Ideal Cardiovascular Health and Vascular Phenotype Associations in Mothers with Obesity and Their Six-Year-Old Children

Abstract

Linda Litwin,1,2 Johnny KM Sundholm,1,3 Jelena Meinilä,4 Janne Kulmala,5 Tuija H Tammelin,5 Kristiina Rönö,6 Saila B Koivusalo,6 Johan G Eriksson,7– 10 Taisto Sarkola1,3 1Children’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 2Department of Congenital Heart Defects and Pediatric Cardiology, FMS in Zabrze, Medical University of Silesia, Katowice, Poland; 3Minerva Foundation Institute for Medical Research, Helsinki, Finland; 4Department of Food and Nutrition, University of Helsinki, Helsinki, Finland; 5LIKES Research Centre for Physical Activity and Health, Jyväskylä, Finland; 6Women’s Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 7Folkhälsan Research Center, Helsinki, Finland; 8Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; 9Human Potential Translational Research Programme and Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University Singapore, Singapore; 10Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A*STAR), SingaporeCorrespondence: Linda LitwinDepartment of Congenital Heart Defects and Pediatric Cardiology, FMS in Zabrze, Medical University of Silesia, M.Sklodowskiej-Curie 9, Zabrze, 41-800, PolandTel [phone]Fax [phone]Email [email protected]: Heredity and family-shared lifestyle contribute to cardiovascular risk, but the magnitude of their influence on arterial structure and function in early childhood is unknown. We aimed to assess associations between child and maternal ideal cardiovascular health, maternal subclinical atherosclerosis, and child arterial phenotype.Methods: Cross-sectional analysis of 201 mother-child pairs originating from the Finnish Gestational Diabetes Prevention Study (RADIEL) longitudinal cohort was done at child age 6.1 ± 0.5 years with assessments of ideal cardiovascular health (BMI, blood pressure, fasting glucose, total cholesterol, diet quality, physical activity, smoking), body composition, very-high frequency ultrasound of carotid arteries (25 and 35 MHz), and pulse wave velocity.Results: We found no association between child and maternal ideal cardiovascular health but report evidence of particular metrics correlations: total cholesterol (r=0.24, P=0.003), BMI (r=0.17, P=0.02), diastolic blood pressure (r=0.15, P=0.03), and diet quality (r=0.22, P=0.002). Child arterial phenotype was not associated with child or maternal ideal cardiovascular health. In the multivariable regression explanatory model adjusted for child sex, age, systolic blood pressure, lean body mass, and body fat percentage, child carotid intima-media thickness was independently associated only with maternal carotid intima-media thickness (0.1 mm increase [95% CI 0.05, 0.21, P=0.001] for each 1 mm increase in maternal carotid intima-media thickness). Children of mothers with subclinical atherosclerosis had decreased carotid artery distensibility (1.1 ± 0.2 vs 1.2 ± 0.2%/10 mmHg, P=0.01) and trend toward increased carotid intima-media thickness (0.37 ± 0.04 vs 0.35 ± 0.04 mm, P=0.06).Conclusion: Ideal Cardiovascular Health metrics are heterogeneously associated in mother-child pairs in early childhood. We found no evidence of child or maternal Ideal Cardiovascular Health effect on child arterial phenotype. Maternal carotid intima-media thickness predicts child carotid intima-media thickness, but the underlying mechanisms remain unclear. Maternal subclinical atherosclerosis is associated with local carotid arterial stiffness in early childhood.Keywords: cardiovascular disease, atherosclerosis, carotid intima-media thickness, risk factor, child

Keywords

• cardiovascular disease
• atherosclerosis
• carotid intima-media thickness
• risk factor
• child