Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands.
J Hypertens. 2011 Nov;29(11):2201-9. doi: 10.1097/HJH.0b013e32834b0ecf.
To investigate the associations between smoking in adolescence and adulthood, and changes in smoking behaviour between these age periods, with arterial stiffness in young adults; and whether any such associations could be explained by concomitant smoking-related levels of inflammation and endothelial dysfunction.
We studied 424 individuals (216 women) in whom smoking status was assessed in adolescence (age 15 years) and again in young adulthood (mean age of 22.6 ± 1.6 years), along with aorto-iliac, aorto-radial, and aorto-dorsalis pedis pulse wave velocity (PWV), and markers of inflammation (i.e. C-reactive protein and fibrinogen) and endothelial dysfunction (i.e. von Willebrand factor and tissue-plasminogen activator antigen) in young adulthood only.
Smoking in adolescence was associated with higher aorto-iliac PWV, as well as with inflammation and endothelial dysfunction levels (expressed as two scores), independently of other adolescent and adult lifestyles. Compared with never smokers, continuing smokers, but not starters nor quitters, showed higher aorto-iliac PWV, independent of changes in other lifestyle variables: +0.157 m/s (95% confidence interval 0.026-0.288). This difference was attenuated to 0.124 m/s (-0.009 to 0.257) after adjustment for changes in traditional biological risk factors, but was not materially affected when adjusted for the inflammation and endothelial dysfunction scores, despite the continuing smoking-related higher levels of inflammation and endothelial dysfunction. Smoking was not associated with aorto-radial and aorto-dorsalis pedis PWV.
Starting to smoke in adolescence and continuing to do so up to young adulthood is adversely associated with aortic stiffness. The continuing smoking-related aortic stiffness was not explained by concomitant higher inflammation and endothelial dysfunction. Prevention of smoking should target the young to prevent arterial stiffness in young adults.
探讨青少年和成年期吸烟行为以及这两个年龄段之间吸烟行为的变化与年轻人动脉僵硬度之间的关系；以及这些关联是否可以通过同时存在的与吸烟相关的炎症和内皮功能障碍水平来解释。
我们研究了 424 名个体（216 名女性），他们在青少年时期（15 岁）和青年时期（平均年龄 22.6 ± 1.6 岁）评估了吸烟状况，同时还评估了主动脉髂、主动脉桡和主动脉-足背脉搏波速度（PWV），以及炎症标志物（即 C 反应蛋白和纤维蛋白原）和内皮功能障碍标志物（即血管性血友病因子和组织型纤溶酶原激活物抗原）仅在青年时期。
青少年时期吸烟与较高的主动脉髂 PWV 以及炎症和内皮功能障碍水平（表示为两个分数）独立于其他青少年和成年期生活方式有关。与从不吸烟者相比，继续吸烟者而非开始吸烟者或戒烟者，显示出更高的主动脉髂 PWV，独立于其他生活方式变量的变化：+0.157 m/s（95%置信区间 0.026-0.288）。调整传统生物学危险因素变化后，这一差异缩小至 0.124 m/s（-0.009 至 0.257），但在调整炎症和内皮功能障碍评分后，差异并未明显改变，尽管持续的吸烟与更高的炎症和内皮功能障碍有关。吸烟与主动脉桡和主动脉-足背 PWV 无关。
青少年开始吸烟并持续到成年期与主动脉僵硬度呈负相关。持续的与吸烟相关的主动脉僵硬度不能通过同时存在的更高的炎症和内皮功能障碍来解释。预防吸烟应针对年轻人，以预防年轻人的动脉僵硬度。
