. SBP, T -chol and TG significantly (p<0.05) increased as the quantity of smoking increased. Conclusion: Smoking is associated with derangement of vital hemodynamic parameters and lipid profile across the age. Anti-smoking campaign should be organized to discourage both personal smoking and smoking in public places. IMC J Med Sci. 2023. 17(1): 007. DOI : https://doi.org/10.55010/imcjms.17.007 *Correspondence: Bhupendra Kumar Jain, Department of Pulmonary Medicine, School of Chhindwara Institute Of Medical Sciences, Jabalpur Medical University, Chhindwara, Madhya Pradesh, India. Email: drbhupendrakjain@gmail.com

Smoking, Adolescents and Health: Isfahan Healthy Heart Programme-Heart Health Promotion from Childhood

To evaluate the effect of some environmental factors on smoking, and to assess some health hazards of smoking in adolescents, this cross-sectional study was performed among 1950 students, ages11-18, selected by multi-stage random sampling from three cities in Iran. According to self-administered questionnaires, 12.9% of boys and 4% of girls reported to be smoker (OR=3.34, 95%CI: 2.33, 4.77, p<0.001). The mean values of total-and LDL-cholesterol were higher in smokers and their HDL-C was lower than non-smokers (163.33± 33.83, 90.73± 31 and 46.7± 12.24 vs.156± 29.53, 85±26.5 and 49.4±13.7 mg/dl, respectively, p<0.05). The mean systolic and diastolic blood pressures were higher in smokers than non-smokers (110.7± 14.5, 67.6± 11.55 vs. 104.9± 14.3, 63.2± 10.8 mmHg, respectively, p<0.05). The smokers had higher BMI than non-smokers (20.34 ±3.84 vs.19.55 ± 3.66, p<0.05). The mean food consumption frequency was lower for fruits and vegetables and higher for fat/salty snacks and fast foods in smokers than non-smokers. Logistic regression analysis showed significant association between sex, age, the number of family members and number of smokers in the family and smoking in students. The findings of this study have implications for future tobacco prevention strategies through community-based interventions. Asia Pac JPublic Health 2004; 16(1): 15-22.

Passive and Active Tobacco Exposure and Children's Lipid Profiles

INTRODUCTION

Despite reductions in smoking rates, exposure to cigarette smoke remains common among US children and adolescents. In adults, active smoking and secondhand smoke (SHS) exposure have been linked to adverse changes in lipid profiles and increases in inflammatory markers. Evidence that such changes are present before adulthood remains limited, and the extent to which active smoking and SHS exposure affect these cardiovascular measures in children has not been thoroughly assessed.

METHODS

We employed data from 2008 individuals aged 12-19 years from the 2005-2010 National Health and Nutrition Examination Survey. Comparisons of the lipid and inflammatory marker levels among active smokers, those exposed to SHS (as determined by serum cotinine levels), and those unexposed to tobacco smoke were made using linear regression with multiple propensity score adjustment.

RESULTS

Compared to unexposed children, lipid and inflammatory marker profiles did not differ among those exposed to SHS exposure. Among active smokers, differences compared to unexposed children were observed in triglyceride levels ( β=8.5 mg/dL, P = .01), the ratio of triglycerides to high-density lipoprotein ( β=0.2, P = .045), and low-density lipoprotein cholesterol ( β=-4.1 mg/dL , P = .03), though these did not reach levels of confirmatory statistical significance.

CONCLUSIONS

After accounting for sociodemographic characteristics and medical comorbidities, serum lipids and markers of systemic inflammation were not associated with SHS exposure. Tobacco smoke exposure in children may require longer durations of compounded effect before serum lipid abnormalities are detected.

IMPLICATIONS

This paper adds detail to the study of secondhand smoke's effects on lipid profiles of children and adolescents. Prior research on this topic for these age groups has been limited, and this study provides national, cross-sectional data to show that both secondhand smoke and active smoking in childhood and adolescence is not associated with changes in lipid profiles or markers of inflammation. Tobacco smoke exposure may require longer durations of compounded effect before abnormalities are detected.

Lipid and lipoprotein profiles among middle aged male smokers: a study from southern India

Objectives

The objectives were to investigate into the relationship between lipid profile including Apolipoprotein-A1 (Apo-A1) and Apolipoprotein-B (Apo-B) and smokers and to relate them with smoking pack years.

Materials and Methods

A total of 274 active male smokers without any other illnesses and age matched male healthy control subjects (78) with similar socio-cultural background were assessed for clinical details, dietary habits, physical activities, smoking and alcohol consumption. Standard methods were adopted to check the lipid levels. The data were analyzed statistically.

Results

Their ages ranged from 40 to 59 years, systolic BP from 110 to 130 mmHg, and diastolic BP from 76 to 88 mmHg. All of them had similar pattern of diet (vegetarianism with occasional meat). None was on any medication influences lipid level. Their physical activity was moderate. Number of pack years varied from 10 to 14 (mild), 15 to 19 (moderate) and 20 and above (heavy) among 69, 90 and 115 cases, whose mean ages were 43, 44 and 49 respectively. The mean (+SD) values in mg/dl of total cholesterol (TC), Triglyceride (TGL), Apo-B, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and Apo-A1 in mg/dl among mild/ moderate/ heavy smokers and control subjects were 198 (30.6)/ 224 (27.2)/ 240 (24.3) and 160 (20.4); 164(42.6)/ 199 (39.5)/ 223(41.7) and 124 (31.6); 119 (24.9)/ 121 (27)/ 127 (28.3) and 116 (21.4); 94 (19.7)/ 104 (21.8)/ 120 (20.5) and 82 (17.6); 42 (5.9)/ 39 (3.1)/ 35(4.4) and 48 (5.3); and 120 (17)/ 119 (21)/ 115 (25) and 126 (19), respectively. In smokers, there was a rise in TC, TGL, LDL, Apo-B and fall in HDL and Apo-A; these changes were significant (P < 0.05).

Conclusion

Number of pack years was directly proportional to abnormal lipid profile. It is also concluded that changes in Apo-A1 and Apo-B were more significant when compared to HDL and LDL cholesterol among smokers. In the view of double risk for smokers (smoking and altered lipid profile) efforts may be made to introduce smoking cessation program.

Hábito alimentar, níveis de lipídios sangüíneos e o status antioxidante de adultos jovens fumantes e não fumantes

OBJETIVO: Avaliar o hábito alimentar, os níveis dos lipídios sangüíneos e o status antioxidante de jovens fumantes e não fumantes. MÉTODOS: Trata-se de um estudo transversal em que 68 indivíduos, de 18 a 26 anos, emparelhados por sexo e idade, foram divididos em dois grupos: fumantes (n=34) e não fumantes (n=34). Os voluntários selecionados em instituições de ensino, em Viçosa (MG) foram questionados quanto a: hábito de fumar, consumo de bebidas alcoólicas e atividade física; também foi estimada a dependência nicotínica. O hábito alimentar foi avaliado por questionário de freqüência de consumo. Quantificaram-se níveis séricos de lipídios, nível plasmático de malondialdeído, vitamina E e vitamina C. RESULTADOS: Os jovens começaram a fumar precocemente, independentemente do sexo. O hábito de fumar foi estratificado e encontrou-se 58,8% de fumantes leves e 41,2% de fumantes pesados. Os fumantes apresentaram hábitos alimentares inadequados e consumo freqüente de bebida alcoólica. De acordo com a recomendação do International Physical Activity Questionnaire 69% dos fumantes eram ativos e 27,6% eram muito ativos. Não se observou diferença significante na concentração sérica de lipídios entre fumantes e não fumantes. No grupo de fumantes mulheres, verificou-se correlação positiva entre o número de cigarros fumados por dia e os triglicerídeos séricos (r=0,824 e p=0,0001) e também entre o tempo que fumavam em anos e o nível de colesterol total (r=0,523 e p=0,031). Os fumantes apresentaram concentração inferior de vitaminas E e C (p=0,002 e p=<0,001, respectivamente) e a concentração de malondialdeído plasmático correlacionou-se ao tempo de tabagismo em anos (r=0,352 e p=0,041). CONCLUSÃO: O grupo de fumantes apresentou hábito alimentar inadequado, principalmente para alimentos gordurosos, e consumo freqüente de bebida alcoólica. Os valores para malondialdeído plasmático apresentaram correlação positiva com o tempo de tabagismo, mas não com o número de cigarros fumados por dia.

Risk factors for dyslipidemia in Chinese children

AIM

Since the mortality rate due to cardiovascular disease continues to increase, research into dyslipidemia has been emphasized in not only adults but also paediatric populations. We aimed to study the risk factors of dyslipidemia in Chinese children.

METHODS

Nine hundred and sixty-two children, aged 6-18 years, in Beijing were enrolled. For each child, data were collected on body height (cm), body weight (kg), sitting height (cm), waist circumference, upper arm circumference, serum lipid levels, as well as familial history of dyslipidemia and early onset cardiovascular disease. Subgroups were determined on the basis of age and sex.

RESULTS

The prevalence rate of dyslipidemia was 11.1% (107/962). Children with dyslipidemia differed significantly from those without, in sitting height, upper arm circumference, body mass index (BMI), waist-to-height ratio (WHR) and diastolic and systolic blood pressure (p < 0.05). Logistic regression analysis suggested that WHR, diastolic blood pressure and positive familial history were risk factors for dyslipidemia in children.

CONCLUSION

Sitting height, upper arm circumference, BMI, WHR, diastolic pressure and systolic pressure were significantly higher in dyslipidemic children than in normal subjects in China. BMI, WHR, diastolic pressure and familial history of dyslipidemia and early-onset cardiovascular disease were risk factors for dyslipidemia in Chinese children.

In a prospective study in young people, associations between changes in smoking behavior and risk factors for cardiovascular disease were complex

OBJECTIVE

This study investigates how voluntary changes in tobacco consumption are related to changes in biological risk factors for cardiovascular disease in 21- to 36-year-old men and women.

STUDY DESIGN AND SETTING

Data of the Amsterdam Growth and Health Longitudinal Study (AGAHLS) were used to study the association between voluntary changes in tobacco consumption and changes in biological risk factors for cardiovascular disease (CVD) during 4-6 years of follow-up in 165 men and 195 women aged 21-36 years. We used multiple linear regression analyses with corrections for age and changes in other lifestyles.

RESULTS

In both sexes, we found trends for a reduction in blood pressure, high-density lipoprotein cholesterol (HDL-C), body weight, and waist-to-hip ratio (WHR) and a rise in the ratio between total serum cholesterol (TC) and HDL-C (TC/HDL-C) with increasing tobacco consumption. Opposite trends were found with reducing tobacco consumption. In women, body weight, WHR, and waist circumference reduced significantly and independently with increasing tobacco consumption and increased significantly with decreasing tobacco consumption.

CONCLUSION

These results suggest that voluntary changes in tobacco consumption go together with both healthy and unhealthy changes in biological risk factors for CVD.

The state of office-based interventions for youth tobacco use

Tobacco use is a serious pediatric health issue as dependence begins during childhood or adolescence in the majority of tobacco users. Primary care settings provide tremendous opportunities for delivering tobacco treatment to young tobacco users. Although evidence-based practice guidelines for treating nicotine dependence in youths are not yet available, professional organizations and the current clinical practice guideline for adults provide recommendations based on expert opinion. This article reports on the current tobacco treatment practices of pediatric and family practice clinicians, discusses similarities and differences between adolescent and adult tobacco use, summarizes research efforts to date and current cutting-edge research that may ultimately help to inform and guide clinicians, and presents existing recommendations regarding treating tobacco use in youths. Finally, recommendations are made for the primary care clinician, professional organizations, and health care systems and policies. Pediatricians and other clinicians can and should play an important role in treating tobacco dependence in youths.

Relationship between measures of fatness, lipids and ethnicity in a cohort of adolescent boys

BACKGROUND/AIM

The investigators were invited into a boys' high school to assess the lipid risk profile of a single year cohort and advise on how the findings could be incorporated into a healthy lifestyle program. The aim of the study was to investigate the relationship between measures of fatness, ethnicity and cardiac risk factors in a cohort of adolescent boys.

METHODS

Anthropometric measurements of weight, height, waist and hips were used to calculate body mass index (BMI) and waist to hip ratio (WHR); percent total body fat (%TBF) was estimated by bioelectric impedance analysis. Demographic and behavioral variables were assessed by questionnaire. Total cholesterol (TC), high-density lipoprotein-cholesterol (HDL-C), triglyceride (TG), apolipoprotein A1 (apoA1), apoliproprotein B (apoB) and insulin were measured in 137 subjects; low-density lipoprotein (LDL-C) was calculated.

RESULTS

The study sample was comprised of 139 boys aged 15.7 +/- 0.04 years; 46% were Caucasians, 41% were East Asians and 13% were from the Indian subcontinent (South Asian). The crude mean BMI, %TBF and waist measurements were not significantly different between the ethnic groups. South Asians had a higher mean WHR than East Asians (p < 0.004; ANOVA), and also had higher mean %TBF than Caucasians when BMI was adjusted for, and lower BMI than either of the other groups when adjusted for waist (ANCOVA). There was no difference between groups in lipid profiles except for a higher apoB in East Asians compared with Caucasians (p < 0.04). Twenty-two percent of the subjects had TC higher than the desirable level for children (4.5 mmol/l), 7.3% had low HDL-C (<0.9 mmol/l) and 4.3% had high LDL-C (>3.5 mmol/l). Overweight and hypercholesterolemia had individual prevalences of around 20%, while hyperinsulinemia was 48%.

CONCLUSION

The present study confirms that the relationship between BMI and %TBF is dependent on ethnicity, even in adolescent subjects of similar age and gender. The assessment of cardiovascular risk on a school year and age basis would suggest that there are enough affected individuals to support at least a nontargeted intervention which focuses on healthy eating and physical activity.

The importance of physical activity in the prevention of overweight and obesity in childhood: a review and an opinion

The prevalence of childhood obesity is increasing and there are a number of theoretical reasons as to why intervention may be more effective in childhood. There are certain risk times for the development of obesity in childhood, which provide a basis for targeted intervention. In addition, tracking data supports the persistence of obesity, at least in later childhood, as well as cardiovascular risk factors. Physical activity is the discretionary component of energy expenditure and there is evidence that falling levels of physical activity are contributing to the obesity epidemic. Physical activity in children is related to developmental stage, is reduced with increasing age and is influenced by parental physical activity. While there is debate about the immediate health benefits of physical activity to children, there are data to support that lower physical activity levels and sedentary behaviours are associated with a higher prevalence of obesity in children. Physical activity is an accepted strategy in the treatment of established obesity (tertiary prevention). The role of physical activity in the prevention of obesity (primary and secondary prevention) is less clear. However a number of recent school-based interventions directed at either increasing physical activity and/or decreasing sedentary behaviours, have shown encouraging results. On balance, increasing physical activity in children is an attractive and non-restrictive approach to obesity prevention. To adopt this approach requires the support and involvement of many community sectors other than health.