Joint effect of maternal plasma homocysteine and prepregnancy obesity on child blood pressure: a prospective birth cohort study.
Joint effect of maternal plasma homocysteine and prepregnancy obesity on child blood pressure: a prospective birth cohort study.
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DOI：
10.1038/ijo.2017.109
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发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Wang G
中科院分区：
文献类型：
--
作者：
Wang H;Xu BP;Xu RB;Walker SO;Wang G
高同型半胱氨酸（Hcy）是一种已知的心血管危险因素。然而，其在代际心脏代谢风险中的作用尚不清楚。我们假设母亲同型半胱氨酸升高可以单独或与母亲孕前肥胖相结合，以增加儿童收缩压（SBP）。这项研究包括1279对出生时入组的母子，并在2003-2014年在波士顿医疗中心进行了长达9年的前瞻性随访。根据美国参考数据计算儿童SBP百分位数，SBP升高定义为SBP≥第75百分位数。母亲同型半胱氨酸水平与其子女收缩压呈U型关系。最低四分位数（Q1，比值比（OR）：1.27; 95%置信区间（CI）：0.94 - 1.72）和最高四分位数（Q4，OR：1.34; 95% CI：1.00 - 1.81）儿童SBP升高的风险高于第2和第3四分位数。与Q2-Q3的非肥胖母亲的孩子相比，Q4的肥胖母亲的孩子发生SBP升高的风险最高（OR：2.22; 95%CI：1.35 - 3.64）。这种关联独立于母亲的叶酸和维生素B12状态，并且不受胎龄或出生时大小的影响。在这个前瞻性的出生队列中，我们观察到母亲的同型半胱氨酸水平和孩子的收缩压升高之间呈U型关系。母亲高同型半胱氨酸（Q4）和孕前肥胖共同增加儿童SBP升高的风险超过2倍。
Elevated homocysteine (Hcy) is a known cardiovascular risk factor. However, its role in intergenerational cardiometabolic risk is unknown. We hypothesized that maternal elevated Hcy can act alone or in combination with maternal prepregnancy obesity to increase child systolic blood pressure (SBP). This study included 1279 mother-child pairs who were enrolled at birth and followed prospectively up to age 9 years from 2003-2014 at the Boston Medical Center. Child SBP percentile was calculated according to U.S. reference data and elevated SBP was defined as SBP≥75th percentile. A U-shaped relationship between maternal Hcy and her child SBP was observed. The risk for child elevated SBP was higher amongst those in the lowest quartile (Q1, odds ratio (OR): 1.27; 95% confidence interval (CI): 0.94 - 1.72), and highest quartile (Q4, OR: 1.34; 95% CI: 1.00 -1.81) as compared with those in quartiles 2 and 3. The highest risk of child elevated SBP was found amongst children born to obese mothers with Hcy in Q4 (OR: 2.22; 95%CI: 1.35 - 3.64), compared with children of non-obese mothers with Hcy in Q2-Q3. This association was independent from maternal folate and vitamin B12 status, and was not mediated by gestational age or size at birth. In this prospective birth cohort, we observed a U- shaped association between maternal Hcy levels and child elevated SBP. Maternal high Hcy (Q4) and prepregnancy obesity jointly increased the risk of child elevated SBP by more than two fold.
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