Document Type

Master's Culminating Experience

Publication Date



Background & Purpose: The childhood obesity epidemic is associated with increased metabolic syndrome (MetS) and cardiovascular morbidity. The purpose of this study was to determine whether secondhand tobacco smoke exposure (SHSe) is associated with MetS in children with elevated body mass index (BMI).

Method: A retrospective chart review was conducted on children aged six to 11 years with elevated BMI seen in a pediatric lipid clinic from 2008-2014. Data included age, sex, race, BMI, and five MetS criteria. MetS was defined as BMI ≥85th percentile and ≥two of the following: systolic or diastolic blood pressure ≥90th percentile, HDL/dL, triglycerides >150 mg/dL, fasting glucose >100 mg/dL, or fasting insulin ≥17 μIU/mL. Parents/guardians self-reported the number of smokers in the household; children were classified as SHSe+ if ≥one smokers resided in the household. Comparisons between exposed (SHSe+) and unexposed (SHSe-) were made with chi-square and Mann-Whitney tests. Adjusted odds ratios were determined with multiple logistic regression.

Results: Of 1,027 eligible patients, 514 had information for SHSe and MetS. Two hundred fifty-five patients (49.6%) lived with ≥one smokers. The prevalence of MetS was significantly higher in the SHSe+ group (54.1% vs. 31.3% SHSe- group, P

Conclusion: MetS is associated with secondhand smoke exposure in children. More efforts are needed to decrease SHSe, including increased physician screening pediatric patient exposure.

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