Childhood Secondhand Smoke and Longitudinal Cardiovascular Risk Profile

描述（由申请人提供）：烟草使用是导致心血管（C-V）疾病的最有效的可避免原因之一。流行病学研究表明，即使少量的二手烟暴露也会增加C-V疾病的风险。然而，儿童期SHS暴露对生命过程中C-V疾病风险的长期影响尚不清楚。重要的是，关于剂量-反应关系、SHS与C-V危险因素的相互作用以及种族（黑人-白人）差异的数据有限。拟议的研究旨在验证一个假设，即在黑人-白人人群中，儿童时期的SHS暴露及其对儿童期至成年期C-V疾病风险的影响因种族而异。根据FOA （PA-11-244）“二手烟对心血管和肺部疾病机制的影响（R01）”，本研究主要针对以下假设：1)在黑人和白人非吸烟人群中，研究儿童时期暴露于二手烟对儿童期至成年期纵向C-V风险变量的影响。C-V风险变量包括从童年开始连续测量的肥胖指标、葡萄糖、胰岛素、血脂和血压，以及成年后测量的炎症、氧化应激和内皮功能指标；2)确定儿童期SHS的独立作用及其与C-V危险变量的联合作用对成年黑人与白人非吸烟者亚临床C-V结构/功能变化的影响。亚临床C- V结构/功能测量包括颈动脉内膜-中膜厚度、主动脉-股动脉脉波速度、动脉壁顺应性、左心室几何重塑和功能；3)确定儿童期SHS和出生体重对黑人与白人非吸烟者儿童期和成年期亚临床C-V结构/功能变化的纵向风险变量谱的共同影响。上述具体目标将通过Bogalusa心脏研究的纵向队列进行检查，Bogalusa心脏研究是一项自1973年开始的儿童期C-V疾病的长期双种族（黑人-白人）社区流行病学研究。拟议的研究队列由800名白人和800名黑人成年人组成，年龄在29-52岁之间，他们已经获得了整个队列从童年和出生体重开始连续测量6次的C-V危险因素变量数据，并对50%的队列进行了成年亚临床C-V结构/功能测量。本研究的发现将进一步深入了解C-V疾病的潜在机制，并有助于在生命早期实施原始预防策略。

DESCRIPTION (provided by applicant): Tobacco use is one of the most potent avoidable causes for cardiovascular (C-V) disease. Epidemiologic studies indicate that even small amounts of secondhand smoke (SHS) exposure increase C-V disease risk. However, the long-term effect of childhood SHS exposure on the life course C-V disease risk is not clear. Importantly, data on dose-response relationship, interaction of SHS with C-V risk factors and racial (black-white) divergence are limited. The proposed research is designed to test the hypothesis that childhood SHS exposure and its impact on C-V disease risk from childhood to adulthood vary by race within a black-white population. In response to the FOA (PA-11-244) "Effects of Secondhand Smoke on Cardiovascular and Pulmonary Disease Mechanisms (R01)", the proposed research is directed to the following hypothesis-based Specific Aims: 1) to examine the impact of childhood SHS exposure on longitudinal C-V risk variables profile from childhood to adulthood in black versus white nonsmoking cohorts. The C-V risk variables include obesity measures, glucose, insulin, lipids and blood pressure measured serially since childhood, and markers of inflammation, oxidative stress and endothelial function measured in adulthood; 2) to determine the independent effect of childhood SHS and its joint effect with C-V risk variables on adult subclinical C-V structure/function changes in black versus white nonsmokers. The subclinical C- V structure/function measures include carotid artery intima-media thickness, aorta-femoral pulse wave velocity, arterial wall compliance, and left ventricular geometric remodeling and function; 3) to determine the joint effect of childhood SHS and birth weight on longitudinal C-V risk variables profile from childhood and adult subclinical C-V structure/function changes in black versus white nonsmokers. The above specific aims will be examined using a longitudinal cohort followed since childhood in the Bogalusa Heart Study, a long-term biracial (black-white) community-based epidemiologic study of C-V disease beginning in childhood since 1973. The proposed study cohort consists of 800 white and 800 black adults, aged 29-52 years, who already have data on C-V risk factor variables measured serially 6 times from childhood and birth weight in the entire cohort and adulthood subclinical C-V structure/function measures on 50% of the cohort. The findings from the proposed research will provide further insights into the potential underlying mechanisms of C-V disease and help in the implementation strategies of primordial prevention in early life. PUBLIC HEALTH RELEVANCE: Cigarette smoking is one of the avoidable causes for cardiovascular disease. Even small amounts of secondhand smoke exposure increase cardiovascular disease risk. Findings from this study will provide further insights into the potential underlying mechanisms of C-V disease associated with the long-term influence of secondhand smoke exposure in childhood, help strengthen the preventive strategies in early life, and promote comprehensive smoke-free legislation.