Khan Sophia, Whatmore Andrew, Perchard Reena, Khan Aysha, Vyas Avni, Dua Jaspal, Cruickshank J Kennedy, Clayton Peter
Division of Developmental Biology and Medicine, Faculty of Biology, Medicine and Health, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
North West, North Wales and Isle of Man Adult Congenital Heart Disease Network, Liverpool Heart and Chest Hospital NHS Foundation Trust, Liverpool, United Kingdom.
Front Pediatr. 2022 Jul 19;10:900404. doi: 10.3389/fped.2022.900404. eCollection 2022.
The links between maternal and offspring adiposity and metabolic status are well established. There is much less evidence for the impact of these relationships combined with ethnic background on cardiac structure and function in childhood.
To test the hypothesis that ethnicity, maternal adiposity and glycemic status, and child adiposity affect cardiac structure and function.
A prospective cohort study.
A single-center mother-child cohort study. The cohort is a subset of the international multi-center Hyperglycemia and Adverse Pregnancy Outcomes (HAPO) study.
This study included 101 healthy pre-pubertal British-born children [56 White Europeans (WEs) and 45 South Asians (SAs)] with a median age of 9.1 years, range 6.0-12.2 years, at the time of the investigation.
Anthropometric and echocardiographic measurements were made on the cohort. Maternal pregnancy and birth data were available. Relationships between maternal parameters (BMI and glucose status), child adiposity, and echo measures were assessed.
Despite no ethnic difference in BMI SDS at a median age of 9.1 years, SA children exhibited higher levels of body fat than WE children (whole body, right arm, and truncal fat all < 0.001). SA children also exhibited greater changes in weight and height SDS but not BMI SDS from birth than WE children. As expected, maternal BMI correlated with child BMI ( = 0.28; = 0.006), and body fat measures (e.g., whole body fat = 0.25; = 0.03). Maternal fasting glucose levels were associated with child body fat measures ( = 0.22-0.28; = 0.02-0.05). Left ventricular (LV) indices were not different between SA and WE children, but E/A and E'/A' (measures of diastolic function) were lower in SA when compared with WE children. LV indices correlated positively to BMI SDS and body fat markers only in SA children. Maternal fasting and 2-h glucose were negatively correlated with E'/A' in SA children ( = -0.53, = 0.015, and = -0.49, = 0.023, respectively) but not in WE children.
SA and WE children exhibit differences in adiposity and diastolic function at a median age of 9.1 years. Novel relationships between maternal glycemia, child adiposity, and cardiac structure and function, present only in SA children, were identified.
母亲与后代肥胖及代谢状况之间的联系已得到充分证实。而关于这些关系与种族背景相结合对儿童心脏结构和功能的影响，证据则少得多。
检验种族、母亲肥胖和血糖状况以及儿童肥胖会影响心脏结构和功能这一假设。
一项前瞻性队列研究。
一项单中心母婴队列研究。该队列是国际多中心高血糖与不良妊娠结局（HAPO）研究的一个子集。
本研究纳入了101名健康的青春期前在英国出生的儿童[56名白种欧洲人（WEs）和45名南亚人（SAs）]，在调查时中位年龄为9.1岁，范围为6.0 - 12.2岁。
对该队列进行人体测量和超声心动图测量。可获取母亲的妊娠和分娩数据。评估母亲参数（BMI和血糖状况）、儿童肥胖与超声心动图测量指标之间的关系。
尽管在9.1岁中位年龄时BMI SDS没有种族差异，但南亚儿童的体脂水平高于白种欧洲儿童（全身、右臂和躯干脂肪均P < 0.001）。与白种欧洲儿童相比，南亚儿童从出生到现在体重和身高SDS的变化也更大，但BMI SDS没有变化。正如预期的那样，母亲BMI与儿童BMI相关（r = 0.28；P = 0.006），与体脂测量指标也相关（例如全身脂肪r = 0.25；P = 0.03）。母亲空腹血糖水平与儿童体脂测量指标相关（r = 0.22 - 0.28；P = 0.02 - 0.05）。南亚和白种欧洲儿童的左心室（LV）指标没有差异，但与白种欧洲儿童相比，南亚儿童的E/A和E'/A'（舒张功能指标）较低。仅在南亚儿童中，LV指标与BMI SDS和体脂标志物呈正相关。母亲空腹血糖和2小时血糖与南亚儿童的E'/A'呈负相关（分别为r = -0.53，P = 0.015和r = -0.49，P = 0.023），而在白种欧洲儿童中则无此相关性。
在9.1岁中位年龄时，南亚和白种欧洲儿童在肥胖和舒张功能方面存在差异。发现了仅在南亚儿童中存在的母亲血糖、儿童肥胖与心脏结构和功能之间的新关系。
