46. The association of umbilical cord blood vitamin D level with children’s arterial stiffness at 7 years of age – HAPO follow up study

2018 
Introduction We recently reported the effect in utero exposure to maternal hyperglycaemia on children’s risk of abnormal glucose tolerance, obesity and higher blood pressure (BP) at 7 years of age among 962 offspring from the Hyperglycemia and Adverse Pregnancy Outcome study (HAPO) study. Objective To investigate the association of maternal and umbilical cord vitamin D deficiency with children’s cardiometabolic risk at 7 years of age. Methods Mothers who had joined the HAPO study, along with their children were assessed 7 years post-delivery for cardio-metabolic risk, which included carotid-femoral pulse wave velocity (cf-PWV). We performed interim analysis after 566 maternal serum at mid-gestation and 673 umbilical cord serum were analyzed for total vitamin D (25-OHD) levels using a liquid chromatography tandem mass spectrometry method which separates the biological inactive 3-epi-25(OH) D3 from 25(OH) D3, an isomer commonly present in infants. Results The mean maternal and umbilical cord 25-OHD levels were 58.52 ± 20.68 nmol/L and 41.06 ± 15.04 nmol/L respectively; 38.3% mothers had level below 50 nmol/l (vitamin D deficient). Maternal and umbilical cord 25-OHD significantly varied with the seasons. Umbilical cord, but not maternal, vitamin D level was negatively associated with children’s cf-PWV (unstandardized coefficients = −0.005, p = 0.003), independent of maternal glucose level at pregnancy, maternal hypertensive status at follow-up and other confounders, such as children’s age, sex & height. The association remained significant even adjusting for children’s BP (unstandardized coefficients = −0.004, p = 0.006). Discussion The result suggests that in utero vitamin D deficiency may be an independent factor for children’s future vascular risk. Further study is required to explore the association with the children’s Vitamin D status and the underlying mechanism.
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