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04-01-2011 | Cardiometabolic | Article

Unbalanced maternal lipid profiles increase children’s risk for congenital heart disease

Abstract

Free abstract

MedWire News: Unbalanced maternal lipid levels are associated with increased risk for congenital heart disease (CHD) in children, results of the Haven study suggest.

"Mildly elevated maternal cholesterol, low-density lipoprotein (LDL) cholesterol, and apolipoprotein B are significantly associated with an almost two-fold increased risk for CHD offspring," say the researchers.

Eric Steegers, from the Erasmus Medical Centre in Rotterdam, The Netherlands, and team conducted a case-control study on 261 mothers of children with CHD (case) and 325 mothers of children without CHD (control) to determine associations between CHD risk and maternal lipid profiles.

Maternal lipid levels were measured 16 months after the index-pregnancy and characteristics of case and control mothers were compared.

The researchers found that mothers of children with CHD had significantly higher levels of total cholesterol (4.9 vs 4.7 mmol/l [189.2 vs 181.5 mg/dl]), LDL cholesterol (3.2 vs 3.0 mmol/l [123.6 vs 115.8 mg/dl]), apolipoprotein B (84.0 vs 80.0 mg/dl [2.2 vs 2.1 mmol/l]), and homocysteine (10.8 vs 10.2 mmol/l [417.0 vs 393.8 mg/dl]) than mothers of children without CHD.

A maternal lipid profile with apolipoprotein B levels greater than 85.0 mg/dl (>2.2 mmol/l), an apolipoprotein B/A-I ratio greater than 0.6, and a total/high-density lipoprotein (HDL) cholesterol ratio greater than 3.5 was associated with an almost two-fold increased risk for CHD, after adjusting for maternal age, diabetes, ethnicity, body mass index, parity, peri-conception folic acid use, and total homocysteine levels.

This finding was supported by an elevated CHD risk (between 20% and 30%) per standard deviation (SD) increase in total cholesterol, LDL cholesterol, apolipoprotein B, total homocysteine, and ratios of total/HDL cholesterol and apolipoprotein B/A-I.

Apolipoprotein B was the strongest predictor of CHD; each 1-SD increase in apolipoprotein B resulted in a 40% increased risk for CHD.

Writing in the journal Nutrition, Metabolism and Cardiovascular Diseases, the researchers say: "These findings are interesting because apolipoprotein B and A-I are both the main structural proteins of atherogenic lipoproteins and HDL particles, respectively.

"Apolipoprotein B also reflects the whole spectrum of proatherogenic particles and, therefore, serves as a valid biomarker for the atherogenicity of LDL cholesterol."

The team suggests that the unbalanced lipid profiles observed in case mothers could be used to determine maternal risk for developing cardiovascular disease later in life.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Nikki Withers

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