Abstract
Both maternal 25-hydroxyvitamin D(25OHD) status and pre-pregnancy BMI(pBMI) may influence offspring cardio-metabolic outcomes. Lower 25OHD concentrations have been observed in women with both low and high pBMIs, but the combined influence of pBMI and 25OHD on offspring cardio-metabolic outcomes is unknown. Therefore, this study investigated the role of pBMI in the association between maternal 25OHD concentration and cardio-metabolic outcomes in 5-6 year old children. Data were obtained from the ABCD cohort study and 1882 mother-child pairs were included. The offspring outcomes investigated were systolic and diastolic blood pressure, heart rate, BMI, body fat percentage(%BF), waist-to-height ratio, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, glucose, C-peptide, and insulin resistance(HOMA2-IR). 62% of the C-peptide samples were below the detection limit and were thus imputed using survival analysis. Models were corrected for maternal and offspring covariates and tested for interaction with pBMI. Interaction with pBMI was observed in the associations with insulin resistance markers: in offspring of overweight mothers(≥25.0kg/m2), a 10 nmol/L increase in maternal 25OHD was associated with a 0.007(99%CI:-0.01,-0.001) nmol/L decrease in C-peptide and a 0.02(99%CI:-0.03,-0.004) decrease in HOMA2-IR. When only non-imputed data were analyzed, there was a trend for interaction in the relationship but the results lost significance. Interaction with pBMI was not observed for the other outcomes. A 10 nmol/L increase in maternal 25OHD was significantly associated with a 0.13%(99%CI:-0.3,-0.003) decrease in %BF after correction for maternal and child covariates. Thus, intrauterine exposure to both low 25OHD and maternal overweight may be associated with increased insulin resistance in offspring, while exposure to low 25OHD in utero may be associated with increased offspring %BF with no interactive effects from pBMI. Due to the limitations of this study, these results are not conclusive, however the observations of this study pose important research questions for future studies to investigate.
Highlights
Exposure to certain nutritional factors in utero, such as insufficient maternal 25-hydroxyvitamin D (25OHD), may be related to adverse cardio-metabolic outcomes in offspring [1, 2]
Laboratory and observational evidence suggest that an individual’s own 25OHD status may influence the risk for developing chronic diseases, such as type 2 diabetes mellitus and cardiovascular disease [3, 5] and some studies suggest that maternal 25OHD status during gestation influences this risk in offspring [2, 6, 7]
Maternal 25OHD deficiency was more likely if blood samples were drawn in winter, pregnancy BMI (pBMI) was higher, and women were younger, less educated, not Dutch, multiparous, smokers during pregnancy, and not users of vitamin D supplements
Summary
Exposure to certain nutritional factors in utero, such as insufficient maternal 25-hydroxyvitamin D (25OHD), may be related to adverse cardio-metabolic outcomes in offspring [1, 2]. It is possible that maternal 25OHD deficiency during gestation contributes to cardio-metabolic abnormalities in offspring, which track into adulthood and increase the risk of future chronic disease [2, 3, 8]. Low maternal 25OHD has been associated with insulin resistance and with increased fat mass in young children [4, 9], while other studies have not observed these relationships [10, 11]. The relationship between maternal 25OHD status and offspring cardio-metabolic outcomes warrants further investigation
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