Clinical Nutrition:怀孕期间维生素 B12、叶酸和同型半胱氨酸的浓度与儿童学龄期动脉粥样硬化的早期迹象的关系

2021-09-27 MedSci原创 MedSci原创

动脉粥样硬化和相关的心血管疾病似乎至少部分起源于生命的最早阶段。尸检研究表明,内膜增厚和脂肪条纹的形成都与动脉粥样硬化的发病机制有关。

      动脉粥样硬化和相关的血管疾病似乎至少部分起源于生命的最早阶段。尸检研究表明,内膜增厚和脂肪条纹的形成都与动脉粥样硬化的发病机制有关,有些患者在它们儿童时期就已经开始,甚至在胎儿中也有观察到这样的现象。较高的颈动脉内中膜厚度和较低的颈动脉可扩张性被认为是动脉粥样硬化的早期迹象。观察性研究的结果表明,较高的体重指数和血压、较高的胰岛素和胆固醇浓度、不合理的体脂分布、I 型糖尿病和早产儿心肌梗塞的父母史等与较高的颈动脉内中膜厚度和/ 或儿童动脉扩张性受损有关。

 

      叶酸、维生素 B12 和同型半胱氨酸是在一碳代谢中相互作用的微量营养素,对细胞生长和分化、核酸合成和 DNA 甲基化至关重要。本项研究假设胎儿发育期间较高的循环维生素 B12 和叶酸浓度以及较低的循环同型半胱氨酸浓度与学龄期较高的颈动脉内中膜厚度和较低的颈动脉扩张性有关。

 

 

      对此,研究人员针对 3826 名学龄儿童及其母亲进行了研究,这是一项基于人群的前瞻性队列研究,从怀孕早期开始一直随访至儿童入学为止,研究人员检查了 10 岁儿童的早孕和脐带血血清总和活性 B12 以及血浆叶酸和同型半胱氨酸浓度与颈总动脉内中膜厚度和可扩张性之间的关联。

 

      研究结果显示与正常的早孕血清总 B12 浓度(≥145 pmol/L)相比,低血清总 B12 浓度(<145 pmol/L)与学龄儿童颈动脉内中膜厚度较高有关(95% (CI):0.01, 0.16)。与正常的早孕血浆叶酸浓度 (≥8 nmol/L) 相比,低血浆叶酸浓度 (<8 nmol/L) 与学龄儿童颈动脉扩张性较低相关(差异 -0.16;95% CI:-0.28,-0.04)。持续测量的妊娠早期循环总和活性 B12、叶酸和同型半胱氨酸浓度与学龄儿童的颈动脉内中膜厚度或颈动脉扩张性无关。出生时脐带血中测得较高血浆同型半胱氨酸浓度与学龄时较低的颈动脉扩张性相关,而脐血总和活性维生素 B12 和叶酸浓度与学龄期颈动脉内中膜厚度或颈动脉扩张性无关。

 

      本项研究证实胎儿期的循环总维生素 B12、叶酸和同型半胱氨酸浓度似乎与学龄期亚临床动脉粥样硬化有关。

 

 

原始出处:

Giulietta S. Monasso. Et al. Vitamin B12, folate and homocysteine concentrations during pregnancy and early signs of atherosclerosis at school-age.Clinical Nutrition. 2021.

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