gms | German Medical Science

MAINZ//2011: 56. GMDS-Jahrestagung und 6. DGEpi-Jahrestagung

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V.
Deutsche Gesellschaft für Epidemiologie e. V.

26. - 29.09.2011 in Mainz

Prenatal and postnatal tobacco smoke exposure and development of insulin resistance in 10 year old children

Meeting Abstract

  • Elisabeth Thiering - Helmholtz Zentrum München, Neuherberg
  • Irene Brüske - Helmholtz Zentrum München, Neuherberg
  • Jürgen Kratzsch - Universitätsklinikum Leipzig, Leipzig
  • Joachim Thiery - Universitätsklinikum Leipzig, Leipzig
  • Christine Meisinger - Helmholtz Zentrum München, München
  • Sybille Koletzko - Ludwig-Maximilians Universität, München
  • Carl-Peter Bauer - Technische Universität, München
  • Stefanie Sausenthaler - Helmholtz Zentrum München, Neuherberg
  • Andrea von Berg - Marien-Hospital Wesel, Wesel
  • Dietrich Berdel - Marien-Hospital Wesel, Wesel
  • Irina Lehmann - UFZ, Leipzig
  • Olf Herbarth - Universität Leipzig, Leipzig
  • Ursula Krämer - IUF, Düsseldorf
  • H.-Erich Wichmann - Helmholtz Zentrum München, Neuherberg
  • Joachim Heinrich - Helmholtz Zentrum München, Neuherberg

Mainz//2011. 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi). Mainz, 26.-29.09.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11gmds265

doi: 10.3205/11gmds265, urn:nbn:de:0183-11gmds2651

Published: September 20, 2011

© 2011 Thiering et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: In this study, we evaluated the association between prenatal and postnatal exposure to environmental tobacco smoke and the development of insulin resistance in 10 year old children.

Material and methods: Fasting blood samples were collected from 470 children participating in two prospective birth cohorts. Of those 276 were selected population based and enriched with 194 children exceeding the 85th percentile of body mass index in this age group. Children already having diabetes type 1 or 2 at the age of 10 years were excluded. Fasting blood insulin and glucose levels and calculated HOMA index for insulin resistance assessment were analysed using generalised additive models. Potential confounders were adjusted for.

Results: Insulin resistance was increased by 24 % in children frequently exposed to environmental tobacco smoke during childhood (MRadj=1.24, p=0.001), while glucose levels were not. Exclusion of prenatally exposed children did not attenuate the association (MRadj=1.25, p=0.006). After stratification, the effect sizes were identical within overweight children and the population based sample of children. Insulin resistance and insulin levels were increasing with increasing numbers of cigarettes smoked in children’s home. Maternal smoking during the third trimester of pregnancy increased children’s insulin levels (MRadj=1.19, p=0.037), and even more so, if children were exclusively breastfed after birth (MRadj=1.31, p=0.016). Increased mean ratios were found for smoking of a third person in addition to maternal smoking.

Conclusion: Positive dose-dependent associations and independent effects of postnatal exposure suggest involvement of environmental tobacco smoke in the risk for development of insulin resistance in children.