Woo K S, Chook P, Leong H C, Huang X S, Celermajer D S
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, People's Republic of China.
J Am Coll Cardiol. 2000 Oct;36(4):1228-32. doi: 10.1016/s0735-1097(00)00860-3.
The study evaluated whether heavy exposure to environmental tobacco smoke (passive smoking) might damage arterial function in modernized Chinese.
Heavy passive smoking is associated with arterial endothelial dysfunction in Caucasian, but not rural Chinese, subjects.
We studied 20 young (mean age 36.6 +/- 7.0 years) nonsmoking asymptomatic casino workers (9 men) in Macau who were exposed to environmental tobacco smoke for over 8 h/day for at least two years and 20 normal subjects (control subjects). These two groups were carefully matched for age, gender, body mass index (BMI), blood pressure, vessel diameter, cholesterol and glucose levels. Brachial artery diameter was measured by high-resolution B-mode ultrasound at rest, after flow increase (causing flow-mediated endothelium-dependent dilation) and after sublingual nitroglycerin (an endothelium-independent dilator).
Flow-mediated dilation (mean +/- SD% of diameter changes) was significantly lower in passive smokers (6.6 +/- 3.4%) compared with the controls (10.6 +/- 2.3%) (p < 0.0001). Nitroglycerin-induced dilation of the two groups were similar. Upon multivariate analysis, passive smoking exposure was the strongest independent predictor (beta = -0.59; p = 0.0001) for impaired flow-mediated endothelium-dependent dilation (model R2 = 0.75, F value = 6.1, p = 0.0001).
In modernized Chinese, as in Caucasians, exposure to heavy environmental tobacco smoke causes arterial endothelial dysfunction, a key early event in atherosclerosis. This may have serious implications for cardiovascular health in China, currently in a process of rapid modernization.
本研究评估了重度暴露于环境烟草烟雾（被动吸烟）是否会损害现代化进程中的中国人的动脉功能。
重度被动吸烟与白种人而非中国农村受试者的动脉内皮功能障碍有关。
我们研究了20名年轻（平均年龄36.6±7.0岁）、不吸烟且无症状的澳门赌场工作人员（9名男性），他们每天暴露于环境烟草烟雾中超过8小时，至少持续两年，以及20名正常受试者（对照组）。这两组在年龄、性别、体重指数（BMI）、血压、血管直径、胆固醇和血糖水平方面进行了仔细匹配。通过高分辨率B型超声在静息状态下、血流增加后（引起血流介导的内皮依赖性舒张）以及舌下含服硝酸甘油后（一种非内皮依赖性舒张剂）测量肱动脉直径。
被动吸烟者的血流介导舒张（直径变化的平均值±标准差%）（6.6±3.4%）显著低于对照组（10.6±2.3%）（p<0.0001）。两组硝酸甘油诱导的舒张相似。多变量分析显示，被动吸烟暴露是血流介导的内皮依赖性舒张受损的最强独立预测因素（β=-0.59；p=0.0001）（模型R2=0.75，F值=6.1，p=0.0001）。
与白种人一样，在现代化进程中的中国人中，暴露于重度环境烟草烟雾会导致动脉内皮功能障碍，这是动脉粥样硬化的一个关键早期事件。这可能对目前正处于快速现代化进程中的中国心血管健康产生严重影响。
