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Oberhoffer FS, Langer M, Li P, Vilsmaier T, Sciuk F, Kramer M, Kolbinger B, Jakob A, Rogenhofer N, Dalla-Pozza R, Thaler C, Haas NA. Vascular function in a cohort of children, adolescents and young adults conceived through assisted reproductive technologies-results from the Munich heARTerY-study. Transl Pediatr 2023; 12:1619-1633. [PMID: 37814707 PMCID: PMC10560362 DOI: 10.21037/tp-23-67] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 06/12/2023] [Indexed: 10/11/2023] Open
Abstract
Background Over 8 million individuals worldwide have been conceived through assisted reproductive technologies (ART). There is conflicting evidence on the cardiovascular health of ART offspring. This study aimed to investigate vascular function in a cohort of children, adolescents and young adults conceived through ART compared to spontaneously conceived peers. Methods Anthropometric variables, diet quality, level of physical activity and sedentary behavior were assessed. An extensive evaluation of vascular function was conducted. Blood pressure as well as endothelial function were evaluated. Carotid intima-media thickness was recorded sonographically. Blood draws were taken to determine blood lipids as well as HbA1c. Results In total, 66 ART subjects conceived through in vitro fertilization (IVF) or intracytoplasmic sperm injection and 86 spontaneously conceived peers were included in this observational cohort study. Both groups were similar in age [11.31 (8.10-18.00) vs. 11.85 (8.72-18.27) years, P=0.373]. ART subjects displayed a significantly higher body fat percentage [19.30% (15.80-26.02%) vs. 15.91% (13.21-21.00%), P=0.007]. Both groups did not differ significantly in diet quality, physical activity, sedentary behavior, and vascular function. Blood lipids and HbA1c were comparable between both groups. ART subjects showed significantly lower levels of triglycerides compared to spontaneously conceived peers. The prevalence of lipoprotein (a) [Lp(a)] ≥50 mg/dL tended to be higher within the ART cohort. Vascular function did not deteriorate more profoundly with age in ART subjects than in spontaneously conceived peers. Conclusions The results of the current study do not indicate a significantly lower vascular function in a cohort of children, adolescents and young adults conceived through ART compared to spontaneously conceived peers. Future studies should address the prevalence of elevated Lp(a) levels in infertile individuals who sought ART treatment. In addition, more studies evaluating body fat percentage as well as cardiovascular morbidity in adult ART subjects are required. For a more precise cardiovascular risk stratification, multi-center studies with larger ART sample sizes, preferably at adult age, are required in the future.
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Affiliation(s)
| | - Magdalena Langer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Pengzhu Li
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Theresa Vilsmaier
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - Franziska Sciuk
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Marie Kramer
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Brenda Kolbinger
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - André Jakob
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Nina Rogenhofer
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - Robert Dalla-Pozza
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
| | - Christian Thaler
- Division of Gynecological Endocrinology and Reproductive Medicine, Department of Gynecology and Obstetrics, University Hospital, LMU Munich, Germany
| | - Nikolaus Alexander Haas
- Division of Pediatric Cardiology and Intensive Care, University Hospital, LMU Munich, Munich, Germany
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Papadopoulou-Legbelou K, Triantafyllou A, Vampertzi O, Koletsos N, Douma S, Papadopoulou-Alataki E. Similar Myocardial Perfusion and Vascular Stiffness in Children and Adolescents with High Lipoprotein (a) Levels, in Comparison with Healthy Controls. Pulse (Basel) 2022; 9:64-71. [PMID: 35083172 DOI: 10.1159/000517871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background and Aims This study investigated the possible correlation between elevated lipoprotein (a) (Lp(a)) levels and early vascular aging biomarkers in healthy children and adolescents. Methods Twenty-seven healthy children/adolescents, mean age 9.9 ± 3.7 years, with high Lp(a) levels without other lipid abnormalities and 27 age- and sex-matched controls with normal Lp(a) levels, were included in the study. The investigation of possible early vascular aging was assessed by measuring vascular function indices: carotid intima-media thickness (c-IMT), pulse wave velocity (PWV), augmentation index (AIx), and subendocardial viability ratio (SEVR). Results Although serum lipid values were within normal levels, mean values of total cholesterol and apolipoprotein B were higher in the group of children with high Lp(a) levels than controls (p = 0.006 and p < 0.001, respectively). Vascular function indices did not show significant differences, neither between the 2 groups nor in the subgroups of children with increased Lp(a) levels. These subgroups were defined by the presence or absence of family history of premature coronary artery disease. Lp(a) levels did not show a significant correlation with the other parameters studied, both regarding the whole sample (patients and controls), as well as in the subgroups of elevated Lp(a) levels. However, in the group of children with high Lp(a) levels, c-IMT and PWV were positively correlated with diastolic blood pressure (r = 0.427, p = 0.026 and r = 0.425, p = 0.030, respectively), while SEVR was negatively correlated with AIx (r = -0.455, p = 0.017). Conclusions Healthy children and adolescents with high Lp(a) levels do not yet have impaired vascular indices, compared to controls. However, in order to prevent early atherosclerosis, it is crucial to early identify and follow up children with high Lp(a) levels and positive family history of premature coronary disease or other cardiovascular risk factors.
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Affiliation(s)
- Kyriaki Papadopoulou-Legbelou
- 4th Department of Pediatrics, School of Medicine, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Areti Triantafyllou
- 3rd Department of Internal Medicine, School of Medicine, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Olga Vampertzi
- 4th Department of Pediatrics, School of Medicine, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Koletsos
- 3rd Department of Internal Medicine, School of Medicine, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Stella Douma
- 3rd Department of Internal Medicine, School of Medicine, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efimia Papadopoulou-Alataki
- 4th Department of Pediatrics, School of Medicine, "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Enkhmaa B, Kim K, Zhang W, Prakash N, Truax K, Anuurad E, Berglund L. PCSK9 in African Americans and Caucasians in Relation to Lp(a) Level, Apo(a) Size and Heritability. J Endocr Soc 2020; 4:bvaa073. [PMID: 32685870 PMCID: PMC7358566 DOI: 10.1210/jendso/bvaa073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023] Open
Abstract
Context Inhibition of proprotein convertase subtilisin/kexin type 9 (PCSK9) reduces lipoprotein(a) [Lp(a)] levels, but the association of PCSK9 with Lp(a) level and its major determinant, apolipoprotein(a) [apo(a)] size, is not fully understood. Objective To assess the relationship between PCSK9, Lp(a) level, apo(a) size, age, and ethnicity/race. Design Cross-sectional Setting General population Participants Healthy African Americans and Caucasians (n = 267); age range: 6 to 74 years. Interventions None. Main outcome measure(s) PCSK9 levels, apo(a) isoform and LPA allele sizes, and isoform-specific Lp(a) levels. Results Plasma PCSK9 levels were significantly higher in African Americans vs Caucasians, in females vs males, and in adults vs children. PCSK9 levels were not associated with total plasma Lp(a) levels either in all participants or in ethnicity-specific analyses. However, PCSK9 levels were significantly positively associated with isoform-specific Lp(a) levels carried by the larger apo(a) size in all participants (r = 0.139, P = 0.0361). In ethnicity/race analyses, a significant association was seen for African Americans (r = 0.268, P = 0.0199), but not for Caucasians. In contrast, there were no significant associations of PCSK9 with isoform-specific Lp(a) levels for the smaller apo(a) sizes in all participants nor in ethnic-specific analyses. Furthermore, heritability (h2) analyses revealed a significant heritability for PCSK9 level in both ethnic groups, with a higher estimate in Caucasians than in African Americans (47% vs 22%, respectively). Conclusions Among African Americans, but not Caucasians, PCSK9 levels were associated with isoform-specific Lp(a) levels carried on larger, but not smaller, apo(a) sizes. The findings illustrate a diverging relationship of PCSK9 with isoform-specific Lp(a) levels across ethnicity.
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Affiliation(s)
- Byambaa Enkhmaa
- Departments of Internal Medicine, University of California, Davis, CA, USA
| | - Kyoungmi Kim
- Public Health Sciences, University of California, Davis, CA, USA
| | - Wei Zhang
- Departments of Internal Medicine, University of California, Davis, CA, USA
| | - Nishant Prakash
- Departments of Internal Medicine, University of California, Davis, CA, USA
| | - Kevin Truax
- Departments of Internal Medicine, University of California, Davis, CA, USA
| | - Erdembileg Anuurad
- Departments of Internal Medicine, University of California, Davis, CA, USA
| | - Lars Berglund
- Departments of Internal Medicine, University of California, Davis, CA, USA
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Deng T, Xie J, Ge H, Liu Q, Song X, Hu L, Meng L, Zhang C. Tauroursodeoxycholic acid (TUDCA) enhanced intracytoplasmic sperm injection (ICSI) embryo developmental competence by ameliorating endoplasmic reticulum (ER) stress and inhibiting apoptosis. J Assist Reprod Genet 2019; 37:119-126. [PMID: 31802346 DOI: 10.1007/s10815-019-01627-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 11/01/2019] [Indexed: 01/16/2023] Open
Abstract
PURPOSE The objective of this study was to examine the effect of tauroursodeoxycholic acid (TUDCA) on intracytoplasmic sperm injection (ICSI) embryos by evaluating endoplasmic reticulum (ER) stress, apoptosis, and embryo developmental competence in vitro and in vivo. METHODS ER stress-associated genes and apoptosis-associated genes were measured and apoptosis index was analyzed. Embryo developmental competence was assessed in vitro and in vivo via the inner cell mass (ICM)/trophectoderm (TE) index, pregnancy and implantation rates, and birth rate. RESULTS The relative mRNA and protein expression of binding immunoglobulin protein (BIP) was significantly higher in the ICSI embryo group without TUDCA treatment (ICSI-C) than in the in vitro fertilization (IVF) group and in the ICSI embryo group with TUDCA treatment (200 μM) (ICSI-T), while TUDCA ameliorated ER stress in ICSI embryos. Embryos in the ICSI-C group showed a higher apoptosis index than those in the IVF group and ICSI-T group, and there was no significant difference between the IVF group and ICSI-T group. TUDCA can significantly improve ICSI embryo developmental competence in vitro and in vivo based on the ICM/TE index, pregnancy and implantation rates, and birth rate. CONCLUSION ICSI embryos manifested high ER stress and high apoptosis, while TUDCA ameliorated ER stress and reduced apoptosis in ICSI embryos. TUDCA can significantly improve the developmental competence of ICSI embryos in vitro and in vivo. This study provides a new idea for improving the efficiency of ICSI, and it will also have a positive effect on the development of assisted reproduction technologies for humans and other animals.
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Affiliation(s)
- Tengfei Deng
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China
| | - Juanke Xie
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China
| | - Hengtao Ge
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China
| | - Qi Liu
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China
| | - Xiaobing Song
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China
| | - Lin Hu
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China
| | - Li Meng
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.,LA IVF Clinic, Los Angeles, CA, USA
| | - Cuilian Zhang
- Reproductive Medical Center, Henan Provincial People's Hospital, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China. .,Reproductive Medical Center, People's Hospital of Zhengzhou University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China. .,Reproductive Medical Center, Henan Provincial People's Hospital, School of Clinical Medicine, Henan University, 7 Weiwu Rd, Zhengzhou City, 450003, Henan, China.
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