Maternal obesity and gestational diabetes: Impact on arterial wall layer thickness and stiffness in early childhood - RADIEL study six-year follow-up
Johnny K.M. Sundholm, Linda Litwin, Kristiina Rönö, Saila B. Koivusalo, Johan G. Eriksson, Taisto SarkolaAtherosclerosis2019
Background and aims: Gestational diabetes (GDM) and maternal obesity are linked to weight gain in childhood and an increased risk of cardiovascular disease later in life. We assessed the effects of GDM and maternal obesity on arterial function and morphology in relation to body anthropometrics and composition in early childhood. Methods: We assessed body size and composition, blood pressure (BP), arterial morphology and stiffness in 201 pairs of obese mothers (pre-pregnancy BMI 30.7 ± 5.6 kg/m2, 96 with GDM) and their children at 6.1 years (SD 0.5). Results: Child BMI (z-score 0.45 ± 0.92; p < 0.001) and common carotid intima-media thickness (IMT, z-score 0.15 ± 0.75, p=0.003) were increased compared with a healthy Finnish reference population. No associations with maternal GDM was found. Carotid IMT and pulse wave velocity were unrelated to child sex, anthropo- metrics, body composition, BP, as well as maternal anthropometrics and body composition. Carotid stiffness was independently predicted by second trimester fasting glucose. Child lean body mass was the strongest in- dependent predictor for radial (RA), and brachial artery (BA) lumen diameter (LD) and BA IMT (LD: RA: r2=0.068, p < 0.001; BA: r2=0.108, p < 0.001; IMT: BA: r2=0.161, p < 0.001) and carotid LD (r2=0.066, p < 0.001). Conclusions: Children of obese mothers have increased BMI, blood pressure and carotid IMT suggesting a transgenerational effect of maternal obesity and clustering of cardiovascular risk factors in the population. Arterial dimensions were mainly predicted by child LBM, and not associated with maternal or child adiposity, or GDM. There was a weak association with maternal gestational fasting glucose and increased carotid artery stiffness.