A new study shows that teenagers exposed to tobacco smoke, even if they aren't smokers themselves, are more likely to develop a condition that leads to heart disease and diabetes.

The report, published this week in the journal Circulation, finds a correlation between secondhand smoke and metabolic syndrome, a condition characterized by obesity, high blood pressure, high cholesterol, and abnormal insulin levels.

Researchers from the University of Rochester in New York examined data collected from more than 2,200 kids ages 12 to 19 as part of the Centers for Disease Control and Prevention's National Health and Nutrition Examination Survey.

Among adolescents who had no exposure to tobacco smoke, only 1.2 percent fit the criteria for metabolic syndrome. But for those exposed to secondhand smoke, the rate was 5.4 percent, and among kids who were active smokers, 8.7 percent had the condition.

These results could have grim implications for Georgia, where one in four adults is a smoker and two-thirds of adults are overweight or obese.

Stephen Cook, a New York pediatrician and internist who co-authored the study, said kids who are already developing metabolic syndrome may be looking at a lifetime of poor health.

"It's very scary," he said. "Metabolic syndrome predates diabetes by about 10 years and heart disease by about 15 years."

That means by the time these children are in their 20s or 30s, they could end up in the offices of doctors like Mitch Davis, a cardiologist at Northeast Georgia Heart Center in Gainesville.

"Metabolic syndrome is very common among my patients," he said. "It's a substantial risk factor for heart disease."

Davis said he was not surprised to hear that the syndrome is associated with secondhand smoke. "Even if you're not the person who's smoking, your lungs are still getting the byproducts of a burning cigarette," he said.

In the study, researchers measured blood levels of cotinine, a chemical that nicotine converts to inside the body. Kids who spend a lot of time around smokers tend to have higher cotinine levels.

Cook said nicotine appears to be responsible for triggering metabolic syndrome. "Nicotine causes damage along multiple physiological pathways," he said. "It raises lipid (blood fat) levels, and it worsens insulin resistance."

Many teenage girls take up smoking to control their weight, but Cook said that strategy may backfire.

"Smoking does help some people lose weight, but it's counterproductive," he said. "Nicotine suppresses appetite, but it also reduces muscle mass and changes the location where your body stores fat."

In smokers, fat tends to collect around the abdomen. An unusually large waist measurement is a key feature of metabolic syndrome and greatly increases the risk of heart attack.

When a teenager gains weight around the abdomen, Cook said, doctors should consider that an early warning sign and check the patient's cholesterol, blood pressure and glucose levels.

"Unfortunately, there are no approved medications for metabolic syndrome in children," he said. "You have to treat the whole family with lifestyle changes."

Kristin Taylor, coordinator of chronic disease prevention at District 2 Public Health in Gainesville, is promoting the "Live Healthy Georgia" campaign that includes proper diet and exercise as well as avoidance of tobacco.

"Metabolic syndrome is a little difficult for people to understand," she said. "We'll continue to take a general approach to prevention that can have an impact on a number of chronic diseases."

Mamie Coker, director of health services for Hall County Schools, said she didn't know if school nurses would incorporate information about metabolic syndrome into their health programs.

"Adolescents think they're Superman, they're going to live forever," she said. "So we try to concentrate on the immediate negative effects of smoking rather than the long-term diseases."

Coker said the nurses do discuss secondhand smoke with the students, especially in light of Georgia's new law banning smoking in public places. But she worries that kids are still getting exposed to smoke in the place where they spend the most time: their own homes.

"When I ask kids if there is someone who often smokes in their house, usually about half the students in the class raise their hands," she said.

E-mail: dgilbert@gainesvilletimes.com

Originally published Friday, August 5, 2005