PASSIVE CIGARETTE-SMOKING AND REDUCED HDL CHOLESTEROL LEVELS IN CHILDREN WITH HIGH-RISK LIPID PROFILES

Background HDL cholesterol levels are known to be lower in smokers tha n in nonsmokers. Previous studies have demonstrated an association of decreased HDL cholesterol with passive smoking in children but have no t adjusted for potential confounding factors. Methods and Results In a cross-sectional, pilot-scale study, we examined the relationship of H DL cholesterol levels to passive smoking in children and adolescents r eferred to a tertiary hyperlipidemia clinic. Eligibility criteria incl uded (1) first visit to a lipid clinic, (2) LDL cholesterol >95th perc entile for age or HDL cholesterol <5th percentile, (3) age between 2 a nd 18 years, and (4) absence of secondary causes of hyperlipidemia. So ciodemographic information, diet record, medical history, and fasting lipid profiles were obtained. Of 109 eligible patients, 103 (94%) were studied. Twenty-seven percent came from households with cigarette smo kers. HDL cholesterol levels were 38.7+/-1.2 mg/dL (mean+/-SEM) in pas sive smokers versus 43.6+/-1.2 mg/dL in children without smoke exposur e (P=.005). Smoking exposure was not significantly associated with oth er lipid values. The effect of smoking on HDL cholesterol was minimall y affected by potential confounders. In multivariate regression adjust ing for body mass index, age, sex, exercise, and dietary fat intake, p assive smoking remained a significant risk factor for decreased HDL ch olesterol (P=.012). Conclusions Mean HDL cholesterol levels are lower in dyslipidemic children from households with smokers than in those wi thout household smoke exposure. Passive smoking may worsen the risk pr ofile for later atherosclerosis among high-risk young persons.