Hostname: page-component-5d84bcc8dc-whph2 Total loading time: 0 Render date: 2026-08-11T08:50:50.579Z Has data issue: false hasContentIssue false
  • English
  • Français

The effect of parental smoking on early atherosclerotic changes in paediatric age group

Published online by Cambridge University Press:  26 February 2026

Nesrin Coşkun Open the ORCID record for Nesrin Coşkun [Opens in a new window]  and
Öykü Tosun Open the ORCID record for Öykü Tosun [Opens in a new window]
Nesrin Coşkun*
Affiliation:
Department of Pediatrics, Istanbul Medeniyet University , Istanbul, Turkey
Öykü Tosun
Affiliation:
Department of Pediatric Cardiology, Istanbul Medeniyet University, Istanbul, Turkey
*
Corresponding author: Nesrin Coşkun; Email: nesrinkacoskun@hotmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Background and aims:

This study aimed to evaluate the independent effect of parental smoking on early markers of atherosclerosis in children, specifically carotid intima-media thickness and epicardial adipose tissue thickness.

Methods:

A total of 106 healthy children aged 6–16 years were enrolled, including 53 with parental smoking exposure and 53 unexposed controls. Participants underwent clinical evaluation, laboratory assessment, transthoracic echocardiography, and carotid ultrasonography. Data on parental smoking habits, sociodemographic characteristics, and children’s daily sleep duration were collected. Multivariable analyses were performed to assess the independent association between parental smoking and subclinical atherosclerotic markers.

Results:

Children exposed to parental smoking demonstrated significantly greater epicardial adipose tissue thickness and carotid intima-media thickness compared with controls (p = 0.014 and p = 0.001, respectively). Lipid parameters did not differ significantly between groups. Daily sleep duration was negatively correlated with epicardial adipose tissue thickness (r = –0.325, p = 0.018) and carotid intima-media thickness (r = –0.484, p < 0.001). Parental smoking remained independently associated with both markers after adjustment for relevant covariates.

Conclusions:

Parental smoking is associated with early atherosclerotic changes in children, demonstrated by increased carotid intima-media thickness and epicardial adipose tissue thickness, independent of traditional cardiovascular risk factors.

Keywords

parental smokingatherosclerosisepicardial adipose tissuecarotid intima-media

Information

Type
Original Article
Information
Cardiology in the Young , Volume 36 , Issue 2 , February 2026 , pp. 285 - 293
Check for updates
Copyright
© The Author(s), 2026. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Gülel, O. Kardiyovasküler risk faktörleri. J Exp Clin Med 2013; 29: S107–S116.CrossRefGoogle Scholar
Mallika, V, Goswami, B, Rajappa, M. Atherosclerosis pathophysiology and the role of novel risk factors: a clinicobiochemical perspective. Angiology 2007; 58: 513–522.CrossRefGoogle ScholarPubMed
Li, Y, Wang, D, Wang, Y et al. Impact of parental smoking on adipokine profiles and cardiometabolic risk factors in chinese children. Atherosclerosis 2020; 301: 23–29.CrossRefGoogle ScholarPubMed
Raghuveer, G, White, DA, Hayman, LL et al. Cardiovascular consequences of childhood secondhand tobacco smoke exposure: prevailing evidence, burden, and racial and socioeconomic disparities: a scientific statement from the American heart association. Circulation 2016; 134: e336–e359.CrossRefGoogle ScholarPubMed
Jaddoe, VWV, de Ridder, MAJ, van den Elzen, APM, Hofman, A, Uiterwaal, CSPM, Witteman, JCM. Maternal smoking in pregnancy is associated with cholesterol development in the offspring: A. 27-years follow-up study. Atherosclerosis 2008; 196: 42–48.CrossRefGoogle ScholarPubMed
Geerts, CC, Bots, ML, Grobbee, DE, Uiterwaal, CSPM. Parental smoking and vascular damage in young adult offspring: is early life exposure critical? The atherosclerosis risk in young adults study. Arterioscler Thromb Vasc Biol 2008; 28: 2296–2302.CrossRefGoogle Scholar
Oken, E, Levitan, EB, Gillman, MW. Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis. Int J Obesity 2008; 32: 201–210.CrossRefGoogle ScholarPubMed
Pan, A, Wang, Y, Talaei, M, Hu, FB, Wu, T. Relation of active, passive, and quitting smoking with incident type 2 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015; 3: 958–967.CrossRefGoogle ScholarPubMed
Somm, E, Schwitzgebel, VM, Vauthay, DM et al. Prenatal nicotine exposure alters early pancreatic islet and adipose tissue development with consequences on the control of body weight and glucose metabolism later in life. Endocrinology 2008; 149: 6289–6299.CrossRefGoogle ScholarPubMed
Thomas, C, Hyppönen, E, Power, C. Prenatal exposures and glucose metabolism in adulthood are effects mediated through birth weight and adiposity? Diabetes care 2007; 30: 918–924.CrossRefGoogle ScholarPubMed
Pardo, IMCG, Geloneze, B, Tambascia, MA, Barros, AA. Inverse relationship between cord blood adiponectin concentrations and the number of cigarettes smoked during pregnancy. Diabetes Obes Metab 2005; 7: 144–147.CrossRefGoogle ScholarPubMed
West, HW, Juonala, M, Gall, SL et al. Exposure to parental smoking in childhood is associated with increased risk of carotid atherosclerotic plaque in adulthood: the cardiovascular risk in young finns study. Circulation 2015; 131: 1239–1246.CrossRefGoogle ScholarPubMed
Gall, S, Huynh, QL, Magnussen, CG et al. Exposure to parental smoking in childhood or adolescence is associated with increased carotid intima-media thickness in young adults: evidence from the cardiovascular risk in young finns study and the childhood determinants of adult health study. Eur Heart J 2014; 35: 2484–2491.CrossRefGoogle ScholarPubMed
Lau, WB, Ohashi, K, Wang, Y et al. Role of adipokines in cardiovascular disease. Circ J 2017; 81: 920–928.CrossRefGoogle ScholarPubMed
Scheja, L, Heeren, J. The endocrine function of adipose tissues in health and cardiometabolic disease. Nat Rev Endocrinol 2019; 15(9): 507–524.CrossRefGoogle ScholarPubMed
Juonala, M, Magnussen, CG, Venn, A et al. Parental smoking in childhood and brachial artery flow-mediated dilation in young adults: the cardiovascular risk in young Finns study and the childhood determinants of adult health study. Arterioscler Thromb Vasc Biol 2012; 32(4): 1024–1031.CrossRefGoogle Scholar
Neyzi, O, Bundak, R, Gökçay, G et al. Reference values for weight, height,head circumference, and body mass index in turkish children. J Clin Res Pediatr Endocrinol 2015; 7: 280–293.CrossRefGoogle ScholarPubMed
Sabuncu, T, Bayram, F, Kıyıcı, S et al. Obezite Tanı ve Tedavi Klavuzu. In Türkiye Endokrinoloji ve Metabolizma Derneği, 2019.Google Scholar
Hatipoglu, N, Mazicioglu, MM, Poyrazoglu, S, Borlu, A, Horoz, D, Kurtoglu, S. Waist circumference percentiles among turkish children under the age of 6 years. Eur J Pediatr 2013; 172: 59–69.CrossRefGoogle ScholarPubMed
Öztürk, A, Çiçek, B, Mazıcıoğlu, MM, Zararsız, G, Kurtoğlu, S. Wrist circumference and frame size percentiles in 6-17-year-old turkish children and adolescents in Kayseri. J Clin Res Pediatr Endocrinol 2017; 9: 329–336.CrossRefGoogle ScholarPubMed
Falkner, B, Daniels, SD, Flynn, JT et al. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics 2004; 114 (Supplement_2): 555–576.Google Scholar
Bayram, F, Satman, İ., Sabuncu, T et al. Dislipidemi Tanı ve Tedavi Klavuzu. Türkiye Endokrinoloji ve Metabolizma Derneği, 2021.Google Scholar
Stein, JH, Korcarz, CE, Hurst, RT et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American society of echocardiography carotid intima-media thickness task force. endorsed by the society for vascular medicine. J Am Soc Echocardiogr 2008; 21: 93–111.CrossRefGoogle Scholar
Stocker, R, Keaney, JF. Role of oxidative modifications in atherosclerosis. Physiol Rev 2004; 84: 1381–1478.CrossRefGoogle ScholarPubMed
Kallio, K, Jokinen, E, Raitakari, OT et al. Tobacco smoke exposure is associated with attenuated endothelial function in 11-year-old healthy children. Circulation 2007; 115: 3205–3212.CrossRefGoogle ScholarPubMed
Lamotte, C, Iliescu, C, Libersa, C, Gottrand, F. Increased intima-media thickness of the carotid artery in childhood: a systematic review of observational studies. Eur J Pediatr 2011; 170: 719–729.CrossRefGoogle ScholarPubMed
Dratva, J, v., Breton C, Hodis, HN et al. Birth weight and carotid artery intima-media thickness. J Pediatr 2013; 162: 906–911.e2.CrossRefGoogle ScholarPubMed
Berenson, GS, Srinivasan, SR, Bao, W, Newman, WP, Tracy, RE, Wattigney, WA. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. N Engl J Med 1998; 338: 1650–1656.CrossRefGoogle ScholarPubMed
Iacobellis, G, Barbaro, G. The double role of epicardial adipose tissue as pro- and anti-inflammatory organ. Horm Metab Res 2008; 40: 442–445.CrossRefGoogle ScholarPubMed
Iacobellis, G, Ribaudo, MC, Assael, F et al. Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk. J Clin Endocrinol Metab 2003; 88: 5163–5168.CrossRefGoogle ScholarPubMed
Gastaldelli, A, Basta, G. Ectopic fat and cardiovascular disease: what is the link? Nutr Metab Cardiovasc Dis 2010; 20: 481–490.CrossRefGoogle ScholarPubMed
Gać, P, Czerwińska, K, Poręba, M, Macek, P, Mazur, G, Poręba, R. Environmental tobacco smoke exposure estimated using the SHSES scale and epicardial adipose tissue thickness in hypertensive patients. Cardiovasc Toxicol 2021; 21: 79–87.CrossRefGoogle ScholarPubMed
Lu, Y, Wang, T, Zhan, R et al. Effects of epicardial adipose tissue volume and density on cardiac structure and function in patients free of coronary artery disease. Jpn J Radiol 2020; 38: 666–675.CrossRefGoogle ScholarPubMed
Nagel, G, Arnold, FJ, Wilhelm, M, Link, B, Zoellner, I, Koenig, W. Environmental tobacco smoke and cardiometabolic risk in young children: results from a survey in south-west Germany. Eur Heart J 2009; 30(15): 1885–1893.CrossRefGoogle Scholar
Kong, AP, Wing, YK, Choi, KC et al. Associations of sleep duration with obesity and serum lipid profile in children and adolescents. Sleep Med 2011; 12: 659–665.CrossRefGoogle ScholarPubMed
Navarro-Solera, M, Carrasco-Luna, J, Pin-Arboledas, G, González-Carrascosa, R, Soriano, JM, Codoñer-Franch, P. Short sleep duration is related to emerging cardiovascular risk factors in obese children. J Pediatr Gastroenterol Nutr 2015; 61: 571–576.CrossRefGoogle ScholarPubMed
Grandner, MA, Alfonso-Miller, P, Fernandez-Mendoza, J, Shetty, S, Shenoy, S, Combs, D. Sleep: important considerations for the prevention of cardiovascular disease. Curr Opin Cardiol 2016; 31: 551–565.CrossRefGoogle ScholarPubMed
Hausberg, M, Mark, AL, Winniford, MD, Brown, RE, Somers, VK. Sympathetic and vascular effects of short-term passive smoke exposure in healthy nonsmokers. Circulation 1997; 96: 282–287.Google ScholarPubMed
Weitzman, M, Cook, S, Auinger, P et al. Tobacco smoke exposure is associated with the metabolic syndrome in adolescents. Circulation 2005; 112: 862–869.CrossRefGoogle ScholarPubMed
Özcan, BM. Sosyo ekonomik durum ve sigara İçme davranışı arasındaki İlişki. Ekev Akademi Dergisi 2018; 22(73): 505–514.Google Scholar
Kaneita, Y, Yokoyama, E, Miyake, T et al. Epidemiological study on passive smoking among Japanese infants and smoking behavior of their respective parents: a nationwide cross-sectional survey. Prev Med 2006; 42: 210–217.CrossRefGoogle ScholarPubMed
Kelishadi, R, Noori, A, Qorbani, M et al. Are active and passive smoking associated with cardiometabolic risk factors in adolescents? The CASPIAN-III Study 2016; 36: 181–188.Google ScholarPubMed