Association between secondhand smoke exposure in indoor public places and carotid intima-media thickness in children and adolescents
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摘要:
目的 探讨儿童青少年室内公共场所二手烟暴露与颈动脉内中膜厚度(cIMT)的关系，为儿童青少年心血管结构异常的早期防控提供依据。 方法 数据来源于2021年11—12月进行的“儿童心血管健康随访队列”第二次随访调查。共纳入1 297名具有完整信息(包括性别、年龄、cIMT、体测指标、问卷调查指标及血生化指标)的儿童青少年用于统计分析。采用线性回归分析评估儿童青少年cIMT水平随室内公共场所二手烟暴露天数的变化趋势。调整各种潜在协变量，采用多元线性回归模型分析室内公共场所二手烟暴露天数与cIMT的关系。 结果 在过去1周内，儿童青少年自我报告在室内公共场所暴露于二手烟1~2 d的有407(31.4%)名、3~4 d的有86(6.6%)名、≥5 d的有82(6.3%)名。随着室内公共场所二手烟暴露天数的增加，不同模型下儿童青少年cIMT呈上升趋势(t值分别为3.30，3.05，2.87，P值均＜0.05)；在调整各种协变量后，儿童青少年cIMT值分别为[0 d/周：(551.5±29.3)μm，1~2 d/周：(554.0±28.6)μm，3~4 d/周：(557.0±27.7)μm，≥5 d/周：(559.4±27.5)μm]。与过去7 d未在室内公共场所暴露于二手烟的儿童青少年相比，至少5 d暴露于二手烟的儿童青少年存在cIMT增厚的风险(β=7.91，95%CI=1.47~14.34，P＜0.05)。 结论 儿童青少年室内公共场所二手烟暴露率仍处于较高水平且与cIMT存在较强关联。应采取更严格的控烟措施为儿童青少年提供良好的无烟环境，以降低心血管早期结构异常的发生风险。 Abstract:Objective To examine the association between secondhand smoke exposure (SHS) in indoor public places and carotid intima-media thickness (cIMT) in children and adolescents, so as to provide guidance for the prevention of early abnormal vascular architecture. Methods The data were obtained from the second follow-up of the Children Cardiovascular Health Cohort Study conducted from November to December 2021. A total of 1 297 children and adolescents for who completed data relating to sex, age, cIMT, physical examinations, questionnaires variables and blood biochemical indices, were included for analysis. Linear regression analysis was performed to examine trends in the levels of cIMT with exposure to SHS in indoor public places. Multiple linear regression analysis was carried out to assess the association between SHS exposure in indoor public places and cIMT after adjustment for potential covariates. Results During the previous 7 days, 407 (31.4%) children and adolescents were exposed to SHS in indoor public places for 1-2 days, 86 (6.6%) for 3-4 days, and 82 (6.3%) for ≥5 days. The levels of cIMT in youth increased on different models, with the duration of SHS exposure during the previous 7 days (t=3.30, 3.05, 2.87, P < 0.05). After adjusting for various covariates, the cIMT values of children and adolescents were[0 day: (551.5±29.3) μm, 1-2 days: (554.0±28.6) μm, 3-4 days: (557.0±27.7) μm, ≥5 days: (559.4±27.5) μm]. Compared to those who were not exposed to SHS in indoor public places during the previous 7 days, those exposed for ≥5 days had significantly higher cIMT levels (β=7.91, 95%CI=1.47-14.34, P < 0.05). Conclusion Among children and adolescents, exposure to SHS in indoor public places remains high and is significantly associated with cIMT. The findings highlight the need for stricter regulation and tobacco control policies to provide healthy smoke-free environments for children and adolescents, and to reduce the risk of early abnormal vascular architecture. -
Key words:
- Tobacco smoke pollution /
- Carotid arteries /
- Regression analysis /
- Child /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。2) 马传伟与李成为共同第一作者。 -
表 1 不同室内公共场所二手烟暴露天数儿童青少年在不同模型下cIMT水平的比较(x±s，μm)
Table 1. Comparison of the levels of cIMT in different days of exposure to secondhand smoke in indoor public places across different models among children and adolescents(x±s, μm)
每周暴露天数/d 模型1 模型2 模型3 0 551.1±34.4 551.3±36.9 551.5±29.3 1~2 553.9±34.4 553.8±35.9 554.0±28.6 3~4 557.4±34.4 555.5±34.8 557.0±27.7 ≥5 563.3±34.4 560.5±34.6 559.4±27.5 P值 ＜0.01 0.01 ＜0.01 注：模型1为调整性别和年龄；模型2为模型1+调整睡眠时间、体力活动、蔬菜水果摄入、血压；模型3为模型2+调整BMI、TG、HDL-C、空腹血糖、家庭烟草暴露。 
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表 2 儿童青少年室内公共场所二手烟暴露与cIMT的多元线性回归分析[β值(95%CI)，n=1 297]
Table 2. Multivariate linear regression analysis of association between exposure to secondhand smoke in indoor public places and cIMT among children and adolescents[β(95%CI), n=1 297]
每周暴露天数/d 模型1 模型2 模型3 1~2 2.81(-1.37~6.99) 2.43(-1.71~6.58) 2.48(-0.83~5.80) 3~4 6.27(-1.41~13.97) 4.19(-3.47~11.86) 5.48(-0.74~11.69) ≥5 12.20(4.33~20.05)** 9.16(1.29~17.04)* 7.91(1.47~14.34)* 注：模型1为调整性别和年龄；模型2为模型1+调整睡眠时间、体力活动、蔬菜水果摄入、血压；模型3为模型2+调整BMI、TG、HDL-C、空腹血糖、家庭烟草暴露。*P＜0.05，**P＜0.01。
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