Hebrew University-Hadassah, Braun School of Public Health, Jerusalem, Israel.
Circulation. 2012 Mar 20;125(11):1381-9. doi: 10.1161/CIRCULATIONAHA.111.070060. Epub 2012 Feb 17.
Accumulating evidence demonstrates that both maternal prepregnancy body mass index (mppBMI) and gestational weight gain (GWG) are associated with adult offspring adiposity. However, whether these maternal attributes are related to other cardiometabolic risk factors in adulthood has not been comprehensively studied.
We used a birth cohort of 1400 young adults born in Jerusalem who had extensive archival data and clinical information at 32 years of age to prospectively examine the associations of mppBMI and GWG with adiposity and related cardiometabolic outcomes. Greater mppBMI, independently of GWG and confounders, was significantly associated with higher offspring BMI, waist circumference, systolic and diastolic blood pressures, insulin, and triglycerides and with lower high-density lipoprotein cholesterol. For example, the effect sizes were translated to nearly 5 kg/m(2) higher mean BMI, 8.4 cm higher waist circumference, 0.13 mmol/L (11.4 mg/dL) higher triglycerides, and 0.10 mmol/L (3.8 mg/dL) lower high-density lipoprotein cholesterol among offspring of mothers within the upper mppBMI quartile (mppBMI >26.4 kg/m(2)) compared with the lower quartile (mppBMI <21.0 kg/m(2)). GWG, independently of mppBMI, was positively associated with offspring adiposity; differences of 1.6 kg/m(2) in BMI and 2.4 cm in waist were observed when offspring of mothers in the upper (GWG >14 kg) and lower (GWG <9 kg) quartiles of GWG were compared. Further adjustment for offspring adiposity attenuated the observed associations to the null.
Maternal size both before and during pregnancy is associated with cardiometabolic risk factors in young adult offspring. The associations appear to be driven mainly by offspring adiposity. Future studies that explore mechanisms underlying the intergenerational cycle of obesity are warranted to identify potentially novel targets for cardiometabolic risk-reduction interventions.
越来越多的证据表明，母体孕前体重指数（mppBMI）和孕期体重增加（GWG）均与成年后代肥胖有关。然而，这些母体特征是否与成年后其他心血管代谢危险因素有关尚未得到全面研究。
我们使用了一个出生队列，其中包括 1400 名在耶路撒冷出生的年轻人，他们在 32 岁时拥有广泛的档案数据和临床信息，前瞻性地研究了 mppBMI 和 GWG 与肥胖及相关心血管代谢结局的关系。mppBMI 与 GWG 独立，不受混杂因素影响，与后代 BMI、腰围、收缩压和舒张压、胰岛素和甘油三酯呈正相关，与高密度脂蛋白胆固醇呈负相关。例如，在 mppBMI 处于较高四分位的母亲（mppBMI >26.4 kg/m²）与 mppBMI 处于较低四分位（mppBMI <21.0 kg/m²）的后代中，mppBMI 每增加 5kg/m²，平均 BMI 就会增加近 5kg/m²，腰围增加 8.4cm，甘油三酯增加 0.13mmol/L（11.4mg/dL），高密度脂蛋白胆固醇降低 0.10mmol/L（3.8mg/dL）。GWG 与后代肥胖呈正相关，与 mppBMI 独立相关；与 GWG 处于较高四分位（GWG >14kg）的母亲的后代相比，GWG 处于较低四分位（GWG <9kg）的后代的 BMI 差异为 1.6kg/m²，腰围差异为 2.4cm。进一步调整后代肥胖，观察到的关联减弱至无效。
母亲怀孕前后的体型与成年后代的心血管代谢危险因素有关。这些关联似乎主要是由后代肥胖引起的。需要进一步研究探索肥胖代际循环的潜在机制，以确定潜在的心血管代谢风险降低干预的新靶点。
