Oberhoffer Felix Sebastian, Langer Magdalena, Li Pengzhu, Vilsmaier Theresa, Sciuk Franziska, Kramer Marie, Kolbinger Brenda, Jakob André, Rogenhofer Nina, Dalla-Pozza Robert, Thaler Christian, Haas Nikolaus Alexander
Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany.
Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany.
Transl Pediatr. 2023 Sep 18;12(9):1619-1633. doi: 10.21037/tp-23-67. Epub 2023 Sep 14.
Over 8 million individuals worldwide have been conceived through assisted reproductive technologies (ART). There is conflicting evidence on the cardiovascular health of ART offspring. This study aimed to investigate vascular function in a cohort of children, adolescents and young adults conceived through ART compared to spontaneously conceived peers.
Anthropometric variables, diet quality, level of physical activity and sedentary behavior were assessed. An extensive evaluation of vascular function was conducted. Blood pressure as well as endothelial function were evaluated. Carotid intima-media thickness was recorded sonographically. Blood draws were taken to determine blood lipids as well as HbA1c.
In total, 66 ART subjects conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection and 86 spontaneously conceived peers were included in this observational cohort study. Both groups were similar in age [11.31 (8.10-18.00) 11.85 (8.72-18.27) years, P=0.373]. ART subjects displayed a significantly higher body fat percentage [19.30% (15.80-26.02%) 15.91% (13.21-21.00%), P=0.007]. Both groups did not differ significantly in diet quality, physical activity, sedentary behavior, and vascular function. Blood lipids and HbA1c were comparable between both groups. ART subjects showed significantly lower levels of triglycerides compared to spontaneously conceived peers. The prevalence of lipoprotein (a) [Lp(a)] ≥50 mg/dL tended to be higher within the ART cohort. Vascular function did not deteriorate more profoundly with age in ART subjects than in spontaneously conceived peers.
The results of the current study do not indicate a significantly lower vascular function in a cohort of children, adolescents and young adults conceived through ART compared to spontaneously conceived peers. Future studies should address the prevalence of elevated Lp(a) levels in infertile individuals who sought ART treatment. In addition, more studies evaluating body fat percentage as well as cardiovascular morbidity in adult ART subjects are required. For a more precise cardiovascular risk stratification, multi-center studies with larger ART sample sizes, preferably at adult age, are required in the future.
全球有超过800万人通过辅助生殖技术（ART）受孕。关于ART后代心血管健康的证据存在矛盾。本研究旨在调查通过ART受孕的儿童、青少年和年轻成年人队列与自然受孕同龄人相比的血管功能。
评估人体测量变量、饮食质量、身体活动水平和久坐行为。对血管功能进行了广泛评估。评估血压以及内皮功能。通过超声记录颈动脉内膜中层厚度。采集血样以测定血脂以及糖化血红蛋白（HbA1c）。
本观察性队列研究共纳入了66名通过体外受精（IVF）或卵胞浆内单精子注射受孕的ART受试者和86名自然受孕的同龄人。两组年龄相似[11.31（8.10 - 18.00） 11.85（8.72 - 18.27）岁，P = 0.373]。ART受试者的体脂百分比显著更高[19.30%（15.80 - 26.02%） 15.91%（13.21 - 21.00%），P = 0.007]。两组在饮食质量、身体活动、久坐行为和血管功能方面无显著差异。两组之间的血脂和HbA1c相当。与自然受孕的同龄人相比，ART受试者的甘油三酯水平显著更低。ART队列中脂蛋白（a）[Lp（a）]≥50 mg/dL的患病率倾向于更高。与自然受孕的同龄人相比，ART受试者的血管功能不会随着年龄增长而更严重地恶化。
本研究结果并未表明与自然受孕的同龄人相比，通过ART受孕的儿童、青少年和年轻成年人队列的血管功能显著更低。未来的研究应关注寻求ART治疗的不孕个体中Lp（a）水平升高的患病率。此外，需要更多研究评估成年ART受试者的体脂百分比以及心血管发病率。为了进行更精确的心血管风险分层，未来需要开展样本量更大的多中心研究，最好是针对成年期的ART样本。
