Unit of Preventive Medicine and Public Health, Faculty of Medicine and Health Sciences, IISPV, Universitat Rovira i Virgili, Reus, Spain.
Department of Obstetrics and Gynaecology, The Sahlgrenska Academy, University of Gothenburg, 40530, Gothenburg, Sweden.
Pediatr Res. 2023 Feb;93(3):633-642. doi: 10.1038/s41390-022-02117-5. Epub 2022 May 31.
Inadequate pregnancy cobalamin status has been associated with adverse offspring metabolic health in Indian and Nepalese studies. Studies of pregnancy cobalamin status and mid-childhood health outside of Asia are scarce.
Associations between pregnancy fasting plasma total homocysteine (tHcy), cobalamin status (plasma cobalamin, holotranscobalamin (holoTC), methylmalonic acid (MMA)) and mid-childhood metabolic score (MetSco) ((including fat mass index (zFMI), homeostatic model assessment of insulin resistance (zHOMA-IR) and dyslipidemia (zTG - zHDLc)/2) z-scores)) were investigated in a prospective study of 293 mother-child dyads.
Highest versus low-mid pregnancy tHcy tertile was associated with higher mid-childhood MetSco, specifically with higher child zFMI. Stratifying by sex, the maternal tHcy-child MetSco association was limited to boys and confirmed for zFMI and zHOMA-IR. The maternal tHcy-child zFMI association was not mediated by birth weight z-score. First trimester plasma cobalamin was not associated with child outcomes, but other indicators of cobalamin status were. Lowest versus mid-high plasma holoTC tertile was associated with MetSco (specifically zFMI and zHOMA-IR) and highest versus low-mid plasma MMA tertile with higher MetSco and dyslipidemia in boys.
Moderately elevated pregnancy tHcy and low cobalamin status were associated with mid-childhood metabolic score in boys. The pregnancy tHcy-child zFMI association was not mediated by birth weight.
Fasting plasma total homocysteine (tHcy) during pregnancy and low cobalamin status during early pregnancy are associated with mid-childhood metabolic score and its components in the offspring. These findings were only significant in male offspring. The study provides new evidence that impaired one carbon metabolism during pregnancy is associated with negative health outcomes in the offspring, in a population with low prevalence of cobalamin deficiency. The maternal-offspring associations were observed in the functional markers of cobalamin status (holotranscobalamin and methylmalonic acid) and tHcy, not with plasma cobalamin concentration. Screening for low pregnancy cobalamin status should be considered.
在印度和尼泊尔的研究中，妊娠钴胺素状况不足与后代代谢健康不良有关。在亚洲以外地区研究妊娠钴胺素状况与儿童中期健康之间的关系很少。
在一项前瞻性研究中，对 293 对母婴对子进行了妊娠空腹血浆总同型半胱氨酸 (tHcy)、钴胺素状况（血浆钴胺素、全钴胺素 (holoTC)、甲基丙二酸 (MMA)）和儿童中期代谢评分 (MetSco)（包括脂肪质量指数 (zFMI)、胰岛素抵抗稳态模型评估 (zHOMA-IR) 和血脂异常 (zTG-zHDLc)/2) z 评分）之间的关联进行了调查。
与低-中妊娠 tHcy 三分位组相比，最高妊娠 tHcy 三分位组与儿童中期代谢评分较高相关，具体表现为儿童 zFMI 较高。按性别分层，母亲 tHcy-儿童 MetSco 关联仅限于男孩，并证实了 zFMI 和 zHOMA-IR。母亲 tHcy-儿童 zFMI 关联不受出生体重 z 评分的影响。妊娠早期的血浆钴胺素与儿童结局无关，但其他钴胺素状况指标则有关。与中-高血浆 holoTC 三分位相比，最低血浆 holoTC 三分位与代谢评分（特别是 zFMI 和 zHOMA-IR）以及与男孩最高与低-中血浆 MMA 三分位相比与代谢评分较高和血脂异常相关。
妊娠 tHcy 中度升高和妊娠早期钴胺素状况较低与男孩儿童中期代谢评分相关。妊娠 tHcy-儿童 zFMI 关联不受出生体重的影响。
妊娠期间的空腹血浆总同型半胱氨酸 (tHcy) 和妊娠早期的低钴胺素状态与后代的儿童中期代谢评分及其成分有关。这些发现仅在男性后代中具有统计学意义。这项研究提供了新的证据，表明在妊娠期间一碳代谢受损与后代的健康结果不良有关，而在钴胺素缺乏症发病率较低的人群中则是如此。在钴胺素状况的功能标志物（全钴胺素和甲基丙二酸）和 tHcy 中观察到母婴关联，而不是在血浆钴胺素浓度中。应考虑筛查妊娠期间的低钴胺素状态。
