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Cáceres A, Carreras-Gallo N, Andrusaityte S, Bustamante M, Carracedo Á, Chatzi L, Dwaraka VB, Grazuleviciene R, Gutzkow KB, Lepeule J, Maitre L, Mendez TL, Nieuwenhuijsen M, Slama R, Smith R, Stratakis N, Thomsen C, Urquiza J, Went H, Wright J, Yang T, Casas M, Vrijheid M, González JR. Prenatal environmental exposures associated with sex differences in childhood obesity and neurodevelopment. BMC Med 2023; 21:142. [PMID: 37046291 PMCID: PMC10099694 DOI: 10.1186/s12916-023-02815-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/06/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Obesity and neurodevelopmental delay are complex traits that often co-occur and differ between boys and girls. Prenatal exposures are believed to influence children's obesity, but it is unknown whether exposures of pregnant mothers can confer a different risk of obesity between sexes, and whether they can affect neurodevelopment. METHODS We analyzed data from 1044 children from the HELIX project, comprising 93 exposures during pregnancy, and clinical, neuropsychological, and methylation data during childhood (5-11 years). Using exposome-wide interaction analyses, we identified prenatal exposures with the highest sexual dimorphism in obesity risk, which were used to create a multiexposure profile. We applied causal random forest to classify individuals into two environments: E1 and E0. E1 consists of a combination of exposure levels where girls have significantly less risk of obesity than boys, as compared to E0, which consists of the remaining combination of exposure levels. We investigated whether the association between sex and neurodevelopmental delay also differed between E0 and E1. We used methylation data to perform an epigenome-wide association study between the environments to see the effect of belonging to E1 or E0 at the molecular level. RESULTS We observed that E1 was defined by the combination of low dairy consumption, non-smokers' cotinine levels in blood, low facility richness, and the presence of green spaces during pregnancy (ORinteraction = 0.070, P = 2.59 × 10-5). E1 was also associated with a lower risk of neurodevelopmental delay in girls, based on neuropsychological tests of non-verbal intelligence (ORinteraction = 0.42, P = 0.047) and working memory (ORinteraction = 0.31, P = 0.02). In line with this, several neurodevelopmental functions were enriched in significant differentially methylated probes between E1 and E0. CONCLUSIONS The risk of obesity can be different for boys and girls in certain prenatal environments. We identified an environment combining four exposure levels that protect girls from obesity and neurodevelopment delay. The combination of single exposures into multiexposure profiles using causal inference can help determine populations at risk.
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Affiliation(s)
- Alejandro Cáceres
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain.
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
- Department of Mathematics, Escola d'Enginyeria de Barcelona Est (EEBE), Universitat Politècnica de Catalunya, 08019, Barcelona, Spain.
| | | | - Sandra Andrusaityte
- Department of Environmental Science, Vytautas Magnus University, 44248, Kaunas, Lithuania
| | - Mariona Bustamante
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Center for Genomic Regulation (CRG), Barcelona, Institute of Science and Technology (BIST), Barcelona, Spain
| | - Ángel Carracedo
- Medicine Genomics Group, Centro de Investigación Biomédica en Red Enfermedades Raras (CIBERER), CIMUS, University of Santiago de Compostela, Santiago de Compostela, Spain
- Galician Foundation of Genomic Medicine, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Servicio Gallego de Salud (SERGAS), Galicia, Santiago de Compostela, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | | | - Regina Grazuleviciene
- Department of Environmental Science, Vytautas Magnus University, 44248, Kaunas, Lithuania
| | - Kristine Bjerve Gutzkow
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456, Oslo, Norway
| | - Johanna Lepeule
- Institut National de La Santé Et de La Recherche Médicale (Inserm) and Université Grenoble-Alpes, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | - Léa Maitre
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - Mark Nieuwenhuijsen
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Remy Slama
- Institut National de La Santé Et de La Recherche Médicale (Inserm) and Université Grenoble-Alpes, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, France
| | | | - Nikos Stratakis
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain
| | - Cathrine Thomsen
- Division of Climate and Environmental Health, Norwegian Institute of Public Health, 0456, Oslo, Norway
| | - Jose Urquiza
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Tiffany Yang
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Maribel Casas
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Martine Vrijheid
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain
- Department of Health and Experimental Sciences, Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Juan R González
- Instituto de Salud Global de Barcelona (ISGlobal), 08003, Barcelona, Spain.
- Centro de Investigación Biomédica en Red en Epidemiología Y Salud Pública (CIBERESP), Madrid, Spain.
- Department of Mathematics, Universitat Autònoma de Barcelona, Bellaterra, 08193, Barcelona , Spain.
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