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.