1
|
de Ruyter H, Aitokari L, Lahti S, Riekki H, Huhtala H, Lakka T, Laivuori H, Kurppa K. Maternal gestational hypertension, smoking and pre-eclampsia are associated with metabolic dysfunction-associated fatty liver disease in overweight offspring. Acta Obstet Gynecol Scand 2024; 103:1183-1191. [PMID: 38433535 PMCID: PMC11103127 DOI: 10.1111/aogs.14816] [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: 11/08/2023] [Revised: 01/19/2024] [Accepted: 02/16/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Due to a steep increase in obesity, metabolic dysfunction-associated fatty liver disease (MAFLD) has also become the most common chronic hepatic condition among children and adolescents. Various maternal and pregnancy-related factors have also been implicated in the development of MAFLD, but human studies remain scarce. MATERIAL AND METHODS Comprehensive data of 460 overweight or obese children aged 2-16 years were collected and combined with data on selected maternal and pregnancy-related factors for a case-control study. MALFD was defined as alanine aminotransferase >2× upper limit of normal. Children with and without MAFLD were compared regarding to the study variables and multivariable regression analysis was utilized. RESULTS Median age of the study children was 11.8 (quartiles 9.1-14.2) years; 44% were girls and 17.8% had MAFLD. Children with MAFLD were older (12.7 vs. 11.6 years, p = 0.002), while the groups did not differ age-standardized body mass index (BMI-SDS) or gender. Factors associated with MAFLD in a multivariable model considering also the offspring's present BMI-SDS, sex, and maternal prepregnancy overweight, were child's older age (odds ratio [OR] 1.16, 95% confidence interval [CI]: 1.06-1.28), maternal gestational smoking (OR 2.01, 95% CI: 1.16-3.47), gestational hypertension (OR 3.44, 95% CI: 1.08-11.0) and pre-eclampsia (OR 2.93, 95% CI: 1.15-7.45). There was no significant association between MAFLD and maternal BMI, birth anthropometrics or perinatal complications. CONCLUSIONS Maternal smoking, gestational hypertension and pre-eclampsia were associated with MAFLD among overweight or obese children. Further prospective studies are needed to verify causal relationships.
Collapse
Affiliation(s)
- Hanna de Ruyter
- Tampere Center for Child, Adolescent and Maternal Health ResearchTampere University and Tampere University Hospital, Wellbeing Services County of PirkanmaaTampereFinland
| | - Linnea Aitokari
- Tampere Center for Child, Adolescent and Maternal Health ResearchTampere University and Tampere University Hospital, Wellbeing Services County of PirkanmaaTampereFinland
- Celiac Disease Research CenterTampere UniversityTampereFinland
| | - Siiri Lahti
- Tampere Center for Child, Adolescent and Maternal Health ResearchTampere University and Tampere University Hospital, Wellbeing Services County of PirkanmaaTampereFinland
| | - Hanna Riekki
- Tampere Center for Child, Adolescent and Maternal Health ResearchTampere University and Tampere University Hospital, Wellbeing Services County of PirkanmaaTampereFinland
| | - Heini Huhtala
- Faculty of Social SciencesTampere UniversityTampereFinland
| | - Timo Lakka
- Institute of BiomedicineUniversity of Eastern FinlandKuopioFinland
- Department of Clinical Physiology and Nuclear MedicineKuopio University HospitalKuopioFinland
- Kuopio Research Institute of Exercise MedicineKuopioFinland
| | - Hannele Laivuori
- Tampere Center for Child, Adolescent and Maternal Health ResearchTampere University and Tampere University Hospital, Wellbeing Services County of PirkanmaaTampereFinland
- Medical and Clinical GeneticsUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Kalle Kurppa
- Tampere Center for Child, Adolescent and Maternal Health ResearchTampere University and Tampere University Hospital, Wellbeing Services County of PirkanmaaTampereFinland
- Celiac Disease Research CenterTampere UniversityTampereFinland
- University Consortium of SeinäjokiSeinäjokiFinland
| |
Collapse
|
2
|
Xie Y, Peng G, Zhao H, Scharfe C. Association of Maternal Age and Blood Markers for Metabolic Disease in Newborns. Metabolites 2023; 14:5. [PMID: 38276295 PMCID: PMC10821442 DOI: 10.3390/metabo14010005] [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: 11/16/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/27/2024] Open
Abstract
Pregnancy at an advanced maternal age is considered a risk factor for adverse maternal, fetal, and neonatal outcomes. Here we investigated whether maternal age could be associated with differences in the blood levels of newborn screening (NBS) markers for inborn metabolic disorders on the Recommended Universal Screening Panel (RUSP). Population-level NBS data from screen-negative singleton infants were examined, which included blood metabolic markers and covariates such as age at blood collection, birth weight, gestational age, infant sex, parent-reported ethnicity, and maternal age at delivery. Marker levels were compared between maternal age groups (age range: 1544 years) using effect size analyses, which controlled for differences in group sizes and potential confounding from other covariates. We found that 13% of the markers had maternal age-related differences, including newborn metabolites with either increased (Tetradecanoylcarnitine [C14], Palmitoylcarnitine [C16], Stearoylcarnitine [C18], Oleoylcarnitine [C18:1], Malonylcarnitine [C3DC]) or decreased (3-Hydroxyisovalerylcarnitine [C5OH]) levels at an advanced maternal age (≥35 years, absolute Cohen's d > 0.2). The increased C3DC levels in this group correlated with a higher false-positive rate in newborn screening for malonic acidemia (p-value < 0.001), while no significant difference in screening performance was seen for the other markers. Maternal age is associated with inborn metabolic differences and should be considered together with other clinical variables in genetic disease screening.
Collapse
Affiliation(s)
- Yuhan Xie
- Department of Biostatistics, Yale School of Public Health, New Haven, CT 06510, USA
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | - Gang Peng
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Hongyu Zhao
- Department of Biostatistics, Yale School of Public Health, New Haven, CT 06510, USA
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| | - Curt Scharfe
- Department of Genetics, Yale School of Medicine, New Haven, CT 06510, USA
| |
Collapse
|
3
|
Snyder BM, Nian H, Miller AM, Ryckman KK, Li Y, Tindle HA, Ammar L, Ramesh A, Liu Z, Hartert TV, Wu P. Associations between Smoking and Smoking Cessation during Pregnancy and Newborn Metabolite Concentrations: Findings from PRAMS and INSPIRE Birth Cohorts. Metabolites 2023; 13:1163. [PMID: 37999258 PMCID: PMC10673147 DOI: 10.3390/metabo13111163] [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: 09/20/2023] [Revised: 11/13/2023] [Accepted: 11/18/2023] [Indexed: 11/25/2023] Open
Abstract
Newborn metabolite perturbations may identify potential biomarkers or mechanisms underlying adverse, smoking-related childhood health outcomes. We assessed associations between third-trimester smoking and newborn metabolite concentrations using the Tennessee Pregnancy Risk Assessment Monitoring System (PRAMS, 2009-2019) as the discovery cohort and INSPIRE (2012-2014) as the replication cohort. Children were linked to newborn screening metabolic data (33 metabolites). Third-trimester smoking was ascertained from birth certificates (PRAMS) and questionnaires (INSPIRE). Among 8600 and 1918 mother-child dyads in PRAMS and INSPIRE cohorts, 14% and 13% of women reported third-trimester smoking, respectively. Third-trimester smoking was associated with higher median concentrations of free carnitine (C0), glycine (GLY), and leucine (LEU) at birth (PRAMS: C0: adjusted fold change 1.11 [95% confidence interval (CI) 1.08, 1.14], GLY: 1.03 [95% CI 1.01, 1.04], LEU: 1.04 [95% CI 1.03, 1.06]; INSPIRE: C0: 1.08 [95% CI 1.02, 1.14], GLY: 1.05 [95% CI 1.01, 1.09], LEU: 1.05 [95% CI 1.01, 1.09]). Smoking cessation (vs. continued smoking) during pregnancy was associated with lower median metabolite concentrations, approaching levels observed in infants of non-smoking women. Findings suggest potential pathways underlying fetal metabolic programming due to in utero smoke exposure and a potential reversible relationship of cessation.
Collapse
Affiliation(s)
- Brittney M. Snyder
- Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA (H.A.T.)
| | - Hui Nian
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Angela M. Miller
- Division of Population Health Assessment, Tennessee Department of Health, Nashville, TN 37243, USA
| | - Kelli K. Ryckman
- Department of Epidemiology and Biostatistics, Indiana University School of Public Health—Bloomington, Bloomington, IN 47405, USA
| | - Yinmei Li
- Division of Family Health and Wellness, Tennessee Department of Health, Nashville, TN 37243, USA;
| | - Hilary A. Tindle
- Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA (H.A.T.)
- The Vanderbilt Center for Tobacco, Addiction and Lifestyle, Vanderbilt University Medical Center, Nashville, TN 37203, USA
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN 37212, USA
| | - Lin Ammar
- Vanderbilt University School of Medicine, Nashville, TN 37203, USA;
| | - Abhismitha Ramesh
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA 52242, USA
| | - Zhouwen Liu
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Tina V. Hartert
- Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA (H.A.T.)
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| | - Pingsheng Wu
- Department of Medicine, Vanderbilt University Medical Center, 2525 West End Avenue, Nashville, TN 37203, USA (H.A.T.)
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN 37203, USA
| |
Collapse
|