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Pedersen JN, Dalgård C, Möller S, Andersen LB, Birukov A, Andersen MS, Christesen HT. Early pregnancy vitamin D status is associated with blood pressure in children: an Odense Child Cohort study. Am J Clin Nutr 2022; 116:470-481. [PMID: 35511609 PMCID: PMC9348989 DOI: 10.1093/ajcn/nqac118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 04/27/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Blood pressure in childhood tracks into later life. Vitamin D status in adults is associated with blood pressure, but the impact of vitamin D status in pregnancy and childhood on blood pressure still needs investigation. OBJECTIVE We investigated whether fetal rather than current vitamin D status is associated with blood pressure in children. METHODS In a prospective observational study within the population-based Odense Child Cohort (OCC), we examined serum 25-hydroxyvitamin D2+3 [s-25(OH)D] in early and late pregnancy, cord blood, and at 5 y age, and the associations with systolic and diastolic blood pressure (SBP/DBP) in the 5-y-old children (n = 1,677). Multiple regression models were adjusted for maternal country of origin, parity, smoking during pregnancy, 5-y height, and weight. Two-stage mixed effect modeling was performed, integrating all s-25(OH)D data from pregnancy and cord blood. RESULTS The median (IQR) s-25(OH)D in early pregnancy, late pregnancy, the umbilical cord, and at 5 y was 65.5 (50.7-78.5), 78.5 (60.3- 95.8), 45.4 (31.1- 60.7), and 71.9 (54.6- 86.5) nmol/L, respectively. The mean ±SD 5-y SBP/DBP was 101.0/63.8 (7.1/5.9) mmHg. In adjusted analyses, a 10 nmol/L increase of s-25(OH)D in early pregnancy associated with a 0.3/0.2 mmHg lower SBP/DBP at 5 y (P < 0.05). Optimal s-25(OH)D (>75 nmol/L) in early pregnancy was associated with lower 5-y SBP and DBP, β (95% CI) -1.45 (-2.6, -0.3), and -0.97 (-1.9, -0.1), compared with reference s-25(OH)D (50-74.9 nmol/L). Two-stage analysis combining early pregnancy, late pregnancy, and cord s-25(OH)D data showed an inverse association with 5-y SBP and DBP for boys (P < 0.025) with significant sex-difference for DBP (Pinteraction = 0.004). No associations were found between s-25(OH)D and 5-y BP above the 90th percentile. CONCLUSION Early pregnancy s-25(OH)D concentrations, especially >75 nmol/L, were inversely associated with 5-y blood pressure in the offspring. A novel identified protective effect of optimal vitamin D levels in early pregnancy on offspring BP is suggested.
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Affiliation(s)
- Josefine N Pedersen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark,Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Christine Dalgård
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark,Clinical Pharmacology, Pharmacy and Environmental Medicine, Dept of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sören Möller
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark,Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - Louise B Andersen
- General Practice, Capital Region, Denmark,Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark
| | - Anna Birukov
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
| | - Marianne Skovsager Andersen
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark,Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Birukov A, Herse F, Nielsen JH, Kyhl HB, Golic M, Kräker K, Haase N, Busjahn A, Bruun S, Jensen BL, Müller DN, Jensen TK, Christesen HT, Andersen MS, Jørgensen JS, Dechend R, Andersen LB. Blood Pressure and Angiogenic Markers in Pregnancy: Contributors to Pregnancy-Induced Hypertension and Offspring Cardiovascular Risk. Hypertension 2020; 76:901-909. [PMID: 32507044 DOI: 10.1161/hypertensionaha.119.13966] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pregnancy-induced hypertension is a severe pregnancy complication, increasing risk of long-term cardiovascular disease in mothers and offspring. We hypothesized that maternal blood pressure in pregnancy associated with offspring blood pressure; that the associations were sex-specific; and that maternal circulating placental angiogenic markers (PlGF [placental growth factor] and sFlt-1 [soluble fms-like tyrosine kinase-1]) mediated this relationship. We analyzed data from 2434 women and 2217 children from the Odense Child Cohort, a prospective Danish cohort study. Offspring blood pressure trajectory from 4 months to 5 years was highly associated to maternal first, second, and third trimester blood pressure, and mean blood pressure in pregnancy, independent of maternal and offspring covariates. There were offspring sex-specific associations: Girls from mothers in the highest quartile of first and third trimester blood pressure had significantly higher systolic blood pressure at 5 years than the rest of the cohort (mean difference±SEM: 1.81±0.59 and 2.11±0.59 mm Hg, respectively, all P<0.01); whereas boys had significantly higher diastolic blood pressure at 5 years (mean difference±SEM: 1.11±0.45 and 1.03±0.45, respectively, all P<0.05). Concentrations of PlGF at gestational week 28 correlated inversely to maternal gestational blood pressure trajectory, independent of the diagnosis of pregnancy-induced hypertension, adjusted β coefficients (95% CI) for predicting systolic blood pressure (SBP): -3.18 (-4.66 to -1.70) mm Hg, for predicting diastolic blood pressure (DBP): -2.48 (-3.57 to -1.40) mm Hg. In conclusion, maternal gestational blood pressure predicted offspring blood pressure trajectory until 5 years in a sex-differential manner. Furthermore, subtle alterations in blood pressure in early pregnancy preceded hypertension or preeclampsia, and PlGF was a mediator of cardiovascular health in pregnancy.
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Affiliation(s)
- Anna Birukov
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A. Birukov)
| | - Florian Herse
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Julie H Nielsen
- Department of Endocrinology and Metabolism, Odense University Hospital, Denmark (J.H.N., M.S.A.)
| | - Henriette B Kyhl
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.)
| | - Michaela Golic
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Kristin Kräker
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Nadine Haase
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | | | - Signe Bruun
- OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (S.B., H.T.C.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.).,Strategic Business Unit Pediatric, Arla Foods Ingredients Group P/S, Viby J, Denmark (S.B.)
| | - Boye L Jensen
- Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark (B.L.J.)
| | - Dominik N Müller
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.)
| | - Tina Kold Jensen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,Department of Environmental Medicine, Institute of Public Health, University of Southern Denmark, Odense, Denmark (T.K.J.)
| | - Henrik T Christesen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (S.B., H.T.C.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.)
| | | | - Jan Stener Jørgensen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.B.K., T.K.J., H.T.C., J.S.J.).,OPEN Patient data Explorative Network, Odense University Hospital, Denmark (H.B.K., S.B., H.T.C., J.S.J.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.)
| | - Ralf Dechend
- From the experimental and Clinical Research Center, a joint cooperation between Max-Delbrück-Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,Max Delbrück Center for Molecular Medicine in the Helmholtz Association, Berlin, Germany (A. Birukov, F.H., M.G., K.K., N.H., D.N.M., R.D.).,DZHK (German Centre for Cardiovascular Research), partner site Berlin, Germany (A. Birukov, K.K., N.H., D.N.M., R.D.).,Berlin Institute of Health, Germany (F.H., M.G., K.K., N.H., D.N.M., R.D.).,Department of Cardiology and Nephrology, HELIOS-Klinikum, Berlin, Germany (R.D.)
| | - Louise Bjørkholt Andersen
- Department of Obstetrics and Gynecology, Odense University Hospital, Odense, Denmark (A. Birukov, J.S.J., L.B.A.).,Institute of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark (S.B., H.T.C., J.S.J., L.B.A.).,Department of Obstetrics and Gynecology, Herlev Hospital, Denmark (L.B.A.)
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Larsen SD, Christensen ME, Dalgård C, Lykkedegn S, Andersen LB, Andersen MS, Glintborg D, Christesen HT. Pregnancy or cord 25-hydroxyvitamin D is not associated with measures of body fat or adiposity in children from three months to three years of age. An Odense Child Cohort study. Clin Nutr 2019; 39:1832-1839. [PMID: 31471164 DOI: 10.1016/j.clnu.2019.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/09/2019] [Accepted: 07/25/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND & AIMS The susceptibility to overweight in adults born during winter season may suggest foetal programming of prenatal vitamin D levels on adiposity. We investigated whether cord or pregnancy serum 25-hydroxyvitamin D (s-25OHD) was associated with infant and child body fat measures in a Danish population-based prospective cohort. METHODS In the Odense Child Cohort, 1905 singletons had cord s-25OHD and data on waist circumference (WC), weight, body mass index (BMI), and sum of skin folds (SSF) at median 3.7 months, 18.9 months and three years' age. Early and late pregnancy samples of s-25OHD (mean gestational age 12 and 29 weeks) were chosen as secondary exposures. Multiple linear and logistic regression as well as linear mixed models was applied testing the relation between cord and pregnancy s-25OHD and body fat outcomes and their Z-scores by use of updated national reference populations. Models were adjusted for maternal educational level, maternal ethnicity, pre-gestational BMI and season of birth, a priori stratified by sex. RESULTS The median [IQR] cord s-25OHD was 45.5 [31.1; 60.9] nmol/L. Cord s-25OHD <50 nmol/L was found in 57.5%; values < 25 nmol/L in 16.3%. The mean Z-scores of body fat measures at all ages were in the range of -0.32 to +0.42. No consistent associations were found between s-25OHD in cord, early pregnancy or late pregnancy and WC, weight, BMI, SSF, or their Z-scores at ages 3.7 months, 18.9 months, or 3 years. Neither did a computed composite outcome (WC, SSF, BMI, or weight >90th vs. ≤90 percentile) associate with cord or pregnancy s-25OHD. CONCLUSION Cord or pregnancy s-25OHD was not associated with measures of body fat or adiposity in children up to three years of age. Our data suggested no programming effect of maternal s-25OHD on offspring obesity in a relatively lean and healthy population of mothers.
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Affiliation(s)
- Søs Dragsbæk Larsen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Mathilde Egelund Christensen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark
| | - Christine Dalgård
- Department of Public Health, Environmental Medicine, University of Southern Denmark, Odense, Denmark
| | - Sine Lykkedegn
- Department of Paediatrics, Hospital South West Jutland, Esbjerg, Denmark
| | - Louise Bjørkholt Andersen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Obstetrics and Gynaecology, Herlev Hospital, Copenhagen, Denmark; Department of Obstetrics and Gynaecology, Odense University Hospital, Denmark
| | - Marianne Skovsager Andersen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Department of Medical Endocrinology, Odense University Hospital, Odense, Denmark
| | - Dorte Glintborg
- Department of Medical Endocrinology, Odense University Hospital, Odense, Denmark
| | - Henrik Thybo Christesen
- Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark; Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, Denmark.
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