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Baker-Smith CM. Tracking of blood pressure levels from childhood. Pediatr Nephrol 2024:10.1007/s00467-024-06485-4. [PMID: 39196350 DOI: 10.1007/s00467-024-06485-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 08/29/2024]
Abstract
The overall goal of this review is to summarize what is currently known regarding the tracking of blood pressure levels from early childhood into later adulthood and to describe the factors contributing to increased hypertension prevalence across the lifespan. This review describes 4 theoretical constructs of blood pressure trajectory across the lifespan: forward development, forward tracking, forward reversal, and maintenance of normal blood pressure levels.
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Affiliation(s)
- Carissa M Baker-Smith
- Nemours Center for Cardiovascular Research and Innovation, Nemours Cardiac Center, Nemours Children's Health, Preventive Cardiology Program, 1600 Rockland Road, Wilmington, DE, 19803, USA.
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McGehee DL, Saben JL, Sims CR, Turner D, Thakali KM, Diaz EC, Sobik SR, Edwards T, Krukowski RA, Williams DK, Børsheim E, Andres A. Childhood cardiometabolic risk factors associated with the perinatal environment of the maternal-paternal-child triad. Pediatr Obes 2024:e13162. [PMID: 39183454 DOI: 10.1111/ijpo.13162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/05/2024] [Accepted: 07/29/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION Clustering of cardiometabolic risk factors in childhood significantly increases the risk of atherosclerotic cardiovascular disease later in life. Identification of modifiable parental factors that contribute to offspring cardiometabolic health is critical for the prevention of disease. The objective was to identify factors associated with child cardiometabolic risk factors at age 5 years. METHODS Triads from a longitudinal cohort were recalled at 5 years (n = 68). Dietary intake, anthropometrics, physical activity and serum-based risk factors were collected. Best subset selection, linear and logistic regressions were used to identify triad variables associated with increased risk of cardiometabolic risk factor clustering at age 5 years. RESULTS In this cohort, best subset modelling revealed that increased paternal fat mass, serum low-density lipoproteins and triglycerides, maternal dietary added sugar and being female were associated with increased odds of offspring having two or more cardiometabolic risk factors at age 5 years. CONCLUSIONS Dietary and exercise interventions prior to conception targeting paternal adiposity and dyslipidaemia as well as maternal dietary habits could decrease children's cardiometabolic risk in later life.
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Affiliation(s)
- Diamond L McGehee
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | | | - Clark R Sims
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Donald Turner
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
| | - Keshari M Thakali
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Eva C Diaz
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | - Sarah R Sobik
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Timothy Edwards
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | | | - D Keith Williams
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Elisabet Børsheim
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
| | - Aline Andres
- Arkansas Children's Nutrition Center, Little Rock, Arkansas, USA
- Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Arkansas Children's Research Institute, Little Rock, Arkansas, USA
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3
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Holthaus E, O'Neill M, Jeske W, DeChristopher P, Goodman J, Glynn L, Levin S, Muraskas J. Endocan: A biomarker for endothelial dysfunction and inflammation, linking maternal obesity and pediatric obesity in a cohort of preterm neonates. Eur J Obstet Gynecol Reprod Biol 2024; 297:132-137. [PMID: 38626514 DOI: 10.1016/j.ejogrb.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVES Numerous animal and epidemiologic studies have demonstrated a positive association between maternal obesity in pregnancy and obesity in offspring. The biologic mechanisms of this association remain under investigation. One proposed mechanism includes fetoplacental endothelial dysfunction secondary to inflammation. Endocan is a relatively new biomarker for endothelial dysfunction and inflammation. Our objectives were to examine (1) the association between maternal obesity and neonatal serum endocan at birth, and (2) the association between neonatal serum endocan at birth and pediatric obesity at 24-36 months of age. STUDY DESIGN This was a secondary analysis of a prospective cohort of neonates born < 33 weeks gestation. Serum endocan was collected within 48 hours of birth. Serum endocan levels were compared in neonates born to obese mothers vs. those born to non-obese mothers. BMI data were retrospectively collected from cohort neonates between 24 and 36 months of age. RESULTS The analysis included 120 mother/neonate dyads. Neonates born to obese mothers had higher median serum endocan at birth compared to neonates born to non-obese mothers (299 ng/L [205-586] vs. 251 ng/L [164-339], p = 0.045). In a linear regression modeled on neonatal serum endocan level, maternal obesity had a statistically significant positive association (p = 0.021). Higher mean serum endocan level at birth was associated with pediatric obesity between 24 and 36 months (obese vs. non-obese offspring; 574 ng/L (222) vs. 321 ng/L (166), p = 0.005). CONCLUSIONS In our cohort of preterm neonates, elevated serum endocan at birth was associated with both maternal obesity and downstream pediatric obesity. More research is needed to understand intergenerational transmission of obesity. A large focus has been on epigenetic modification. Endothelial dysfunction and inflammation may play important roles in these pathways. Effective biomarkers, including endocan, may also serve as intermediate outcomes in future pregnancy research.
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Affiliation(s)
- E Holthaus
- Maternal Fetal Medicine, Loyola University Medical Center, 2160 S. 1(st) Ave, Maywood, IL 60153, USA.
| | - M O'Neill
- Loyola University Stritch School of Medicine, 2160 S. 1(st) Ave, Maywood, IL 60153, USA
| | - W Jeske
- Thoracic and Cardiovascular Surgery, Cell and Molecular Physiology, Loyola University Chicago, 2160 S. 1(st) Ave, Maywood, IL 60153, USA
| | - P DeChristopher
- Pathology and Laboratory Medicine, Transfusion Medicine. Loyola University Medical Center, 2160 S. 1(st) Ave, Maywood, IL 60153, USA
| | - J Goodman
- Maternal Fetal Medicine, University of Missouri School of Medicine, MU Women's Hospital, 404 N Keene St, Columbia, MO 65201, USA
| | - L Glynn
- Pediatric Surgery, NYU Langone Hospital, 120 Mineola Blvd, Suite 210, Mineola, NY 11501, USA
| | - S Levin
- Neonatal Perinatal. University of Oklahoma College of Medicine, 1200 North Everett Drive, ETNP 7504, Oklahoma City, OK, 73104, USA
| | - J Muraskas
- Neonatal-Perinatal Research, Neonatology, Loyola University Medical Center, 2160 S. 1(st) Ave, Maywood, IL 60153, USA
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4
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Horta BL, Coca KP, Desai M, Dias MS, B Jaccottet M, Ross MG. Breastfeeding moderates the association of maternal pre-pregnancy nutritional status with offspring body composition at 30 years. J Dev Orig Health Dis 2024; 15:e3. [PMID: 38487898 DOI: 10.1017/s2040174424000047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Maternal pre-pregnancy body mass index is positively associated with offspring obesity, even at adulthood, whereas breastfeeding decreases the risk of obesity. The present study was aimed at assessing whether breastfeeding moderates the association of maternal pre-pregnancy body mass index with offspring body composition at adulthood, using data from 3439 subjects enrolled in a southern Brazilian birth cohort. At 30 years of age, maternal pre-pregnancy body mass index was positively associated with offspring prevalence of obesity, abdominal obesity, as well as body mass index and fat and lean mass index. Breastfeeding moderated the association of maternal pre-pregnancy obesity with offspring adiposity at 30 years of age. For those breastfed<6 months, body mass index was 4.13 kg/m2 (95% confidence interval: 2.98; 5.28) higher among offspring of obese mothers, in relation to offspring of normal weight mothers, whereas among those breastfed≥6 months the magnitude of the difference was small [2.95 kg/m2 (95% confidence interval: 1.17; 4.73)], p-value for interaction = 0.03. Concerning obesity, among those who had been breastfed < 6 months, the prevalence of obesity was 2.56 (95% confidence interval: 1.98; 3.31) times higher among offspring of obese mothers. On the other hand, among those who were breastfed ≥ 6 months, the prevalence of obesity was 1.82 (95% confidence interval: 1.09; 3.04) times higher among offspring of obese mothers. Therefore, among overweight mothers breastfeeding for more than 6 months should be supported, as it may mitigate the consequences of maternal overweight on offspring body composition.
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Affiliation(s)
- Bernardo L Horta
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Kelly P Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Mina Desai
- Perinatal Research Laboratory, The Lundquist Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Mariane S Dias
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Manoella B Jaccottet
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Michael G Ross
- Perinatal Research Laboratory, The Lundquist Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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Skowronski AA, Leibel RL, LeDuc CA. Neurodevelopmental Programming of Adiposity: Contributions to Obesity Risk. Endocr Rev 2024; 45:253-280. [PMID: 37971140 PMCID: PMC10911958 DOI: 10.1210/endrev/bnad031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/29/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023]
Abstract
This review analyzes the published evidence regarding maternal factors that influence the developmental programming of long-term adiposity in humans and animals via the central nervous system (CNS). We describe the physiological outcomes of perinatal underfeeding and overfeeding and explore potential mechanisms that may mediate the impact of such exposures on the development of feeding circuits within the CNS-including the influences of metabolic hormones and epigenetic changes. The perinatal environment, reflective of maternal nutritional status, contributes to the programming of offspring adiposity. The in utero and early postnatal periods represent critically sensitive developmental windows during which the hormonal and metabolic milieu affects the maturation of the hypothalamus. Maternal hyperglycemia is associated with increased transfer of glucose to the fetus driving fetal hyperinsulinemia. Elevated fetal insulin causes increased adiposity and consequently higher fetal circulating leptin concentration. Mechanistic studies in animal models indicate important roles of leptin and insulin in central and peripheral programming of adiposity, and suggest that optimal concentrations of these hormones are critical during early life. Additionally, the environmental milieu during development may be conveyed to progeny through epigenetic marks and these can potentially be vertically transmitted to subsequent generations. Thus, nutritional and metabolic/endocrine signals during perinatal development can have lifelong (and possibly multigenerational) impacts on offspring body weight regulation.
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Affiliation(s)
- Alicja A Skowronski
- Division of Molecular Genetics, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
- Naomi Berrie Diabetes Center, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Rudolph L Leibel
- Division of Molecular Genetics, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
- Naomi Berrie Diabetes Center, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Charles A LeDuc
- Division of Molecular Genetics, Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY 10032, USA
- Naomi Berrie Diabetes Center, Columbia University Irving Medical Center, New York, NY 10032, USA
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Ruiz OA, Ancira-Moreno M, Omaña-Guzmán I, Cordero SH, Morales ACB, Navarro CP, Méndez SB, Flores EM, Trejo A, Kaufer-Horwitz M, Cajero A, Sánchez B, Bernat C, Salgado-Amador E, Hoyos-Loya E, Mazariegos M, Manrique CM, Cruz RP, Mendoza E, Brero M, Sachse M, Armijo FC. Low quality of maternal and child nutritional care at the primary care in Mexico: an urgent call to action for policymakers and stakeholders. Int J Equity Health 2024; 23:35. [PMID: 38388936 PMCID: PMC10885649 DOI: 10.1186/s12939-024-02129-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/10/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Maternal and child malnutrition represents a public health problem in Mexico Primary care (PC) is responsible for introducing women and children under five to the health system, detecting diseases on time, and providing medical services, including pharmacological treatment if necessary. Providing these services with quality is essential to improve maternal and child health. This study evaluated the quality of nutritional care during preconception, pregnancy, postpartum, infancy, and preschool age at the PC health units across six Mexican states between 2020 and 2021. METHODS We conducted a cross-sectional study with a mixed approach in units of the Secretary of Health to assess the quality of nutritional care during preconception, pregnancy, postpartum, childhood, and preschool age. The level of quality was calculated by the percentage of compliance with 16 indicators that integrated a Quality Index of Maternal and Child Nutritional Care (ICANMI, by its Spanish acronym). Compliance by indicator, by life stage, and overall was categorized using the following cut-off points: poor quality (≤ 70%), insufficient quality (71-89%), and good quality (≥ 90%). The perceptions of the barriers and facilitators that affect maternal and child nutrition were evaluated through semi-structured interviews with health professionals (HP) and users. All qualitative instruments were developed with a gender and intercultural perspective. RESULTS Considering the whole sample studied, maternal and child nutritional care quality during the five life stages evaluated was bad (compliance: ≤12%), reflected in the ICANMI, which had a compliance of 8.3%. Principal barriers identified to providing high-quality nutritional care were the lack of knowledge and training of health professionals, shortages of equipment, medicine, personnel, and materials, the disappearance of the social cash transfer program Prospera, the absence of local indigenous language translators to support communication between doctor and patient, and the persistence of machismo and other practices of control over women. CONCLUSIONS These findings underscore the need for initiatives to improve the quality of nutritional care in PC facilities across Chihuahua, State of Mexico, Veracruz, Oaxaca, Chiapas, and Yucatan. It is necessary for government and health authorities, along with various stakeholders, to collaboratively devise, implement, and assess intercultural and gender-oriented policies and programs geared towards ensuring the health infrastructure and enhancing the training of health professionals to diagnose and treat the prevalence and occurrence of diverse forms of malnutrition in both maternal and child populations.
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Affiliation(s)
- Omar Acosta Ruiz
- Center for Research in Evaluation and Surveys, National Institute of Public Health, Cuernavaca, Mexico
| | - Monica Ancira-Moreno
- Health Department, Universidad Iberoamericana, Mexico City, Mexico.
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico.
| | - Isabel Omaña-Guzmán
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
- Pediatric Obesity Clinic and Wellness Unit, Hospital General de México, "Dr. Eduardo Liceaga,", Mexico City, Mexico
| | - Sonia Hernández Cordero
- Research Center for Equitable Development EQUIDE, Universidad Iberoamericana, Mexico City, Mexico
| | | | | | - Soraya Burrola Méndez
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
| | - Eric Monterrubio Flores
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Alejandra Trejo
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Martha Kaufer-Horwitz
- Dirección de Nutrición, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Ariana Cajero
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Belén Sánchez
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Constanza Bernat
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Elder Salgado-Amador
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
| | - Elizabeth Hoyos-Loya
- Observatorio Materno Infantil (OMI), Universidad Iberoamericana, Mexico City, Mexico
| | - Mónica Mazariegos
- Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala
| | - Cinthya Muñoz Manrique
- Departamento de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Mexico City, Mexico
| | - Royer Pacheco Cruz
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
- Instituto de Nutrición, Universidad de la Sierra Sur, Oaxaca, México
| | - Elvia Mendoza
- Health Department, Universidad Iberoamericana, Mexico City, Mexico
| | - Mauro Brero
- United Nations International Children's Emergency Fund (UNICEF), Mexico City, México
| | - Matthias Sachse
- United Nations International Children's Emergency Fund (UNICEF), Mexico City, México
| | - Fernanda Cobo Armijo
- United Nations International Children's Emergency Fund (UNICEF), Mexico City, México
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Rallis D, Papathanasiou AE, Christou H. Maternal Obesity Modulates Cord Blood Concentrations of Proprotein Convertase Subtilisin/Kexin-type 9 Levels. J Endocr Soc 2024; 8:bvae031. [PMID: 38440108 PMCID: PMC10910593 DOI: 10.1210/jendso/bvae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Indexed: 03/06/2024] Open
Abstract
Context In utero exposure to maternal obesity or diabetes is considered a pro-inflammatory state. Objective To evaluate whether cord blood proprotein convertase subtilisin/kexin-type 9 (PCSK9), which is regulated by inflammation and metabolic derangements, is elevated in neonates born to overweight, obese, or diabetic mothers. Methods A retrospective study in full-term neonates born between 2010 and 2023, at Brigham and Women's Hospital. There were 116 neonates included in our study, of which 74 (64%) were born to overweight/obese mothers and 42 (36%) were born to nonoverweight/nonobese mothers. Results Neonates born to overweight/obese mothers had significantly higher cord blood concentrations of PCSK9 compared with neonates born to nonoverweight/nonobese group (323 [253-442] ng/mL compared with 270 [244-382] ng/mL, P = .041). We found no significant difference in cord blood concentrations of PCSK9 between neonates of diabetic mothers compared with neonates of nondiabetic mothers. In multivariate linear regression analysis, higher cord plasma PCSK9 concentration was significantly associated with maternal overweight/obesity status (b = 50.12; 95% CI, 4.02-96.22; P = .033), after adjusting for gestational age, birth weight, male sex, and intrauterine growth restriction. Conclusion Neonates born to mothers with overweight/obesity have higher cord blood PCSK9 concentrations compared with the nonoverweight/nonobese group, and higher cord blood PCSK9 concentrations were significantly associated with maternal overweight/obesity status, after adjusting for perinatal factors. Larger longitudinal studies are needed to examine the role of PCSK9 in the development of metabolic syndrome in high-risk neonates born to overweight, obese, or diabetic mothers.
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Affiliation(s)
- Dimitrios Rallis
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Neonatal Intensive Care Unit, University of Ioannina, Faculty of Medicine, Ioannina 45110, Greece
| | | | - Helen Christou
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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Lazarev A, Nath S, Nguyen CQ, Demian AM, Bertasi RAO, Bertasi TGO, Pujalte GGA. Sports and Weight Control in Children. Cureus 2024; 16:e53731. [PMID: 38455821 PMCID: PMC10919905 DOI: 10.7759/cureus.53731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2024] [Indexed: 03/09/2024] Open
Abstract
Pediatric obesity is a global concern with distressing comorbid conditions, including mood disturbance, cardiovascular changes, endocrine imbalance, liver disease, sleep apnea, and orthopedic conditions. The primary treatment of this condition includes physical activity. Participating in organized sports has been shown to reduce weight and the complications of pediatric obesity more effectively than individual exercise.
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Affiliation(s)
- Artemii Lazarev
- Internal Medicine, Mount Sinai Hospital Chicago, Chicago, USA
| | - Sahil Nath
- Family Medicine, Mayo Clinic, Jacksonville, USA
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Gómez-Vilarrubla A, Mas-Parés B, Carreras-Badosa G, Bonmatí-Santané A, Martínez-Calcerrada JM, Niubó-Pallàs M, de Zegher F, Ibáñez L, López-Bermejo A, Bassols J. DNA Methylation Signatures in Paired Placenta and Umbilical Cord Samples: Relationship with Maternal Pregestational Body Mass Index and Offspring Metabolic Outcomes. Biomedicines 2024; 12:301. [PMID: 38397903 PMCID: PMC10886657 DOI: 10.3390/biomedicines12020301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
An epigenomic approach was used to study the impact of maternal pregestational body mass index (BMI) on the placenta and umbilical cord methylomes and their potential effect on the offspring's metabolic phenotype. DNA methylome was assessed in 24 paired placenta and umbilical cord samples. The differentially methylated CpGs associated with maternal pregestational BMI were identified and the metabolic pathways and the potentially related diseases affected by their annotated genes were determined. Two top differentially methylated CpGs were studied in 90 additional samples and the relationship with the offspring's metabolic phenotype was determined. The results showed that maternal pregestational BMI is associated with the methylation of genes involved in endocrine and developmental pathways with potential effects on type 2 diabetes and obesity. The methylation and expression of HADHA and SLC2A8 genes in placenta and umbilical cord were related to several metabolic parameters in the offspring at 6 years (weight SDS, height SDS, BMI SDS, Δ BW-BMI SDS, FM SDS, waist, SBP, TG, HOMA-IR, perirenal fat; all p < 0.05). Our data suggest that epigenetic analysis in placenta and umbilical cord may be useful for identifying individual vulnerability to later metabolic diseases.
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Affiliation(s)
- Ariadna Gómez-Vilarrubla
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
| | - Berta Mas-Parés
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
| | - Gemma Carreras-Badosa
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
| | | | | | - Maria Niubó-Pallàs
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
| | - Francis de Zegher
- Department of Development & Regeneration, University of Leuven, 3000 Leuven, Belgium;
| | - Lourdes Ibáñez
- Endocrinology, Pediatric Research Institute, Sant Joan de Déu Children’s Hospital, 08950 Esplugues de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Health Institute Carlos III (ISCIII), 28029 Madrid, Spain
| | - Abel López-Bermejo
- Pediatric Endocrinology Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
- Department of Pediatrics, Dr. Josep Trueta Hospital, 17007 Girona, Spain
| | - Judit Bassols
- Maternal-Fetal Metabolic Research Group, Girona Institute for Biomedical Research (IDIBGI), 17190 Salt, Spain
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Ross MG, Kavasery MP, Cervantes MK, Han G, Horta B, Coca KP, Costa SO, Desai M. High-Fat, High-Calorie Breast Milk in Women with Overweight or Obesity and Its Association with Maternal Serum Insulin Concentration and Triglycerides Levels. CHILDREN (BASEL, SWITZERLAND) 2024; 11:141. [PMID: 38397253 PMCID: PMC10887191 DOI: 10.3390/children11020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
The childhood obesity epidemic continues to be a challenge. Maternal obesity and excessive infant weight gain are strong predictors of childhood obesity, which itself is a major risk factor for adult obesity. The primary source of nutrition during early life is breast milk, and its composition is impacted by maternal habitus and diet. We thus studied the relationship between maternal BMI, serum lipids and insulin, and breast milk fat and calorie content from foremilk to hindmilk. Women who were exclusively breastfeeding at 7-8 weeks postpartum were BMI classified as Normal (18.5-24.9, n = 9) and women with Overweight/Obese (OW/OB ≥ 25, n = 13). Maternal blood and continuous breast milk samples obtained from foremilk to hindmilk were analyzed, and infant milk intake was assessed. Women with OW/OB had significantly higher milk fat and calorie content in the first foremilk and last hindmilk sample as compared to Normal BMI women. Amongst all women, maternal serum triglycerides, insulin, and HOMA were significantly correlated with foremilk triglyceride concentration, suggesting that maternal serum triglyceride and insulin action contribute to human milk fat content. As the milk fat content of OW/OB women has caloric implications for infant growth and childhood obesity, these results suggest the potential for modulating milk fat content by a reduction in maternal serum lipids or insulin.
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Affiliation(s)
- Michael G. Ross
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
- Department of Obstetrics and Gynecology, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Manasa P. Kavasery
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - MacKenzie K. Cervantes
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Guang Han
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Bernardo Horta
- School of Medicine, Universidade Federal de Pelotas, Pelotas 96010-610, Brazil;
| | - Kelly P. Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo 04023-900, Brazil;
| | - Suleyma O. Costa
- Laboratory of Metabolic Disorders, School of Applied Sciences, University of Campinas, Campinas 13083-970, Brazil;
| | - Mina Desai
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
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11
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Kweon JY, Mun H, Choi MR, Kim HS, Ahn YJ. Maternal obesity induced metabolic disorders in offspring and myeloid reprogramming by epigenetic regulation. Front Endocrinol (Lausanne) 2024; 14:1256075. [PMID: 38292775 PMCID: PMC10824939 DOI: 10.3389/fendo.2023.1256075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Maternal obesity and gestational diabetes are associated with childhood obesity and increased cardiovascular risk. In this review, we will discuss and summarize extensive clinical and experimental studies that metabolically imbalanced environment exposure in early life plays a critical role in influencing later susceptibility to chronic inflammatory diseases and metabolic syndrome. The effect of maternal obesity and metabolic disorders, including gestational diabetes cause Large-for-gestational-age (LGA) children to link future development of adverse health issues such as obesity, atherosclerosis, hypertension, and non-alcoholic fatty liver disease by immune reprogramming to adverse micro-environment. This review also addresses intrauterine environment-driven myeloid reprogramming by epigenetic regulations and the epigenetic markers as an underlying mechanism. This will facilitate future investigations regarding maternal-to-fetal immune regulation and the epigenetic mechanisms of obesity and cardiovascular diseases.
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Affiliation(s)
- Joo Young Kweon
- Medical Science and Engineering, Graduate School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Hyeonji Mun
- Medical Science and Engineering, Graduate School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Myeong Ryeol Choi
- Medical Science and Engineering, Graduate School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang, Republic of Korea
| | - Hong Seok Kim
- Department of Molecular Medicine, College of Medicine, Inha University, Incheon, Republic of Korea
| | - Yong Joo Ahn
- Medical Science and Engineering, Graduate School of Convergence Science and Technology, Pohang University of Science and Technology, Pohang, Republic of Korea
- Department IT Convergence, Pohang University of Science and Technology, Pohang, Republic of Korea
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12
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Orós M, Lorenzo M, Serna MC, Siscart J, Perejón D, Salinas-Roca B. Obesity in Pregnancy as a Risk Factor in Maternal and Child Health-A Retrospective Cohort Study. Metabolites 2024; 14:56. [PMID: 38248859 PMCID: PMC10818803 DOI: 10.3390/metabo14010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 01/23/2024] Open
Abstract
The prevalence of overweight and obesity has risen dramatically in the last few years. This has led to an increase in both conditions in pregnant women. Obesity and overweight are associated with complications for both the mother and the newborn. The aim of this study is to determine the prevalence of obesity and its association with the risk of complications during pregnancy. Materials and Methods: We conducted a retrospective cohort study of pregnant women who delivered from 1 January 2012 to 31 December 2018. Results: A higher prevalence of obesity is observed in the group of women aged 35 or older. Women with a BMI > 25 present a higher risk of cesarean section (aOR 1.49, 95% CI: 1.37-1.61), preeclampsia (aOR 1.64, 95% CI: 1.19-2.26), high-risk pregnancy (aOR 2.34, 95% CI: 1.68-2.6), Apgar < 7 at one minute (aOR 1.53, 95% CI: 1.25-1.89) and macrosomia (aOR 2.08, 95% CI: 1.83-2.37). Maternal overweight and obesity are important determinants of the risk of complications for both the mother and the newborn.
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Affiliation(s)
- Miriam Orós
- Family Medicine Department, University of Lleida, 25003 Lleida, Spain; (J.S.); (D.P.)
- Miami Platja Health Center, Catalan Institute of Health, 43892 Tarragona, Spain
| | - Marta Lorenzo
- Family Medicine Department, University of Lleida, 25003 Lleida, Spain; (J.S.); (D.P.)
- Eixample Health Center, Institut Català de la Salut, 25003 Lleida, Spain
| | - María Catalina Serna
- Eixample Health Center, Institut Català de la Salut, 25003 Lleida, Spain
- School of Medicine, Lleida University, 25003 Lleida, Spain
| | - Júlia Siscart
- Family Medicine Department, University of Lleida, 25003 Lleida, Spain; (J.S.); (D.P.)
- Serós Health Center, Catalan Institute of Health, 25183 Lleida, Spain
| | - Daniel Perejón
- Family Medicine Department, University of Lleida, 25003 Lleida, Spain; (J.S.); (D.P.)
- Cervera Health Center, Catalan Institute of Health, 25200 Lleida, Spain
| | - Blanca Salinas-Roca
- Grow-Global Research on Wellbeing (GRoW) Research Group, Blanquerna School of Health Science, Ramon Llull University, Padilla, 326–332, 08025 Barcelona, Spain
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13
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Shrestha A, Dellett SK, Yang J, Sharma U, Ramalingam L. Effects of Fish Oil Supplementation on Reducing the Effects of Paternal Obesity and Preventing Fatty Liver in Offspring. Nutrients 2023; 15:5038. [PMID: 38140297 PMCID: PMC10745816 DOI: 10.3390/nu15245038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/30/2023] [Accepted: 12/02/2023] [Indexed: 12/24/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD) is a serious public health concern, which calls for appropriate diet/nutrition intervention. Fish oil (FO) has several benefits in reducing obesity, but its intergenerational role in reducing the effects of paternal obesity has not been established. Hence, we hypothesized that FO supplementation to an obese father during the pre-conceptional period could improve the metabolic health of the offspring, specifically in the liver. Three groups of male mice were fed with a low-fat (LF), high-fat (HF), or high-fat diet supplemented with FO (HF-FO) for 10 weeks and were then allowed to mate with female mice fed a chow diet. Offspring were sacrificed at 16 weeks. The liver tissue was harvested for genomic and histological analyses. The offspring of HF and HF-FO fathers were heavier compared to that of the LF mice during 9-16 weeks. The glucose tolerance of the offspring of HF-FO fathers were significantly improved as compared to the offspring of HF fathers. Paternal FO supplementation significantly lowered inflammation and fatty acid synthesis biomarkers and increased fatty acid oxidation biomarkers in the offspring liver. In summary, FO supplementation in fathers shows the potential to reduce metabolic and cardiovascular diseases through genetic means in offspring.
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Affiliation(s)
- Akriti Shrestha
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY 13244, USA; (A.S.); (S.K.D.); (J.Y.)
| | - Sarah Katherine Dellett
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY 13244, USA; (A.S.); (S.K.D.); (J.Y.)
| | - Junhui Yang
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY 13244, USA; (A.S.); (S.K.D.); (J.Y.)
| | - Upasna Sharma
- Department of Molecular, Cell and Developmental Biology, University of California Santa Cruz, Santa Cruz, CA 95064, USA;
| | - Latha Ramalingam
- Department of Nutrition and Food Studies, Syracuse University, Syracuse, NY 13244, USA; (A.S.); (S.K.D.); (J.Y.)
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14
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Lee JY, Lee HJ, Jang YH, Kim H, Im K, Yang S, Hoh JK, Ahn JH. Maternal pre-pregnancy obesity affects the uncinate fasciculus white matter tract in preterm infants. Front Pediatr 2023; 11:1225960. [PMID: 38034827 PMCID: PMC10684693 DOI: 10.3389/fped.2023.1225960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/23/2023] [Indexed: 12/02/2023] Open
Abstract
Background A growing body of evidence suggests an association between a higher maternal pre-pregnancy body mass index (BMI) and adverse long-term neurodevelopmental outcomes for their offspring. Despite recent attention to the effects of maternal obesity on fetal and neonatal brain development, changes in the brain microstructure of preterm infants born to mothers with pre-pregnancy obesity are still not well understood. This study aimed to detect the changes in the brain microstructure of obese mothers in pre-pregnancy and their offspring born as preterm infants using diffusion tensor imaging (DTI). Methods A total of 32 preterm infants (born to 16 mothers with normal BMI and 16 mothers with a high BMI) at <32 weeks of gestation without brain injury underwent brain magnetic resonance imaging at term-equivalent age (TEA). The BMI of all pregnant women was measured within approximately 12 weeks before pregnancy or the first 2 weeks of gestation. We analyzed the brain volume using a morphologically adaptive neonatal tissue segmentation toolbox and calculated the major white matter (WM) tracts using probabilistic maps of the Johns Hopkins University neonatal atlas. We investigated the differences in brain volume and WM microstructure between preterm infants of mothers with normal and high BMI. The DTI parameters were compared among groups using analysis of covariance adjusted for postmenstrual age at scan and multiple comparisons. Results Preterm infants born to mothers with a high BMI showed significantly increased cortical gray matter volume (p = 0.001) and decreased WM volume (p = 0.003) after controlling for postmenstrual age and multiple comparisons. We found a significantly lower axial diffusivity in the uncinate fasciculus (UNC) in mothers with high BMI than that in mothers with normal BMI (1.690 ± 0.066 vs. 1.762 ± 0.101, respectively; p = 0.005). Conclusion Our study is the first to demonstrate that maternal obesity impacts perinatal brain development patterns in preterm infants at TEA, even in the absence of apparent brain injury. These findings provide evidence for the detrimental effects of maternal obesity on brain developmental trajectories in offspring and suggest potential neurodevelopmental outcomes based on an altered UNC WM microstructure, which is known to be critical for language and social-emotional functions.
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Affiliation(s)
- Joo Young Lee
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Hyun Ju Lee
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
- Division of Neonatology and Development Medicine, Hanyang University Hospital, Seoul, Republic of Korea
| | - Yong Hun Jang
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Hyuna Kim
- Department of Translational Medicine, Hanyang University Graduate School of Biomedical Science and Engineering, Seoul, Republic of Korea
| | - Kiho Im
- Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States
- Division of Newborn Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, United States
| | - Seung Yang
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
- Department of Pediatrics, Hanyang University Hospital, Seoul, Republic of Korea
| | - Jeong-Kyu Hoh
- Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul, Republic of Korea
- Department of Obstetrics and Gynecology, Hanyang University Hospital, Seoul, Republic of Korea
| | - Ja-Hye Ahn
- Department of Pediatrics, Hanyang University College of Medicine, Seoul, Republic of Korea
- Division of Neonatology and Development Medicine, Hanyang University Hospital, Seoul, Republic of Korea
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15
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Lindblad A, Samkange-Zeeb F, de Henauw S, Solea A, Veidebaum T, Lauria F, Moreno LA, Iguacel I, Molnár D, Ahrens W, Winkler V, Lissner L, Mehlig K. Cardiometabolic risk profile among children with migrant parents and role of parental education: the IDEFICS/I.Family cohort. Int J Obes (Lond) 2023; 47:1074-1080. [PMID: 37658112 PMCID: PMC10600002 DOI: 10.1038/s41366-023-01359-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 09/03/2023]
Abstract
BACKGROUND AND AIMS Evidence shows that migrant children have a higher risk of developing obesity than those with native parents. We aimed to investigate the association between parental migration background and cardiometabolic health in children and adolescents in Europe. METHODS AND RESULTS We included 8745 children aged 2-17 from the second follow-up of the European IDEFICS/I.Family cohort. Linear regression models were used to investigate the association between parental migration background (one or two migrant parent(s) vs native parents) and body mass index (BMI), metabolic syndrome (MetS) score and its individual components. Outcome variables were parametrized as age and sex-specific z-scores. We adjusted for age, sex, country, and parental education, and additionally for parental income, lifestyle including dietary factors, and maternal BMI. On average, children with two migrant parents had higher z-scores of BMI (+0.24 standard deviation (SD)) and MetS score (+0.30 SD) compared to those with native parents, whereas no significant differences were seen for children with one migrant parent. Associations were attenuated when controlling for maternal BMI and sports club activity. Parental education modified the associations with BMI and MetS z-scores such that they were more pronounced in children with low parental education. CONCLUSION Children with two migrant parents were at higher risk for adverse cardiometabolic health compared to children with native parents, especially in families with low parental education. These associations were explained by lower physical activity and maternal body weight and encourages early intervention strategies by schools and communities.
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Affiliation(s)
- Anna Lindblad
- Epidemiology of Transition, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | | | - Stefaan de Henauw
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Antonia Solea
- Research and Education Institute of Child Health, Strovolos, Cyprus
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Isabel Iguacel
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III, Madrid, Spain
- Instituto Agroalimentario de Aragón (IA2), Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Volker Winkler
- Epidemiology of Transition, Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Lauren Lissner
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kirsten Mehlig
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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16
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Guo F, Mao S, Long Y, Zhou B, Gao L, Huang H. The Influences of Perinatal Androgenic Exposure on Cardiovascular and Metabolic Disease of Offspring of PCOS. Reprod Sci 2023; 30:3179-3189. [PMID: 37380913 DOI: 10.1007/s43032-023-01286-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
Hyperandrogenism is an endocrine disorder affecting a large population of reproductive-aged women, thus proportionally high number of fetuses are subjected to prenatal androgenic exposure (PNA). The short-term stimulations at critical ontogenetic stages can wield lasting influences on the health. The most commonly diagnosed conditions in reproductive age women is polycystic ovary syndrome (PCOS). PNA may affect the growth and development of many systems in the whole body and disrupts the normal metabolic trajectory in the offspring of PCOS, contributing to the prevalence of cardiovascular and metabolic diseases (CVMD), including myocardial hypertrophy, hypertension, hyperinsulinemia, insulin resistance, hyperglycemia, obesity, and dyslipidemia, which are the leading causes of hospitalizations in young PCOS offspring. In this review, we focus on the effects of prenatal androgenic exposure on the cardiovascular and metabolic diseases in offspring, discuss the possible pathogenesis respectively, and summarize potential management strategies to improve metabolic health of PCOS offspring. It is expected that the incidence of CVMD and the medical burden will be reduced in the future.
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Affiliation(s)
- Fei Guo
- Department of Reproduction and Development, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences, Shanghai, China
| | - Suqing Mao
- The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People's Hospital, Quzhou, China
| | - Yuhang Long
- Department of Reproduction and Development, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences, Shanghai, China
| | - Bokang Zhou
- Department of Reproduction and Development, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences, Shanghai, China
| | - Ling Gao
- Department of Reproduction and Development, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences, Shanghai, China.
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Hefeng Huang
- Department of Reproduction and Development, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
- Research Units of Embryo Original Diseases, Chinese Academy of Medical Sciences, Shanghai, China.
- Key Laboratory of Reproductive Genetics (Ministry of Education), Department of Reproductive Endocrinology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
- Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, China.
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17
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Gaillard R, Jaddoe VWV. Maternal cardiovascular disorders before and during pregnancy and offspring cardiovascular risk across the life course. Nat Rev Cardiol 2023; 20:617-630. [PMID: 37169830 DOI: 10.1038/s41569-023-00869-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 05/13/2023]
Abstract
Obesity, hypertension, type 2 diabetes mellitus and dyslipidaemia are highly prevalent among women of reproductive age and contribute to complications in >30% of pregnancies in Western countries. An accumulating body of evidence suggests that these cardiovascular disorders in women, occurring before and during their pregnancy, can affect the development of the structure, physiology and function of cardiovascular organ systems at different stages during embryonic and fetal development. These developmental adaptations might, in addition to genetics and sociodemographic and lifestyle factors, increase the susceptibility of the offspring to cardiovascular disease throughout the life course. In this Review, we discuss current knowledge of the influence of maternal cardiovascular disorders, occurring before and during pregnancy, on offspring cardiovascular development, dysfunction and disease from embryonic life until adulthood. We discuss findings from contemporary, large-scale, observational studies that provide insights into specific critical periods, evidence for causality and potential underlying mechanisms. Furthermore, we focus on priorities for future research, including defining optimal cardiovascular and reproductive health in women and men before their pregnancy and identifying specific embryonic, placental and fetal molecular developmental adaptations from early pregnancy onwards. Together, these approaches will help stop the intergenerational cycle of cardiovascular disease.
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Affiliation(s)
- Romy Gaillard
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands.
| | - Vincent W V Jaddoe
- Department of Paediatrics, Erasmus MC, University Medical Center, Rotterdam, Netherlands
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18
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Aurich S, Müller L, Kovacs P, Keller M. Implication of DNA methylation during lifestyle mediated weight loss. Front Endocrinol (Lausanne) 2023; 14:1181002. [PMID: 37614712 PMCID: PMC10442821 DOI: 10.3389/fendo.2023.1181002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
Over the past 50 years, the number of overweight/obese people increased significantly, making obesity a global public health challenge. Apart from rare monogenic forms, obesity is a multifactorial disease, most likely resulting from a concerted interaction of genetic, epigenetic and environmental factors. Although recent studies opened new avenues in elucidating the complex genetics behind obesity, the biological mechanisms contributing to individual's risk to become obese are not yet fully understood. Non-genetic factors such as eating behaviour or physical activity are strong contributing factors for the onset of obesity. These factors may interact with genetic predispositions most likely via epigenetic mechanisms. Epigenome-wide association studies or methylome-wide association studies are measuring DNA methylation at single CpGs across thousands of genes and capture associations to obesity phenotypes such as BMI. However, they only represent a snapshot in the complex biological network and cannot distinguish between causes and consequences. Intervention studies are therefore a suitable method to control for confounding factors and to avoid possible sources of bias. In particular, intervention studies documenting changes in obesity-associated epigenetic markers during lifestyle driven weight loss, make an important contribution to a better understanding of epigenetic reprogramming in obesity. To investigate the impact of lifestyle in obesity state specific DNA methylation, especially concerning the development of new strategies for prevention and individual therapy, we reviewed 19 most recent human intervention studies. In summary, this review highlights the huge potential of targeted interventions to alter disease-associated epigenetic patterns. However, there is an urgent need for further robust and larger studies to identify the specific DNA methylation biomarkers which influence obesity.
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Affiliation(s)
- Samantha Aurich
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Center Munich at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
| | - Luise Müller
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
| | - Peter Kovacs
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Deutsches Zentrum für Diabetesforschung e.V., Neuherberg, Germany
| | - Maria Keller
- Medical Department III - Endocrinology, Nephrology, Rheumatology, University of Leipzig Medical Center, Leipzig, Germany
- Helmholtz Institute for Metabolic, Obesity and Vascular Research (HI-MAG) of the Helmholtz Center Munich at the University of Leipzig and University Hospital Leipzig, Leipzig, Germany
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19
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Sureshchandra S, Doratt BM, True H, Mendoza N, Rincon M, Marshall NE, Messaoudi I. Multimodal profiling of term human decidua demonstrates immune adaptations with pregravid obesity. Cell Rep 2023; 42:112769. [PMID: 37432849 PMCID: PMC10528932 DOI: 10.1016/j.celrep.2023.112769] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/24/2023] [Accepted: 06/23/2023] [Indexed: 07/13/2023] Open
Abstract
Leukocyte diversity of the first-trimester maternal-fetal interface has been extensively described; however, the immunological landscape of the term decidua remains poorly understood. We therefore profiled human leukocytes from term decidua collected via scheduled cesarean delivery. Relative to the first trimester, our analyses show a shift from NK cells and macrophages to T cells and enhanced immune activation. Although circulating and decidual T cells are phenotypically distinct, they demonstrate significant clonotype sharing. We also report significant diversity within decidual macrophages, the frequency of which positively correlates with pregravid maternal body mass index. Interestingly, the ability of decidual macrophages to respond to bacterial ligands is reduced with pregravid obesity, suggestive of skewing toward immunoregulation as a possible mechanism to safeguard the fetus against excessive maternal inflammation. These findings are a resource for future studies investigating pathological conditions that compromise fetal health and reproductive success.
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Affiliation(s)
- Suhas Sureshchandra
- Department of Physiology and Biophysics, School of Medicine, University of California, Irvine, Irvine, CA 92697, USA; Institute for Immunology, University of California, Irvine, Irvine, CA 92697, USA
| | - Brianna M Doratt
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, Lexington, KY 40536, USA
| | - Heather True
- Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, Lexington, KY 40536, USA; Department of Pharmaceutical Sciences, University of Kentucky, Lexington, KY 40536, USA
| | - Norma Mendoza
- Institute for Immunology, University of California, Irvine, Irvine, CA 92697, USA
| | - Monica Rincon
- Maternal-Fetal Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Nicole E Marshall
- Maternal-Fetal Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Ilhem Messaoudi
- Institute for Immunology, University of California, Irvine, Irvine, CA 92697, USA; Department of Microbiology, Immunology and Molecular Genetics, University of Kentucky, Lexington, KY 40536, USA.
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20
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Ekici Avci M, Tosun Ö. Evaluation of subclinical atherosclerosis and cardiac functions in children of mothers with gestational diabetes and maternal obesity. Cardiol Young 2023; 33:1157-1164. [PMID: 35903027 DOI: 10.1017/s1047951122002402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND AIMS We aimed to evaluate the effects of maternal obesity or gestational diabetes on body composition, lipid, and glucose metabolism, arterial morphology, and functions in children, and to investigate these effects in terms of cardiometabolic diseases. METHODS The study group was composed of 48 children who had a history of gestational diabetes or maternal obesity, and the control group was composed of 33 children. Echocardiographic assessments were performed. Socio-economic status and education level of mothers were obtained. RESULTS In the study group, carotid intima-media thickness, epicardial adipose tissue thickness, and arterial stiffness values were found to be significantly higher compared to the control group (p < 0.001, p < 0.001, p = 0.003, respectively), while arterial distensibility and arterial strain values were found to be significantly lower (p = 0.003, p = 0.008, respectively). Among the children who had similar body mass index in both groups, children in the study group had higher carotid intima-media thickness and epicardial adipose tissue thickness values. Arterial stiffness values were significantly reduced (p = 0.028) and arterial distensibility and strain values were significantly increased (p = 0.039, p = 0.033, respectively) in the children whose mothers had gestational diabetes and high socio-economic status. Left ventricular mass and left ventricular end-diastolic internal thickness were found to be significantly increased in the children who had obese and unemployed mothers (p = 0.04, p = 0.03, respectively). CONCLUSION Low socio-economic status was found to be associated with increased maternal obesity and gestational diabetes. Poor socio-economic status, poor glycaemic control and being overweight during pregnancy indicate negative cardiometabolic outcomes for children in the long term.
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Affiliation(s)
- Melda Ekici Avci
- Department of Pediatrics, Istanbul Medeniyet University, Göztepe Profesör Doktor Süleyman Yalçın City Hospital, Istanbul, Turkey
| | - Öykü Tosun
- Department of Pediatric Cardiology, Istanbul Medeniyet University, Göztepe Profesör Doktor Süleyman Yalçın City Hospital, Istanbul, Turkey
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21
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Lister NB, Baur LA, Felix JF, Hill AJ, Marcus C, Reinehr T, Summerbell C, Wabitsch M. Child and adolescent obesity. Nat Rev Dis Primers 2023; 9:24. [PMID: 37202378 DOI: 10.1038/s41572-023-00435-4] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/12/2023] [Indexed: 05/20/2023]
Abstract
The prevalence of child and adolescent obesity has plateaued at high levels in most high-income countries and is increasing in many low-income and middle-income countries. Obesity arises when a mix of genetic and epigenetic factors, behavioural risk patterns and broader environmental and sociocultural influences affect the two body weight regulation systems: energy homeostasis, including leptin and gastrointestinal tract signals, operating predominantly at an unconscious level, and cognitive-emotional control that is regulated by higher brain centres, operating at a conscious level. Health-related quality of life is reduced in those with obesity. Comorbidities of obesity, including type 2 diabetes mellitus, fatty liver disease and depression, are more likely in adolescents and in those with severe obesity. Treatment incorporates a respectful, stigma-free and family-based approach involving multiple components, and addresses dietary, physical activity, sedentary and sleep behaviours. In adolescents in particular, adjunctive therapies can be valuable, such as more intensive dietary therapies, pharmacotherapy and bariatric surgery. Prevention of obesity requires a whole-system approach and joined-up policy initiatives across government departments. Development and implementation of interventions to prevent paediatric obesity in children should focus on interventions that are feasible, effective and likely to reduce gaps in health inequalities.
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Affiliation(s)
- Natalie B Lister
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Louise A Baur
- Children's Hospital Westmead Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
- Weight Management Services, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
| | - Janine F Felix
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Paediatrics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Andrew J Hill
- Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, UK
| | - Claude Marcus
- Division of Paediatrics, Department of Clinical Science Intervention and Technology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Thomas Reinehr
- Vestische Hospital for Children and Adolescents Datteln, University of Witten/Herdecke, Datteln, Germany
| | - Carolyn Summerbell
- Department of Sport and Exercise Sciences, Durham University, Durham, UK
| | - Martin Wabitsch
- Division of Paediatric Endocrinology and Diabetes, Department of Paediatrics and Adolescent Medicine, Ulm University Medical Centre, Ulm, Germany
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22
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Adeleye AJ, Zablotska L, Rinaudo P, Huang D, Lustig RH, Cedars MI. Study protocol for a Developmental Epidemiological Study of Children born through Reproductive Technologies (DESCRT). Hum Reprod Open 2023; 2023:hoad013. [PMID: 37265937 PMCID: PMC10229433 DOI: 10.1093/hropen/hoad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/23/2023] [Indexed: 06/03/2023] Open
Abstract
STUDY QUESTIONS The primary objective of this study is to determine what parental factors or specific ART may influence the risk for adverse cardiometabolic outcomes among children so conceived and their parents. The secondary objective of this study is to prospectively examine the effects of infertility or ART on the intrauterine environment, obstetric and neonatal outcomes. WHAT IS KNOWN ALREADY Pregnancies conceived with ART are at an increased risk of being affected by adverse obstetric and neonatal outcomes when compared to spontaneously conceived (SC) pregnancies among fertile women. Small cohort studies have suggested ART-conceived children may have a higher risk of long-term cardiometabolic disturbances as well. Currently, few studies have compared long-term cardiometabolic outcomes among ART-conceived children and non-IVF treated (NIFT) children, to children conceived spontaneously to parents with infertility (subfertile parents). STUDY DESIGN SIZE DURATION The Developmental Epidemiological Study of Children born through Reproductive Technologies (DESCRT) is a prospective cohort study that aims to: establish a biobank and epidemiological cohort of children born to subfertile or infertile parents who either conceived spontaneously (without assistance) or used reproductive technologies to conceive (all offspring were from couples assessed and/or treated in the same institute); prospectively examine the effects of infertility or ART on the intrauterine environment, obstetric and neonatal outcomes; and determine what parental factors or ART may influence the cardiometabolic risk of children so conceived. Pregnancies and resultant children will be compared by mode of conception, namely offspring that were conceived without medical assistance or SC or following NIFT, IVF with fresh embryo transfer or frozen embryo transfer (FET), and by fertilization method (conventional versus ICSI). DESCRT has a Child group evaluating long-term outcomes of children as well as a Pregnancy group that will compare obstetric and neonatal outcomes of children conceived since the commencement of the study. Recruitment started in May of 2017 and is ongoing. When the study began, we estimated that ∼4000 children would be eligible for enrollment. PARTICIPANTS/MATERIALS SETTING METHODS Eligible participants are first-trimester pregnancies (Pregnancy group) or children (Child group) born to parents who were evaluated at an infertility center in the University of California, San Francisco, CA, USA who were SC or conceived after reproductive treatments (NIFT, IVF ± ICSI, FET). Children in the Child group were conceived at UCSF and born from 2001 onwards. In the Pregnancy group, enrollment began in November of 2017.The primary outcome is the cardiometabolic health of offspring in the Child group, as measured by blood pressure and laboratory data (homeostatic model assessment for insulin resistance (HOMA-IR), oral glucose disposition). There are several secondary outcome measures, including: outcomes from parental survey response (assessing parent/child medical history since delivery-incidence of cardiometabolic adverse events), anthropomorphic measurements (BMI, waist circumference, skinfold thickness), and laboratory data (liver enzymes, lipid panel, metabolomic profiles). In the Pregnancy group, outcomes include laboratory assessments (bhCG, maternal serum analytes, soluble fms-like tyrosine kinase-1 (sFLT-1), and placental growth factor (PlGF)) and placental assessments (placental volume in the second and third trimester and placental weight at delivery). Importantly, aliquots of blood and urine are stored from parents and offspring as part of a biobank. The DESCRT cohort is unique in two ways. First, there is an extensive amount of clinical and laboratory treatment data: parental medical history and physical examination at the time of treatment, along with ovarian reserve and infertility diagnosis; and treatment specifics: for example, fertilization method, culture O2 status, embryo quality linked to each participant. These reproductive data will aid in identifying explanatory variables that may influence the primary cardiometabolic outcomes of the offspring-and their parents. Second, the DESCRT control group includes pregnancies and children SC from parents with subfertility, which may help to assess when infertility, as opposed to reproductive treatments, may be affecting offspring cardiometabolic health. STUDY FUNDING/COMPETING INTERESTS This study is funded by the National Institutes of Health NICHD (1R01HD084380-01A1). A.J.A. is a shareholder in Carrot and consultant for Flo Health. The other authors have no conflicts of interest. TRIAL REGISTRATION NUMBER NCT03799107. TRIAL REGISTRATION DATE 10 January 2019. DATE OF FIRST PATIENT’S ENROLLMENT 10 May 2017.
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Affiliation(s)
- A J Adeleye
- Correspondence address. Section of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, The University of Chicago, 5841 South Maryland Avenue, MC 2050, Chicago, IL 60637, USA. E-mail:
| | - L Zablotska
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - P Rinaudo
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - D Huang
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
| | - R H Lustig
- Division of Endocrinology, Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA
| | - M I Cedars
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, USA
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23
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Gothelf I, Sheiner E, Wainstock T. Maternal Bariatric Surgery and Offspring Health: A Sibling Matched Analysis Comparing Offspring Born before and after the Surgery. J Clin Med 2023; 12:jcm12093056. [PMID: 37176496 PMCID: PMC10179329 DOI: 10.3390/jcm12093056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 04/17/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
(1) Background: Due to the global escalation in the prevalence of obesity, bariatric surgeries have become a popular solution in many western countries. The aim of the current study was to compare offspring health and the obesity of women before and after undergoing bariatric surgeries. (2) Methods: A retrospective population-based study was performed, including all singleton deliveries which occurred at a tertiary medical center between the years 1991-2021. Among women who had bariatric surgeries, the health of the offspring born before and after the surgery were compared. The offspring were followed up until the age of 18 years, and their hospitalization records were summarized. The incidence of hospitalization with either endocrine, cardiac, respiratory, neurologic, or infectious diagnoses were compared between the groups, as well as offspring obesity. Multivariable Cox proportional models were used to match between siblings and to address confounding variables, including maternal age, gestational age at delivery, fertility treatment, smoking and pregnancy hypertensive disorders. (3) Results: The study population included 3074 deliveries of women who underwent bariatric surgeries (1586 were before and 1488 after the surgery). Offspring born after maternal bariatric surgeries were at a comparable risk for most morbidities, besides endocrine-related morbidities (3.1% vs. 5.0%, OR = 1.61; 1.1-2.35) and obesity (2.5% vs. 4.1%, OR = 1.63; 1.08-2.48). The risk for these morbidities was higher among the offspring of mothers after, vs. before, the surgery, despite adjustment for maternal age and other confounding variables. (4) Conclusions: While bariatric surgeries are considered an effective treatment for obesity, it seems to have less of an effect on the offspring of women who underwent such surgeries. Other persistent factors are most likely associated with the offspring's risk for morbidities, especially endocrine morbidities and obesity, which remain even though the mother underwent bariatric surgeries.
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Affiliation(s)
- Itamar Gothelf
- Goldman Medical School, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Tamar Wainstock
- School of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
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24
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Zembura M, Lula P, Matusik P. Ten-Year Differences in Nutritional Status and Obesity-Related Risk Factors in Polish Preschool Children. CHILDREN 2023; 10:children10040636. [PMID: 37189885 DOI: 10.3390/children10040636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/20/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
The aim of this study was to assess ten-year differences in nutritional statuses and obesity prevalences between populations of preschool children from Katowice, Poland, examined in 2007 and 2017, and to determine factors associated with overweight and obesity in preschool children. A cross-sectional questionnaire was conducted among parents and legal guardians of 276 preschool children in 2007 and 259 preschool children in 2017. Basic anthropometric measurements were performed. Overall, the prevalence of overweight and obesity among our sample of Polish preschool children (median age 5.25 year) was 16.82%, whereas 4.49% of children were obese. No significant differences in the number of overweight and obese children were observed when comparing the years 2017 to 2007. Overall body mass index (BMI) z-score was significantly lower in this group of children from 2017. However, median values of the BMI z-score were higher in two of the weight categories (overweight and obesity) in 2017. The child’s BMI z-score was positively correlated with birth weight (r = 0.1, p < 0.05). The BMI z-score was positively correlated with maternal BMI, paternal BMI, and maternal pregnancy weight gain, r = 0.24 p < 0.01; r = 0.16 p < 0.01; r = 0.12 p < 0.05, respectively. A decrease in overweight and obesity prevalence over the past decade and higher median values of BMI z-scores in the group of children with excessive weight in 2017 were observed. Birth weight, maternal BMI, paternal BMI, and maternal pregnancy weight gain all correlate positively with a child’s BMI z-score.
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25
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Alba-Linares JJ, Pérez RF, Tejedor JR, Bastante-Rodríguez D, Ponce F, Carbonell NG, Zafra RG, Fernández AF, Fraga MF, Lurbe E. Maternal obesity and gestational diabetes reprogram the methylome of offspring beyond birth by inducing epigenetic signatures in metabolic and developmental pathways. Cardiovasc Diabetol 2023; 22:44. [PMID: 36870961 PMCID: PMC9985842 DOI: 10.1186/s12933-023-01774-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Obesity is a negative chronic metabolic health condition that represents an additional risk for the development of multiple pathologies. Epidemiological studies have shown how maternal obesity or gestational diabetes mellitus during pregnancy constitute serious risk factors in relation to the appearance of cardiometabolic diseases in the offspring. Furthermore, epigenetic remodelling may help explain the molecular mechanisms that underlie these epidemiological findings. Thus, in this study we explored the DNA methylation landscape of children born to mothers with obesity and gestational diabetes during their first year of life. METHODS We used Illumina Infinium MethylationEPIC BeadChip arrays to profile more than 770,000 genome-wide CpG sites in blood samples from a paediatric longitudinal cohort consisting of 26 children born to mothers who suffered from obesity or obesity with gestational diabetes mellitus during pregnancy and 13 healthy controls (measurements taken at 0, 6 and 12 month; total N = 90). We carried out cross-sectional and longitudinal analyses to derive DNA methylation alterations associated with developmental and pathology-related epigenomics. RESULTS We identified abundant DNA methylation changes during child development from birth to 6 months and, to a lesser extent, up to 12 months of age. Using cross-sectional analyses, we discovered DNA methylation biomarkers maintained across the first year of life that could discriminate children born to mothers who suffered from obesity or obesity with gestational diabetes. Importantly, enrichment analyses suggested that these alterations constitute epigenetic signatures that affect genes and pathways involved in the metabolism of fatty acids, postnatal developmental processes and mitochondrial bioenergetics, such as CPT1B, SLC38A4, SLC35F3 and FN3K. Finally, we observed evidence of an interaction between developmental DNA methylation changes and maternal metabolic condition alterations. CONCLUSIONS Our observations highlight the first six months of development as being the most crucial for epigenetic remodelling. Furthermore, our results support the existence of systemic intrauterine foetal programming linked to obesity and gestational diabetes that affects the childhood methylome beyond birth, which involves alterations related to metabolic pathways, and which may interact with ordinary postnatal development programmes.
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Affiliation(s)
- Juan José Alba-Linares
- Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA-FINBA), University of Oviedo, Oviedo, Spain
- Institute of Oncology of Asturias (IUOPA), University of Oviedo, Oviedo, Spain
- Department of Organisms and Systems Biology (B.O.S.), University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Raúl F Pérez
- Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA-FINBA), University of Oviedo, Oviedo, Spain
- Institute of Oncology of Asturias (IUOPA), University of Oviedo, Oviedo, Spain
- Department of Organisms and Systems Biology (B.O.S.), University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Juan Ramón Tejedor
- Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA-FINBA), University of Oviedo, Oviedo, Spain
- Institute of Oncology of Asturias (IUOPA), University of Oviedo, Oviedo, Spain
- Department of Organisms and Systems Biology (B.O.S.), University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - David Bastante-Rodríguez
- Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA-FINBA), University of Oviedo, Oviedo, Spain
- Institute of Oncology of Asturias (IUOPA), University of Oviedo, Oviedo, Spain
- Department of Organisms and Systems Biology (B.O.S.), University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Francisco Ponce
- Health Research Institute INCLIVA, Valencia, Spain
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Nuria García Carbonell
- Health Research Institute INCLIVA, Valencia, Spain
- Servicio de Pediatría, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Rafael Gómez Zafra
- Health Research Institute INCLIVA, Valencia, Spain
- Servicio de Pediatría, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
| | - Agustín F Fernández
- Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), University of Oviedo, Oviedo, Spain
- Health Research Institute of Asturias (ISPA-FINBA), University of Oviedo, Oviedo, Spain
- Institute of Oncology of Asturias (IUOPA), University of Oviedo, Oviedo, Spain
- Department of Organisms and Systems Biology (B.O.S.), University of Oviedo, Oviedo, Spain
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Madrid, Spain
| | - Mario F Fraga
- Cancer Epigenetics and Nanomedicine Laboratory, Nanomaterials and Nanotechnology Research Center (CINN-CSIC), University of Oviedo, Oviedo, Spain.
- Health Research Institute of Asturias (ISPA-FINBA), University of Oviedo, Oviedo, Spain.
- Institute of Oncology of Asturias (IUOPA), University of Oviedo, Oviedo, Spain.
- Department of Organisms and Systems Biology (B.O.S.), University of Oviedo, Oviedo, Spain.
- Biomedical Research Networking Center on Rare Diseases (CIBERER), Institute of Health Carlos III (ISCIII), Madrid, Spain.
| | - Empar Lurbe
- Health Research Institute INCLIVA, Valencia, Spain.
- Biomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), Institute of Health Carlos III (ISCIII), Madrid, Spain.
- Servicio de Pediatría, Consorcio Hospital General Universitario de Valencia, Valencia, Spain.
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26
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Widen EM, Burns N, Kahn LG, Grewal J, Backlund G, Nichols AR, Rickman R, Foster S, Nhan-Chang CL, Zhang C, Wapner R, Wing DA, Owen J, Skupski DW, Ranzini AC, Newman R, Grobman W, Daniels MJ. Prenatal weight and regional body composition trajectories and neonatal body composition: The NICHD Foetal Growth Studies. Pediatr Obes 2023; 18:e12994. [PMID: 36605025 PMCID: PMC9924063 DOI: 10.1111/ijpo.12994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Gestational weight gain (GWG) and anthropometric trajectories may affect foetal programming and are potentially modifiable. OBJECTIVES To assess concomitant patterns of change in weight, circumferences and adiposity across gestation as an integrated prenatal exposure, and determine how they relate to neonatal body composition. METHODS Data are from a prospective cohort of singleton pregnancies (n = 2182) enrolled in United States perinatal centres, 2009-2013. Overall and by prepregnancy BMI group (overweight/obesity and healthy weight), joint latent trajectory models were fit with prenatal weight, mid-upper arm circumference (MUAC), triceps (TSF) and subscapular (SSF) skinfolds. Differences in neonatal body composition by trajectory class were assessed via weighted least squares. RESULTS Six trajectory patterns reflecting co-occurring changes in weight and MUAC, SSF and TSF across pregnancy were identified overall and by body mass index (BMI) group. Among people with a healthy weight BMI, some differences were observed for neonatal subcutaneous adipose tissue, and among individuals with overweight/obesity some differences in neonatal lean mass were found. Neonatal adiposity measures were higher among infants born to individuals with prepregnancy overweight/obesity. CONCLUSIONS Six integrated trajectory patterns of prenatal weight, subcutaneous adipose tissue and circumferences were observed that were minimally associated with neonatal body composition, suggesting a stronger influence of prepregnancy BMI.
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Affiliation(s)
- Elizabeth M Widen
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
- Department of Women's Health & Pediatrics, Dell Medical School, University of Texas at Austin, Austin, Texas, USA
| | - Natalie Burns
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Linda G Kahn
- Departments of Pediatrics and Population Health, New York University Grossman School of Medicine, New York, New York, USA
| | - Jagteshwar Grewal
- Division of Population Health Research, Division of Intramural Research, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Grant Backlund
- Department of Statistics, University of Florida, Gainesville, Florida, USA
| | - Amy R Nichols
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Rachel Rickman
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Saralyn Foster
- Department of Nutritional Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Chia-Ling Nhan-Chang
- Department of Obstetrics and Gynecology, Columbia University Medical Center, Columbia, South Carolina, USA
| | - Cuilin Zhang
- Division of Population Health Research, Division of Intramural Research, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | - Ronald Wapner
- Department of Obstetrics and Gynecology, Columbia University Medical Center, Columbia, South Carolina, USA
| | - Deborah A Wing
- Division of Maternal-Fetal Medicine, Department of Obstetrics-Gynecology, University of California, Irvine, School of Medicine, Irvine, and Fountain Valley Regional Hospital and Medical Center, Fountain Valley, California, USA
| | - John Owen
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Daniel W Skupski
- Department of Obstetrics and Gynecology, New York-Presbyterian Queens Hospital, Queens, New York, USA
| | - Angela C Ranzini
- Division of Maternal and Fetal Medicine, Department of Obstetrics and Gynecology, St Peter's University Hospital, New Brunswick, New Jersey, USA
| | - Roger Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Columbia, South Carolina, USA
| | - William Grobman
- Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University (WAG), New Rochelle, New York, USA
| | - Michael J Daniels
- Department of Statistics, University of Florida, Gainesville, Florida, USA
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27
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Clark JM, Garvey WT, Niswender KD, Schmidt AM, Ahima RS, Aleman JO, Battarbee AN, Beckman J, Bennett WL, Brown NJ, Chandler‐Laney P, Cox N, Goldberg IJ, Habegger KM, Harper LM, Hasty AH, Hidalgo BA, Kim SF, Locher JL, Luther JM, Maruthur NM, Miller ER, Sevick MA, Wells Q. Obesity and Overweight: Probing Causes, Consequences, and Novel Therapeutic Approaches Through the American Heart Association's Strategically Focused Research Network. J Am Heart Assoc 2023; 12:e027693. [PMID: 36752232 PMCID: PMC10111504 DOI: 10.1161/jaha.122.027693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/03/2023] [Indexed: 02/09/2023]
Abstract
As the worldwide prevalence of overweight and obesity continues to rise, so too does the urgency to fully understand mediating mechanisms, to discover new targets for safe and effective therapeutic intervention, and to identify biomarkers to track obesity and the success of weight loss interventions. In 2016, the American Heart Association sought applications for a Strategically Focused Research Network (SFRN) on Obesity. In 2017, 4 centers were named, including Johns Hopkins University School of Medicine, New York University Grossman School of Medicine, University of Alabama at Birmingham, and Vanderbilt University Medical Center. These 4 centers were convened to study mechanisms and therapeutic targets in obesity, to train a talented cadre of American Heart Association SFRN-designated fellows, and to initiate and sustain effective and enduring collaborations within the individual centers and throughout the SFRN networks. This review summarizes the central themes, major findings, successful training of highly motivated and productive fellows, and the innovative collaborations and studies forged through this SFRN on Obesity. Leveraging expertise in in vitro and cellular model assays, animal models, and humans, the work of these 4 centers has made a significant impact in the field of obesity, opening doors to important discoveries, and the identification of a future generation of obesity-focused investigators and next-step clinical trials. The creation of the SFRN on Obesity for these 4 centers is but the beginning of innovative science and, importantly, the birth of new collaborations and research partnerships to propel the field forward.
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Affiliation(s)
- Jeanne M. Clark
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
| | - W. Timothy Garvey
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAL
| | - Kevin D. Niswender
- Tennessee Valley Healthcare SystemVanderbilt University Medical CenterNashvilleTN
- Division of Diabetes, Department of Medicine, Endocrinology and MetabolismVanderbilt University Medical CenterNashvilleTN
| | - Ann Marie Schmidt
- Department of Medicine, Diabetes Research Program, Division of Endocrinology, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
| | - Rexford S. Ahima
- Department of Medicine, Division of Endocrinology, Diabetes and MetabolismThe Johns Hopkins University School of MedicineBaltimoreMD
| | - Jose O. Aleman
- Division of Endocrinology, Department of Medicine, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
| | - Ashley N. Battarbee
- Division of Maternal Fetal Medicine, Department of Obstetrics and GynecologyUniversity of Alabama at BirminghamBirminghamAL
| | - Joshua Beckman
- Division of Cardiovascular Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTN
| | - Wendy L. Bennett
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
- Department of Population, Family and Reproductive HealthThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | | | | | - Nancy Cox
- Vanderbilt Genetics Institute and Division of Genetic Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTNUSA
| | - Ira J. Goldberg
- Division of Endocrinology, Department of Medicine, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
| | - Kirk M. Habegger
- Division of Endocrinology, Department of Medicine, Diabetes, and MetabolismUniversity of Alabama at BirminghamBirminghamAL
| | - Lorie M. Harper
- Division of Maternal Fetal Medicine, Department of Obstetrics and GynecologyUniversity of Alabama at BirminghamBirminghamAL
- Division of Maternal‐Fetal Medicine, Department of Women’s Health, Dell Medical SchoolUniversity of Texas at AustinAustinTXUSA
| | - Alyssa H. Hasty
- Department of Molecular Physiology and BiophysicsVanderbilt University School of MedicineNashvilleTN
- VA Tennessee Valley Healthcare SystemNashvilleTN
| | - Bertha A. Hidalgo
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAL
| | - Sangwon F. Kim
- Department of Medicine, Division of Endocrinology, Diabetes and MetabolismThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of NeuroscienceThe Johns Hopkins University School of MedicineBaltimoreMD
| | - Julie L. Locher
- Division of Gerontology, Department of Medicine, Geriatrics, and Palliative CareUniversity of Alabama at BirminghamBirminghamAL
| | - James M. Luther
- Division of Clinical Pharmacology, Department of MedicineVanderbilt University Medical Center TennesseeNashvilleTN
| | - Nisa M. Maruthur
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
| | - Edgar R. Miller
- Division of General Internal Medicine, Department of MedicineThe Johns Hopkins University School of MedicineBaltimoreMD
- Department of EpidemiologyThe Johns Hopkins Bloomberg School of Public HealthBaltimoreMD
- Welch Center for Prevention, Epidemiology and Clinical ResearchThe Johns Hopkins UniversityBaltimoreMD
| | - Mary Ann Sevick
- Division of Endocrinology, Department of Medicine, Diabetes and MetabolismNew York University Grossman School of MedicineNew YorkNY
- Department of Population Health, Center for Healthful Behavior ChangeNew York University Langone HealthNew YorkNY
| | - Quinn Wells
- Department of PharmacologyVanderbilt UniversityNashvilleTN
- Department of MedicineVanderbilt University Medical CenterNashvilleTN
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Gao LT, Yuan JQ, Zhang ZY, Zhao HM, Gao L. Hypermethylation of the Bmp4 promoter dampens binding of HIF-1α and impairs its cardiac protective effects from oxidative stress in prenatally GC-exposed offspring. Cell Mol Life Sci 2023; 80:58. [PMID: 36746787 PMCID: PMC9902418 DOI: 10.1007/s00018-023-04703-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/30/2022] [Accepted: 01/22/2023] [Indexed: 02/08/2023]
Abstract
The exposure to an unhealthy environment in utero can lead to the occurrence of cardiovascular diseases in the offspring. Glucocorticoids (GC) are essential for normal development and maturation of fetal organs and is a first-line treatment for pregnant women affected by autoimmune diseases. However, excess prenatal GC exposure might program the development of fetal organs and cause a number of chronic diseases in later life. Our previous studies indicated that cardiac functions were significantly compromised in rat offspring prenatally exposed to the synthetic glucocorticoid dexamethasone (DEX), only after ischemia-reperfusion. In the present study, we further observed that DNA hypermethylation of bone morphogenetic protein 4 (Bmp4) promoter in cardiomyocytes caused by prenatal DEX exposure substantially dampened the binding activity of transcription factor HIF-1α induced by cardiac ischemia. Therefore, prenatal DEX exposure inhibits the induction of BMP4 upon I/R and attenuates the protective effects of BMP4 in cardiomyocytes, which eventually manifests as malfunction of the adult heart. Moreover, we employed two cardiac-specific Bmp4 knock-in mouse models and found that in vivo BMP4 overexpression could rescue the cardiac dysfunction caused by prenatal GC exposure. In depth mechanistic research revealed that BMP4 protects the cardiomyocytes from mitophagy and apoptosis by attenuating mitochondrial PGC-1α expression in a p-Smad and Parkin-dependent manner. These findings suggest that prenatal GC exposure increases the susceptibility of the offspring's heart to a "second strike" after birth, due to the failure of hypoxia-induced HIF-1α transactivation of the hypermethylated Bmp4 promoter in cardiomyocytes. Pretreatment with the DNA methylation inhibitor, 5-Aza-2'-deoxycytidine, could be a potential therapeutic method for this programming effect of GC exposure during pregnancy on neonatal cardiac dysfunction.
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Affiliation(s)
- Ling-Tong Gao
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China
| | - Jian-Qiang Yuan
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China
| | - Zhi-Yu Zhang
- Department of Health Management, Changzheng Hospital, Naval Medical University, Shanghai, 200003, People's Republic of China
| | - Hou-Ming Zhao
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China
| | - Lu Gao
- Department of Physiology, Naval Medical University, 800 Xiangyin Rd., Shanghai, 200433, People's Republic of China. .,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, People's Republic of China. .,Shanghai Key Laboratory of Embryo Original Diseases, Shanghai, People's Republic of China.
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Shen WB, Wang B, Yao R, Goetzinger KR, Wu S, Gao H, Yang P. Obesity impacts placental function through activation of p-IRE1a-XBP1s signaling. Front Cell Dev Biol 2023; 11:1023327. [PMID: 36819099 PMCID: PMC9929362 DOI: 10.3389/fcell.2023.1023327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Maternal obesity is associated with a variety of obstetrical outcomes including stillbirth, preeclampsia, and gestational diabetes, and increases the risk of fetuses for congenital heart defects. Obesity during pregnancy represents a major contribution to metabolic dysregulation, which not only plays a key role in the pathogenesis of adverse outcome but also can potently induce endoplasmic reticulum (ER) stress. However, the mechanism associating such an obesogenic metabolic environment and adverse pregnancy outcomes has remained poorly understood. In this study, we aimed to determine whether the ER stress pathways (also named unfolded protein response (UPR)) were activated in the placenta by obesity. We collected placenta from the obese pregnancy (n = 12) and non-obese pregnancy (n = 12) following delivery by Caesarean-section at term. The specimens were assessed with immunocytochemistry staining and RT-QPCR. Our results revealed that in the obese placenta, p-IRE1α and XBP1s were significantly increased, CHOP and nine UPR chaperone genes were upregulated, including GRP95, PDIA6, Calnexin, p58IPK, SIL-1, EDEM, Herp, GRP58 and Calreticulin. However, Perk and BiP are not activated in the obese placenta. Our data suggest that upregulated p-IRE1α and XBP1s signaling, and UPR chaperone genes may play an important role in maternal obesity-induced placental pathology. In conclusion, this is the first report on ER stress and UPR activation in the placenta of maternal obesity. Our findings represent the first step in the understanding of one of the key ER signaling pathways, also referred to IRE1α-XBP1, in placental pathophysiology affected by obesity, which may be an important mechanism accounting for the observed higher maternal and perinatal risks.
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Affiliation(s)
- Wei-Bin Shen
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Bingbing Wang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Ruofan Yao
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Katherine R. Goetzinger
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Sheng Wu
- Center for Metabolic Disease Research, Department of Cardiovascular Sciences, Temple University School of Medicine, Philadelphia, PA, United States
| | - Haijun Gao
- Departmentof Physiology and Biophysics, Howard University College of Medicine, Washington, DC, United States
| | - Peixin Yang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Maryland School of Medicine, Baltimore, MD, United States,*Correspondence: Peixin Yang,
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Pregnancy homocysteine and cobalamin status predict childhood metabolic health in the offspring. Pediatr Res 2023; 93:633-642. [PMID: 35641553 DOI: 10.1038/s41390-022-02117-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/08/2022] [Accepted: 05/08/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Inadequate pregnancy cobalamin status has been associated with adverse offspring metabolic health in Indian and Nepalese studies. Studies of pregnancy cobalamin status and mid-childhood health outside of Asia are scarce. METHODS Associations between pregnancy fasting plasma total homocysteine (tHcy), cobalamin status (plasma cobalamin, holotranscobalamin (holoTC), methylmalonic acid (MMA)) and mid-childhood metabolic score (MetSco) ((including fat mass index (zFMI), homeostatic model assessment of insulin resistance (zHOMA-IR) and dyslipidemia (zTG - zHDLc)/2) z-scores)) were investigated in a prospective study of 293 mother-child dyads. RESULTS Highest versus low-mid pregnancy tHcy tertile was associated with higher mid-childhood MetSco, specifically with higher child zFMI. Stratifying by sex, the maternal tHcy-child MetSco association was limited to boys and confirmed for zFMI and zHOMA-IR. The maternal tHcy-child zFMI association was not mediated by birth weight z-score. First trimester plasma cobalamin was not associated with child outcomes, but other indicators of cobalamin status were. Lowest versus mid-high plasma holoTC tertile was associated with MetSco (specifically zFMI and zHOMA-IR) and highest versus low-mid plasma MMA tertile with higher MetSco and dyslipidemia in boys. CONCLUSIONS Moderately elevated pregnancy tHcy and low cobalamin status were associated with mid-childhood metabolic score in boys. The pregnancy tHcy-child zFMI association was not mediated by birth weight. IMPACT Fasting plasma total homocysteine (tHcy) during pregnancy and low cobalamin status during early pregnancy are associated with mid-childhood metabolic score and its components in the offspring. These findings were only significant in male offspring. The study provides new evidence that impaired one carbon metabolism during pregnancy is associated with negative health outcomes in the offspring, in a population with low prevalence of cobalamin deficiency. The maternal-offspring associations were observed in the functional markers of cobalamin status (holotranscobalamin and methylmalonic acid) and tHcy, not with plasma cobalamin concentration. Screening for low pregnancy cobalamin status should be considered.
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Andraweera PH, Plummer MD, Garrett A, Leemaqz S, Wittwer MR, Aldridge E, Pathirana MM, Dekker GA, Roberts CT, Arstall MA. Early pregnancy cardio metabolic risk factors and the prevalence of metabolic syndrome 10 years after the first pregnancy. PLoS One 2023; 18:e0280451. [PMID: 36662760 PMCID: PMC9858479 DOI: 10.1371/journal.pone.0280451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 12/29/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND We aimed to compare risk factors for CVD 10 years postpartum among women who had ≥ 1 compared to no cardio metabolic risk factor in early first pregnancy. METHODS Women of the SCOPE (Screening fOr Pregnancy Endpoints) study from Adelaide, South Australia were invited to participate in a cardiovascular risk assessment 10 years after the delivery of the first child. Data from 141 women who completed all the assessments are included in the analyses. RESULT Compared to women who did not have any cardio metabolic risk factor at 15 ± 1 weeks' gestation during the first pregnancy, those who had ≥ 1 risk factor were 5.5 times more likely to have metabolic syndrome 10 years postpartum (aOR = 5.5, 95% CI 1.8-17.3, p = 0.004). Women who had ≥ 1cardio metabolic risk factor during the first pregnancy were more likely to be obese (p = 0.001), have high total cholesterol levels (p <0.001) or have increased insulin resistance (p <0.001) 10 years later compared to women who had no risk factor during the first pregnancy. 63.5% of the women with no cardio metabolic risk factor compared to 39% of women who had ≥ 1 risk factor in first pregnancy, had neither a complicated first pregnancy nor was diagnosed with MetS 10 years postpartum (p = 0.023). CONCLUSION Cardio metabolic risk factors at the booking visit in the first pregnancy may be useful in identifying young women at risk of future CVD.
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Affiliation(s)
- Prabha H. Andraweera
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Michelle D. Plummer
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Amy Garrett
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Shalem Leemaqz
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Melanie R. Wittwer
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Emily Aldridge
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Maleesa M. Pathirana
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
| | - Gus A. Dekker
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Division of Women’s Health, Lyell McEwin Hospital, Elizabeth Vale, Australia
| | - Claire T. Roberts
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Robinson Research Institute, The University of Adelaide, Adelaide, Australia
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia
| | - Margaret A. Arstall
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
- Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, Australia
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Characterisation of the Paternal Influence on Intergenerational Offspring Cardiac and Brain Lipid Homeostasis in Mice. Int J Mol Sci 2023; 24:ijms24031814. [PMID: 36768137 PMCID: PMC9916277 DOI: 10.3390/ijms24031814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/03/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
There is growing evidence that poor paternal diet at the time of conception increase the risk of offspring developing a range of non-communicable metabolic diseases, such as obesity, diabetes and cardiovascular disease, in adulthood. We hypothesise that a paternal low protein-high carbohydrate diet perturbs offspring tissue lipid abundance through both sperm and seminal plasma-mediated mechanisms. To test our hypothesis, we fed male C57BL/6 mice either a control normal protein diet (NPD; 18% protein) or an isocaloric low protein diet (LPD; 9% protein) for a minimum of 8 weeks. We generated offspring through artificial insemination, in combination with vasectomised male mating. Using this approach, we derived offspring from either NPD or LPD sperm but in the presence of NPD or LPD seminal plasma. Using high resolution mass-spectrometry, we found that offspring derived from either LPD sperm or seminal fluid displayed perturbed cardiac and brain lipid abundance from just three weeks of age, typically associated with the altered abundance of tissue triglycerides. We also observed the differential sex-specific patterns of lipids between the control and experimental offspring's hearts and brains. These observations indicate that poor paternal diet at the time of conception affects offspring cardiac and brain lipid profiles in an age-, sex- and generation-specific manner.
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Lim S, Harrison C, Callander E, Walker R, Teede H, Moran L. Addressing Obesity in Preconception, Pregnancy, and Postpartum: A Review of the Literature. Curr Obes Rep 2022; 11:405-414. [PMID: 36318371 PMCID: PMC9729313 DOI: 10.1007/s13679-022-00485-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Reproductive-aged women (aged 19 to 50 years) are a key population warranting focused research for the prevention of overweight and obesity. This review highlights the importance of addressing weight before, during and after pregnancy. RECENT FINDINGS Obesity decreases fertility during the preconception period; increases the risk of adverse pregnancy outcomes including gestational diabetes, pre-eclampsia and caesarean section and postpartum weight retention; and increases the long-term health risks for both the mother and offspring. Despite overwhelming efficacy evidence on solutions, there are significant implementation gaps in translating this evidence into pragmatic models of care and real-world solutions. Interventions during preconception, pregnancy and postpartum are likely to be cost-effective or cost-saving, with future investigation needed in the preconception and postpartum period. International clinical guidelines and public health policies are needed for a concerted effort to prevent unhealthy weight gain in these life stages and to reverse the significant adverse health outcomes for women and the next generation.
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Affiliation(s)
- Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Boxhill, VIC, Australia
| | - Cheryce Harrison
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Emily Callander
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Ruth Walker
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Helena Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, Australia.
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Amruta N, Kandikattu HK, Intapad S. Cardiovascular Dysfunction in Intrauterine Growth Restriction. Curr Hypertens Rep 2022; 24:693-708. [PMID: 36322299 DOI: 10.1007/s11906-022-01228-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW We highlight important new findings on cardiovascular dysfunction in intrauterine growth restriction. RECENT FINDINGS Intrauterine growth restriction (IUGR) is a multifactorial condition which negatively impacts neonatal growth during pregnancy and is associated with health problems during the lifespan. It affects 5-15% of all pregnancies in the USA and Europe with varying percentages in developing countries. Epidemiological studies have reported that IUGR is associated with the pathogenesis of hypertension, activation of the renin-angiotensin system (RAS), disruption in placental-mTORC and TGFβ signaling cascades, and endothelial dysfunction in IUGR fetuses, children, adolescents, and adults resulting in the development of cardiovascular diseases (CVD). Experimental studies are needed to investigate therapeutic measures to treat increased blood pressure (BP) and long-term CVD problems in people affected by IUGR. We outline the mechanisms mediating fetal programming of hypertension in developing CVD. We have reviewed findings from different experimental models focusing on recent studies that demonstrate CVD in IUGR.
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Affiliation(s)
- Narayanappa Amruta
- Department of Pharmacology, Tulane University School of Medicine, 1430 Tulane Avenue, #8683, New Orleans, LA, 70112-2699, USA
| | - Hemanth Kumar Kandikattu
- Department of Medicine, Section of Pulmonary Diseases, Tulane University School of Medicine, New Orleans, LA, 70112, USA
| | - Suttira Intapad
- Department of Pharmacology, Tulane University School of Medicine, 1430 Tulane Avenue, #8683, New Orleans, LA, 70112-2699, USA.
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de Oliveira Andrade F, Verma V, Hilakivi-Clarke L. Maternal obesity and resistance to breast cancer treatments among offspring: Link to gut dysbiosis. Cancer Rep (Hoboken) 2022; 5:e1752. [PMID: 36411524 PMCID: PMC9780430 DOI: 10.1002/cnr2.1752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 08/22/2022] [Accepted: 10/19/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND About 50 000 new cases of cancer in the United States are attributed to obesity. The adverse effects of obesity on breast cancer may be most profound when affecting the early development; that is, in the womb of a pregnant obese mother. Maternal obesity has several long-lasting adverse health effects on the offspring, including increasing offspring's breast cancer risk and mortality. Gut microbiota is a player in obesity as well as may impact breast carcinogenesis. Gut microbiota is established early in life and the microbial composition of an infant's gut becomes permanently dysregulated because of maternal obesity. Metabolites from the microbiota, especially short chain fatty acids (SCFAs), play a critical role in mediating the effect of gut bacteria on multiple biological functions, such as immune system, including tumor immune responses. RECENT FINDINGS Maternal obesity can pre-program daughter's breast cancer to be more aggressive, less responsive to treatments and consequently more likely to cause breast cancer related death. Maternal obesity may also induce poor response to immune checkpoint inhibitor (ICB) therapy through increased abundance of inflammation associated microbiome and decreased abundance of bacteria that are linked to production of SCFAs. Dietary interventions that increase the abundance of bacteria producing SCFAs potentially reverses offspring's resistance to breast cancer therapy. CONCLUSION Since immunotherapies have emerged as highly effective treatments for many cancers, albeit there is an urgent need to enlarge the patient population who will be responsive to these treatments. One of the factors which may cause ICB refractoriness could be maternal obesity, based on its effects on the microbiota markers of ICB therapy response among the offspring. Since about 40% of children are born to obese mothers in the Western societies, it is important to determine if maternal obesity impairs offspring's response to cancer immunotherapies.
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Affiliation(s)
| | - Vivek Verma
- The Hormel Institute, University of Minnesota, Austin, Minnesota, USA
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Kommunal verankerte Versorgungsstrukturen zur Förderung der Ernährungsgesundheit in den ersten 1000 Tagen – eine Analyse des aktuellen Status quo. PRÄVENTION UND GESUNDHEITSFÖRDERUNG 2022. [PMCID: PMC9707151 DOI: 10.1007/s11553-022-00998-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Zusammenfassung
Ziel
Die Ernährung in den ersten 1000 Tagen stellt einen relevanten Einflussfaktor für eine gesunde (Gewichts)entwicklung von Kindern dar. Verhältnispräventive, kommunalbasierte Ansätze scheinen am Erfolg versprechendsten in der Bekämpfung von (kindlichem) Übergewicht bzw. nicht übertragbaren Erkrankungen zu sein. Ziel dieser Arbeit war es, Strategien zum Gelingen der Ernährungsgesundheit in den ersten 1000 Tagen herauszuarbeiten.
Methodik
Auf Basis einer internetbasierten Recherche möglicher kommunalbasierter Praxisprojekte wurden standardisierte, leitfadengestützte Interviews mit Expertinnen und Experten aus Wissenschaft und Praxis durchgeführt. Der Fokus lag auf der allgemeinen Einschätzung der Versorgungslage bzw. einem möglichen Handlungs- und Versorgungsbedarf sowie konkreten Handlungsempfehlungen unter besonderer Berücksichtigung von Schwangeren bzw. jungen Familien in belasteten Lebenslagen. 14 von 40 im Schneeballverfahren ausgewählten Personen nahmen teil.
Ergebnisse
Alle Teilnehmenden schätzen die aktuelle primärpräventive Versorgung als nicht ausreichend ein. Als kritisch wurden von ihnen v. a. die fehlenden strukturellen und politischen Rahmenbedingen, insbesondere die häufig bestehenden zeitlich begrenzten Programme, gesehen. Dadurch seien Maßnahmen zur Förderung der Ernährungsgesundheit oder vergleichbare Interventionen nicht erfolgreich zu etablieren. Gefordert wurde daher eine deutlichere Unterstützung durch politische und andere relevante Stakeholder, z. B. Krankenversicherungen und Vernetzung mit bzw. Einbettung dieses Themenfeldes in den öffentlichen Gesundheitsdienst.
Schlussfolgerung
Unsere Ergebnisse bestätigen aus Sicht von Expertinnen und Experten, dass die Förderung der Ernährungsgesundheit in den ersten 1000 Tagen sinnvoll und wichtig ist. Allerdings ist ein deutlicher Optimierungsbedarf hinsichtlich der Versorgungsstrukturen und der konkreten nachhaltigen Umsetzung von primärpräventiven Angeboten sowie niederschwelligen Zugängen für belastete Schwangere und Familien erkennbar.
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Xiao X, Su L. Editorial: Intrauterine nutrition and adult metabolism. Front Nutr 2022; 9:1085083. [DOI: 10.3389/fnut.2022.1085083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022] Open
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Maternal obesity in pregnancy and children’s cardiac function and structure: A systematic review and meta-analysis of evidence from human studies. PLoS One 2022; 17:e0275236. [DOI: 10.1371/journal.pone.0275236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 09/12/2022] [Indexed: 11/11/2022] Open
Abstract
The prevalence of obesity is increasing worldwide. Experimental animal studies demonstrate that maternal obesity during pregnancy directly affects cardiac structure and function in their offspring, which could contribute to their increased cardiovascular disease (CVD) risk. Currently, a systematic overview of the available evidence regarding maternal obesity and alterations in cardiac structure and function in human offspring is lacking. We systematically searched the electronic databases Embase, MEDLINE and NARCIS from inception to June 29, 2022 including human studies comparing cardiac structure and function from fetal life onwards in offspring of women with and without obesity. The review protocol was registered with PROSPERO International Prospective Register of Systematic Reviews (identifier: CRD42019125071). Risk of bias was assessed using a modified Newcastle-Ottawa scale. Results were expressed using standardized mean differences (SMD). The search yielded 1589 unique publications, of which thirteen articles were included. Compared to offspring of women without obesity, fetuses of women with obesity had lower left ventricular strain, indicative of reduced systolic function, that persisted in infancy (SMD -2.4, 95% confidence interval (CI) -4.4 standard deviation (SD) to -0.4 SD during fetal life and SMD -1.0, 95% CI -1.6 SD to -0.3 SD in infancy). Furthermore, infants born to women with obesity had a thicker interventricular septum (SMD 0.6 SD, 95% CI 0.0 to 1.2 SD) than children born to women without obesity. In conclusion, cardiac structure and function differs between fetuses and children of women with and without obesity. Some of these differences were present in fetal life, persisted in childhood and are consistent with increased CVD risk. Long-term follow-up research is warranted, as studies in offspring of older age are lacking.
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Shook LL, Fourman LT, Edlow AG. Immune Responses to SARS-CoV-2 in Pregnancy: Implications for the Health of the Next Generation. JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2022; 209:1465-1473. [PMID: 36192115 PMCID: PMC9536183 DOI: 10.4049/jimmunol.2200414] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/08/2022] [Indexed: 11/06/2022]
Abstract
Widespread SARS-CoV-2 infection among pregnant individuals has led to a generation of fetuses exposed in utero, but the long-term impact of such exposure remains unknown. Although fetal infection is rare, children born to mothers with SARS-CoV-2 infection may be at increased risk for adverse neurodevelopmental and cardiometabolic outcomes. Fetal programming effects are likely to be mediated at least in part by maternal immune activation. In this review, we discuss recent evidence regarding the effects of prenatal SARS-CoV-2 infection on the maternal, placental, and fetal immune response, as well as the implications for the long-term health of offspring. Extrapolating from what is known about the impact of maternal immune activation in other contexts (e.g., obesity, HIV, influenza), we review the potential for neurodevelopmental and cardiometabolic morbidity in offspring. Based on available data suggesting potential increased neurodevelopmental risk, we highlight the importance of establishing large cohorts to monitor offspring born to SARS-CoV-2-positive mothers for neurodevelopmental and cardiometabolic sequelae.
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Affiliation(s)
- Lydia L Shook
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA; and
| | - Lindsay T Fourman
- Metabolism Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Andrea G Edlow
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, Boston, MA;
- Vincent Center for Reproductive Biology, Massachusetts General Hospital, Boston, MA; and
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Martin SL, Zhang L, Callahan ML, Bahorski J, Lewis CE, Hidalgo BA, Durant N, Harper LM, Battarbee AN, Habegger K, Moore BA, Everett A, Aslibekyan S, Sertie R, Yi N, Garvey WT, Chandler‐Laney P. Mother-child cardiometabolic health 4-10 years after pregnancy complicated by obesity with and without gestational diabetes. Obes Sci Pract 2022; 8:627-640. [PMID: 36238222 PMCID: PMC9535673 DOI: 10.1002/osp4.599] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/20/2021] [Accepted: 01/30/2022] [Indexed: 11/25/2022] Open
Abstract
Objective Obesity in pregnancy and gestational diabetes (GDM) increase cardiometabolic disease risk but are difficult to disentangle. This study aimed to test the hypothesis that 4-10 years after a pregnancy complicated by overweight/obesity and GDM (OB-GDM), women and children would have greater adiposity and poorer cardiometabolic health than those with overweight/obesity (OB) or normal weight (NW) and no GDM during the index pregnancy. Methods In this cross-sectional study, mother-child dyads were stratified into three groups based on maternal health status during pregnancy (OB-GDM = 67; OB = 76; NW = 76). Weight, height, waist and hip circumferences, and blood pressure were measured, along with fasting glucose, insulin, HbA1c, lipids, adipokines, and cytokines. Results Women in the OB and OB-GDM groups had greater current adiposity and poorer cardiometabolic health outcomes than those in the NW group (p < 0.05). After adjusting for current adiposity, women in the OB-GDM group had higher HbA1c, glucose, HOMA-IR and triglycerides than NW and OB groups (p < 0.05). Among children, adiposity was greater in the OB-GDM versus NW group (p < 0.05), but other indices of cardiometabolic health did not differ. Conclusions Poor cardiometabolic health in women with prior GDM is independent of current adiposity. Although greater adiposity among children exposed to GDM is evident at 4-10 years, differences in cardiometabolic health may not emerge until later.
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Affiliation(s)
- Samantha L. Martin
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Li Zhang
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Makenzie L. Callahan
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Jessica Bahorski
- School of NursingUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Cora E. Lewis
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Bertha A. Hidalgo
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Nefertiti Durant
- Department of PediatricsDivision of Adolescent MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Lorie M. Harper
- Department of Women's HealthDivision of Maternal‐Fetal MedicineDell Medical SchoolThe University of Texas at AustinAustinTexasUSA
| | - Ashley N. Battarbee
- Department of Obstetrics and GynecologyDivision of Maternal Fetal MedicineUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Kirk Habegger
- Department of MedicineDivision of Endocrinology, Diabetes, and MetabolismUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Bethany A. Moore
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Alysha Everett
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Stella Aslibekyan
- Department of EpidemiologyUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Rogerio Sertie
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Nengjun Yi
- Department of BiostatisticsUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - W. Timothy Garvey
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
| | - Paula Chandler‐Laney
- Department of Nutrition SciencesUniversity of Alabama at BirminghamBirminghamAlabamaUSA
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Brombach C, Tong W, Giussani DA. Maternal obesity: new placental paradigms unfolded. Trends Mol Med 2022; 28:823-835. [PMID: 35760668 DOI: 10.1016/j.molmed.2022.05.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 01/24/2023]
Abstract
The prevalence of maternal obesity is increasing at an alarming rate, and is providing a major challenge for obstetric practice. Adverse effects on maternal and fetal health are mediated by complex interactions between metabolic, inflammatory, and oxidative stress signaling in the placenta. Endoplasmic reticulum (ER) stress and activation of the unfolded protein response (UPR) are common downstream pathways of cell stress, and there is evidence that this conserved homeostatic response may be a key mediator in the pathogenesis of placental dysfunction. We summarize the current literature on the placental cellular and molecular changes that occur in obese women. A special focus is cast onto placental ER stress in obese pregnancy, which may provide a novel link for future investigation.
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Affiliation(s)
| | - Wen Tong
- Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge CB2 3EL, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge CB2 3EG, UK; Cambridge Strategic Research Initiative in Reproduction, Cambridge CB2 3EL, Cambridge UK.
| | - Dino A Giussani
- Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge CB2 3EL, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge CB2 3EG, UK; Cambridge Strategic Research Initiative in Reproduction, Cambridge CB2 3EL, Cambridge UK; Cambridge Cardiovascular Centre for Research Excellence, Cambridge CB2 0QQ, UK.
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Lindholm A, Almquist-Tangen G, Alm B, Bremander A, Dahlgren J, Roswall J, Staland-Nyman C, Bergman S. Early rapid weight gain, parental body mass index and the association with an increased waist-to-height ratio at 5 years of age. PLoS One 2022; 17:e0273442. [PMID: 36070291 PMCID: PMC9451094 DOI: 10.1371/journal.pone.0273442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 08/08/2022] [Indexed: 11/27/2022] Open
Abstract
Background/Objectives Obesity-related adverse health consequences are closely associated with abdominal obesity. Risk factors for overweight and obesity have been studied but there is a lack of information regarding risk factors for abdominal obesity, especially in the preschool population. The aim of the present study was to examine early life risk factors for an increased waist-to-height ratio (WHtR) in children at five years of age and, in addition, to investigate if these risk factors also were associated with overweight or obesity. Subjects/Methods The study population comprised 1,540 children from a population-based longitudinal birth cohort study that included 2,666 Swedish children. The children were included if they had complete growth data for the analyses used in this study. Children were classified as having WHtR standard deviation scores (SDS) ≥ 1 or < 1 at five years of age, according to Swedish reference values, and as having body mass index standard deviation scores (BMISDS) for overweight/obesity, or normal weight/underweight according to the International Obesity Task Force criteria. Associations between child-related, socioeconomic status-related, parental health-related and nutrition- and feeding practice-related factors during the first two years and a WHtRSDS ≥ 1 or a BMISDS for overweight/obesity at five years were investigated with logistic regression analyses. Results At five years of age, 15% of the children had WHtRSDS ≥ 1 and 11% had overweight or obesity. In multivariable analyses, rapid weight gain (RWG) during 0–6 months (OR: 1.90, 95% CI: 1.23–2.95, p = 0.004), maternal pre-pregnancy BMI (1.06, 1.01–1.11, p = 0.019) and paternal BMI (1.11, 1.01–1.21, p = 0.028) were associated with WHtRSDS ≥ 1. RWG during 0–6 months (2.53, 1.53–4.20, p<0.001), 6–12 months (2.82, 1.37–5.79, p = 0.005), and maternal pre-pregnancy BMI (1.11, 1.06–1.17, p<0.001) were associated with overweight or obesity. Conclusions Early risk factors, including rapid weight gain, are associated with increased WHtRSDS and overweight or obesity at 5 years of age. Preventive interventions should target early RWG and parental overweight and obesity.
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Affiliation(s)
- Annelie Lindholm
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Research and Development Center Spenshult, Halmstad, Sweden
- * E-mail:
| | - Gerd Almquist-Tangen
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Child Health Care Unit, Region Halland, Halmstad, Sweden
| | - Bernt Alm
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Ann Bremander
- Research and Development Center Spenshult, Halmstad, Sweden
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Josefine Roswall
- Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Halland Hospital, Halmstad, Sweden
| | | | - Stefan Bergman
- Research and Development Center Spenshult, Halmstad, Sweden
- Primary Health Care Unit, Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Groves AM, Price AN, Russell-Webster T, Jhaveri S, Yang Y, Battersby EE, Shahid S, Costa Vieira M, Hughes E, Miller F, Briley AL, Singh C, Seed PT, Chowienczyk PJ, Stern KWD, Cohen J, Pasupathy D, Edwards AD, Poston L, Taylor PD. Impact of maternal obesity on neonatal heart rate and cardiac size. Arch Dis Child Fetal Neonatal Ed 2022; 107:481-487. [PMID: 34789488 DOI: 10.1136/archdischild-2021-322860] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/29/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Maternal obesity may increase offspring risk of cardiovascular disease. We assessed the impact of maternal obesity on cardiac structure and function in newborns as a marker of fetal cardiac growth. METHODS Neonates born to mothers of healthy weight (body mass index (BMI) 20-25 kg/m2, n=56) and to mothers who were obese (BMI ≥30 kg/m2, n=31) underwent 25-minute continuous ECG recording and non-sedated, free-breathing cardiac MRI within 72 hours of birth. RESULTS Mean (SD) heart rate during sleep was higher in infants born to mothers who were versus were not obese (123 (12.6) vs 114 (9.8) beats/min, p=0.002). Heart rate variability during sleep was lower in infants born to mothers who were versus were not obese (SD of normal-to-normal R-R interval 34.6 (16.8) vs 43.9 (16.5) ms, p=0.05). Similar heart rate changes were seen during wakefulness. Left ventricular end-diastolic volume (2.35 (0.14) vs 2.54 (0.29) mL/kg, p=0.03) and stroke volume (1.50 (0.09) vs 1.60 (0.14), p=0.04) were decreased in infants born to mothers who were versus were not obese. There were no differences in left ventricular end-systolic volume, ejection fraction, output or myocardial mass between the groups. CONCLUSION Maternal obesity was associated with increased heart rate, decreased heart rate variability and decreased left ventricular volumes in newborns. If persistent, these changes may provide a causal mechanism for the increased cardiovascular risk in adult offspring of mothers with obesity. In turn, modifying antenatal and perinatal maternal health may have the potential to optimise long-term cardiovascular health in offspring.
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Affiliation(s)
- Alan M Groves
- Department of Pediatrics, The University of Texas at Austin Dell Medical School, Austin, Texas, USA
| | - Anthony N Price
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Tamarind Russell-Webster
- Women's and Children's Health, King's College London, London, UK
- Academic Women's Health, University of Bristol, Bristol, UK
| | - Simone Jhaveri
- Department of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Yang Yang
- Biomedical Engineering and Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ellie E Battersby
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Shiffa Shahid
- Women's and Children's Health, King's College London, London, UK
| | | | - Emer Hughes
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Faith Miller
- Women's and Children's Health, King's College London, London, UK
| | - Annette L Briley
- Women's and Children's Health, King's College London, London, UK
| | - Claire Singh
- Women's and Children's Health, King's College London, London, UK
| | - Paul T Seed
- Women's and Children's Health, King's College London, London, UK
| | | | - Kenan W D Stern
- Department of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jennifer Cohen
- Department of Pediatric Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Dharmintra Pasupathy
- Women's and Children's Health, King's College London, London, UK
- Department of Maternal and Fetal Medicine, University of Sydney, Sydney, New South Wales, Australia
| | - A David Edwards
- Centre for the Developing Brain, Division of Imaging Sciences and Biomedical Engineering, King's College London, London, UK
| | - Lucilla Poston
- Women's and Children's Health, King's College London, London, UK
| | - Paul D Taylor
- Women's and Children's Health, King's College London, London, UK
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Marley AR, Ryder JR, Turcotte LM, Spector LG. Maternal obesity and acute lymphoblastic leukemia risk in offspring: A summary of trends, epidemiological evidence, and possible biological mechanisms. Leuk Res 2022; 121:106924. [PMID: 35939888 DOI: 10.1016/j.leukres.2022.106924] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/13/2022] [Accepted: 08/01/2022] [Indexed: 10/16/2022]
Abstract
Acute lymphoblastic leukemia, a heterogenous malignancy characterized by uncontrolled proliferation of lymphoid progenitors and generally initiated in utero, is the most common pediatric cancer. Although incidence of ALL has been steadily increasing in recent decades, no clear reason for this trend has been identified. Rising concurrently with ALL incidence, increasing maternal obesity rates may be partially contributing to increasing ALL prevelance. Epidemiological studies, including a recent meta-analysis, have found an association between maternal obesity and leukemogenesis in offspring, although mechanisms underlying this association remain unknown. Therefore, the purpose of this review is to propose possible mechanisms connecting maternal obesity to ALL risk in offspring, including changes to fetal/neonatal epigenetics, altered insulin-like growth factor profiles and insulin resistance, modified adipokine production and secretion, changes to immune cell populations, and impacts on birthweight and childhood obesity/adiposity. We describe how each proposed mechanism is biologically plausible due to their connection with maternal obesity, presence in neonatal and/or fetal tissue, observation in pediatric ALL patients at diagnosis, and association with leukemogenesis, A description of ALL and maternal obesity trends, a summary of epidemiological evidence, a discussion of the pathway from intrauterine environment to subsequent malignancy, and propositions for future directions are also presented.
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Affiliation(s)
- Andrew R Marley
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, 420 Delaware St SE MMC 715, Minneapolis, MN 55455, USA.
| | - Justin R Ryder
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, 420 Delaware St SE MMC 715, Minneapolis, MN 55455, USA; Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota, 2450 Riverside Ave S AO-102, Minneapolis, MN 55454, USA
| | - Lucie M Turcotte
- Division of Hematology/Oncology, Department of Pediatrics, University of Minnesota, 420 Delaware St SE MMC 484, Minneapolis, MN 55455, USA; Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455, USA
| | - Logan G Spector
- Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, 420 Delaware St SE MMC 715, Minneapolis, MN 55455, USA; Masonic Cancer Center, University of Minnesota, 425 East River Parkway, Minneapolis, MN 55455, USA
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45
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Programming by maternal obesity: a pathway to poor cardiometabolic health in the offspring. Proc Nutr Soc 2022; 81:227-242. [DOI: 10.1017/s0029665122001914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is an ever increasing prevalence of maternal obesity worldwide such that in many populations over half of women enter pregnancy either overweight or obese. This review aims to summarise the impact of maternal obesity on offspring cardiometabolic outcomes. Maternal obesity is associated with increased risk of adverse maternal and pregnancy outcomes. However, beyond this exposure to maternal obesity during development also increases the risk of her offspring developing long-term adverse cardiometabolic outcomes throughout their adult life. Both human studies and those in experimental animal models have shown that maternal obesity can programme increased risk of offspring developing obesity and adipose tissue dysfunction; type 2 diabetes with peripheral insulin resistance and β-cell dysfunction; CVD with impaired cardiac structure and function and hypertension via impaired vascular and kidney function. As female offspring themselves are therefore likely to enter pregnancy with poor cardiometabolic health this can lead to an inter-generational cycle perpetuating the transmission of poor cardiometabolic health across generations. Maternal exercise interventions have the potential to mitigate some of the adverse effects of maternal obesity on offspring health, although further studies into long-term outcomes and how these translate to a clinical context are still required.
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Freaney PM, Harrington K, Molsberry R, Perak AM, Wang MC, Grobman W, Greenland P, Allen NB, Capewell S, O’Flaherty M, Lloyd‐Jones DM, Khan SS. Temporal Trends in Adverse Pregnancy Outcomes in Birthing Individuals Aged 15 to 44 Years in the United States, 2007 to 2019. J Am Heart Assoc 2022; 11:e025050. [PMID: 35583146 PMCID: PMC9238733 DOI: 10.1161/jaha.121.025050] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/18/2022] [Indexed: 11/16/2022]
Abstract
Background Adverse pregnancy outcomes (APOs) (hypertensive disorders of pregnancy [HDP], preterm delivery [PTD], or low birth weight [LBW]) are associated adverse maternal and offspring cardiovascular outcomes. Therefore, we sought to describe nationwide temporal trends in the burden of each APO (HDP, PTD, LBW) from 2007 to 2019 to inform strategies to optimize maternal and offspring health outcomes. Methods and Results We performed a serial cross-sectional analysis of APO subtypes (HDP, PTD, LBW) from 2007 to 2019. We included maternal data from all live births that occurred in the United States using the National Center for Health Statistics Natality Files. We quantified age-standardized and age-specific rates of APOs per 1000 live births and their respective mean annual percentage change. All analyses were stratified by self-report of maternal race and ethnicity. Among 51 685 525 live births included, 15% were to non-Hispanic Black individuals, 24% Hispanic individuals, and 6% Asian individuals. Between 2007 and 2019, age standardized HDP rates approximately doubled, from 38.4 (38.2-38.6) to 77.8 (77.5-78.1) per 1000 live births. A significant inflection point was observed in 2014, with an acceleration in the rate of increase of HDP from 2007 to 2014 (+4.1% per year [3.6-4.7]) to 2014 to 2019 (+9.1% per year [8.1-10.1]). Rates of PTD and LBW increased significantly when co-occurring in the same pregnancy with HDP. Absolute rates of APOs were higher in non-Hispanic Black individuals and in older age groups. However, similar relative increases were seen across all age,racial and ethnic groups. Conclusions In aggregate, APOs now complicate nearly 1 in 5 live births. Incidence of HDP has increased significantly between 2007 and 2019 and contributed to the reversal of favorable trends in PTD and LBW. Similar patterns were observed in all age groups, suggesting that increasing maternal age at pregnancy does not account for these trends. Black-White disparities persisted throughout the study period.
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Affiliation(s)
- Priya M. Freaney
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Katharine Harrington
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Rebecca Molsberry
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Amanda M. Perak
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Michael C. Wang
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - William Grobman
- Department of Obstetrics and GynecologyNorthwestern University Feinberg School of MedicineChicagoIL
| | - Philip Greenland
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Norrina B. Allen
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Simon Capewell
- Institute of Population HealthUniversity of LiverpoolUnited Kingdom
| | | | - Donald M. Lloyd‐Jones
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
| | - Sadiya S. Khan
- Division of CardiologyDepartment of MedicineNorthwestern University Feinberg School of MedicineChicagoIL
- Department of Preventive MedicineNorthwestern University Feinberg School of MedicineChicagoIL
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Rodrigo N, Saad S, Pollock C, Glastras SJ. Diet Modification before or during Pregnancy on Maternal and Foetal Outcomes in Rodent Models of Maternal Obesity. Nutrients 2022; 14:2154. [PMID: 35631295 PMCID: PMC9146671 DOI: 10.3390/nu14102154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/16/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022] Open
Abstract
The obesity epidemic has serious implications for women of reproductive age; its rising incidence is associated not just with health implications for the mother but also has transgenerational ramifications for the offspring. Increased incidence of diabetes, cardiovascular disease, obesity, and kidney disease are seen in both the mothers and the offspring. Animal models, such as rodent studies, are fundamental to studying maternal obesity and its impact on maternal and offspring health, as human studies lack rigorous controlled experimental design. Furthermore, the short and prolific reproductive potential of rodents enables examination across multiple generations and facilitates the exploration of interventional strategies to mitigate the impact of maternal obesity, both before and during pregnancy. Given that obesity is a major public health concern, it is important to obtain a greater understanding of its pathophysiology and interaction with reproductive health, placental physiology, and foetal development. This narrative review focuses on the known effects of maternal obesity on the mother and the offspring, and the benefits of interventional strategies, including dietary intervention, before or during pregnancy on maternal and foetal outcomes. It further examines the contribution of rodent models of maternal obesity to elucidating pathophysiological pathways of disease development, as well as methods to reduce the impact of obesity on the mothers and the developing foetus. The translation of these findings into the human experience will also be discussed.
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Affiliation(s)
- Natassia Rodrigo
- Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, Sydney 2065, Australia;
- Kolling Institute of Medical Research, Sydney 2065, Australia; (S.S.); (C.P.)
- Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Sonia Saad
- Kolling Institute of Medical Research, Sydney 2065, Australia; (S.S.); (C.P.)
- Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
| | - Carol Pollock
- Kolling Institute of Medical Research, Sydney 2065, Australia; (S.S.); (C.P.)
- Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
- Department of Renal Medicine, Royal North Shore Hospital, Sydney 2065, Australia
| | - Sarah J. Glastras
- Department of Diabetes, Endocrinology and Metabolism, Royal North Shore Hospital, Sydney 2065, Australia;
- Kolling Institute of Medical Research, Sydney 2065, Australia; (S.S.); (C.P.)
- Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia
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Billah MM, Khatiwada S, Morris MJ, Maloney CA. Effects of paternal overnutrition and interventions on future generations. Int J Obes (Lond) 2022; 46:901-917. [PMID: 35022547 PMCID: PMC9050512 DOI: 10.1038/s41366-021-01042-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/17/2021] [Accepted: 11/25/2021] [Indexed: 02/06/2023]
Abstract
In the last two decades, evidence from human and animal studies suggests that paternal obesity around the time of conception can have adverse effects on offspring health through developmental programming. This may make significant contributions to the current epidemic of obesity and related metabolic and reproductive complications like diabetes, cardiovascular disease, and subfertility/infertility. To date, changes in seminal fluid composition, sperm DNA methylation, histone composition, small non-coding RNAs, and sperm DNA damage have been proposed as potential underpinning mechanism to program offspring health. In this review, we discuss current human and rodent evidence on the impact of paternal obesity/overnutrition on offspring health, followed by the proposed mechanisms, with a focus on sperm DNA damage underpinning paternal programming. We also summarize the different intervention strategies implemented to minimize effects of paternal obesity. Upon critical review of literature, we find that obesity-induced altered sperm quality in father is linked with compromised offspring health. Paternal exercise intervention before conception has been shown to improve metabolic health. Further work to explore the mechanisms underlying benefits of paternal exercise on offspring are warranted. Conversion to healthy diets and micronutrient supplementation during pre-conception have shown some positive impacts towards minimizing the impact of paternal obesity on offspring. Pharmacological approaches e.g., metformin are also being applied. Thus, interventions in the obese father may ameliorate the potential detrimental impacts of paternal obesity on offspring.
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Affiliation(s)
| | - Saroj Khatiwada
- School of Medical Sciences, UNSW Sydney, Sydney, NSW, 2052, Australia
| | - Margaret J Morris
- School of Medical Sciences, UNSW Sydney, Sydney, NSW, 2052, Australia
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Wang B, Xia L, Zhu D, Zeng H, Wei B, Lu L, Li W, Shi Y, Liu J, Zhang Y, Sun M. Paternal High-Fat Diet Altered Sperm 5'tsRNA-Gly-GCC Is Associated With Enhanced Gluconeogenesis in the Offspring. Front Mol Biosci 2022; 9:857875. [PMID: 35480893 PMCID: PMC9035875 DOI: 10.3389/fmolb.2022.857875] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/16/2022] [Indexed: 12/13/2022] Open
Abstract
Background: Paternal lifestyle, stress and environmental exposures play a crucial role in the health of offspring and are associated with non-genetic inheritance of acquired traits, however the underlying mechanisms are unclear. In this study, we aimed to find out how the sperm tsRNA involved in paternal high-fat diet induced abnormal gluconeogenesis of F1 offspring, and explore the underlying molecular mechanism of its regulation. Method: We generated a paternal high fat diet (42% kcal fat) model to investigate the mechanism by which paternal diet affects offspring metabolism. Four-week-old C57BL/6J male mice were randomly assigned into two groups to receive either a control diet (CD; 10% kcal fat) or a high-fat (HFD; 42% kcal fat) diet for 10 weeks, and mice from each group were then mated with 8-week-old females with control diet in a 1:2 ratio to generate F1. F0 sperms were isolated and small RNAs was sequenced by high-throughput sequencing. Metabolic phenotypes were examined with both F0 and F1. Results: A significant increase in body weight was observed with HFD-F0 mice at 8 weeks of age as compared to CD mice at the same age. F0 mice showed impaired glucose tolerance (GTT), resistance to insulin tolerance (ITT) and increased pyruvate tolerance (PTT) at 14 weeks. HFD-F1 male mice showed no significant difference in body weight. An increase in PTT was found at 13 weeks of age and no significant changes in GTT and ITT. PEPCK and G6Pase that related to gluconeogenesis increased significantly in the liver of HFD-F1 male mice. Sperm sequencing results showed that 5′tsRNA-Gly-GCC derived from tRNA-Gly-GCC-2 specifically was remarkably upregulated in sperm of HFD F0 mice. Q-PCR further showed that this tsRNA was also increased in the liver of HFD-F1 comparison with CD-F1 mice. In addition, we found that 5′tsRNA-Gly-GCC can regulate Sirt6-FoxO1 pathway and be involved in the gluconeogenesis pathway in liver. Conclusion: 5′tsRNA-Gly-GCC that increased in HFD mice mature sperms can promote gluconeogenesis in liver by regulating Sirt6-FoxO1 pathway, which might represent a potential paternal epigenetic factor mediating the intergenerational inheritance of diet-induced metabolic alteration.
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Affiliation(s)
- Bin Wang
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Lin Xia
- Medical Center of Hematology, The Xinqiao Hospital of Army Medical University, Chongqing, China
| | - Dan Zhu
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Hongtao Zeng
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Bin Wei
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Likui Lu
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Weisheng Li
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Yajun Shi
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Jingliu Liu
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
| | - Yunfang Zhang
- Shanghai Key Laboratory of Signaling and Disease Research, School of Life Sciences and Technology, Clinical and Translational Research Center of Shanghai First Maternity and Infant Hospital, Tongji University, Shanghai, China
- *Correspondence: Yunfang Zhang, ; Miao Sun,
| | - Miao Sun
- Institute for Fetology, The First Affiliated Hospital of Soochow University, Suzhou City, China
- *Correspondence: Yunfang Zhang, ; Miao Sun,
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Akhabir L, Stringer R, Desai D, Mandhane PJ, Azad MB, Moraes TJ, Subbarao P, Turvey SE, Paré G, Anand SS, Anand SS, Atkinson SA, Azad MB, Becker AB, Brook J, Denburg JA, Desai D, de Souza RJ, Gupta M, Kobor M, Lefebvre DL, Lou W, Mandhane PJ, McDonald S, Mente A, Meyre D, Moraes TJ, Morrison K, Paré G, Sears MR, Subbarao P, Teo KK, Turvey SE, Wilson J, Yusuf S, Atkinson S, Wahi G, Zulyniak MA. DNA methylation changes in cord blood and the developmental origins of health and disease – a systematic review and replication study. BMC Genomics 2022; 23:221. [PMID: 35305575 PMCID: PMC8933946 DOI: 10.1186/s12864-022-08451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 03/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Environmental exposures in utero which modify DNA methylation may have a long-lasting impact on health and disease in offspring. We aimed to identify and replicate previously published genomic loci where DNA methylation changes are attributable to in utero exposures in the NutriGen birth cohort studies Alliance.
Methods
We reviewed the literature to identify differentially methylated sites of newborn DNA which are associated with the following five traits of interest maternal diabetes, pre-pregnancy body mass index (BMI), diet during pregnancy, smoking, and gestational age. We then attempted to replicate these published associations in the Canadian Healthy Infant Longitudinal Development (CHILD) and the South Asian birth cohort (START) cord blood epigenome-wide data.
Results
We screened 68 full-text articles and identified a total of 17 cord blood epigenome-wide association studies (EWAS) of the traits of interest. Out of the 290 CpG sites reported, 19 were identified in more than one study; all of them associated with maternal smoking. In CHILD and START EWAS, thousands of sites associated with gestational age were identified and maintained significance after correction for multiple testing. In CHILD, there was differential methylation observed for 8 of the published maternal smoking sites. No other traits tested (i.e., folate levels, gestational diabetes, birthweight) replicated in the CHILD or START cohorts.
Conclusions
Maternal smoking during pregnancy and gestational age are strongly associated with differential methylation in offspring cord blood, as assessed in the EWAS literature and our birth cohorts. There are a limited number of reported methylation sites associated in more than two independent studies related to pregnancy. Additional large studies of diverse populations with fine phenotyping are needed to produce robust epigenome-wide data in order to further elucidate the effect of intrauterine exposures on the infants’ methylome.
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