DALLAS – Elevated LDL cholesterol in women before childbirth was associated with a fivefold increased risk of elevated LDL 2 decades later in their young adult offspring in a new analysis from the Framingham Heart Study.
In contrast, paternal elevation of LDL pre pregnancy was not associated with increased likelihood of hyperlipidemia in children at age 20 years.
In utero exposure to maternal dyslipidemia appears to have lasting adverse consequences in terms of cardiovascular disease risk. If confirmed, the implications of the findings are huge, given that an estimated 25% of American women of childbearing age have elevated LDL, according to National Health and Nutrition Examination Survey data, Dr. Michael M. Mendelson noted at the American Heart Association scientific sessions.
"We postulate that identifying young women of childbearing age with dyslipidemia and reducing abnormal LDL with lipid-specific healthy lifestyle interventions may further reduce the transgenerational cycle of dyslipidemia and cardiovascular disease risk," declared Dr. Mendelson of Boston Children’s Hospital.
He presented prospectively acquired data on 343 maternal-child pairs enrolled in the Framingham Heart Study. Parental serum lipids were measured roughly 3 years prior to childbirth and again 20 years later, when the now young-adult offspring also had their serum lipids measured as part of their first comprehensive assessment as Framingham participants.
Women with an LDL level greater than 130 mg/dL at their prebirth assessment were fivefold more likely to have young-adult offspring with an elevated LDL in a multivariate analysis adjusted for maternal age and offspring gender. With further adjustment for prepregnancy maternal body mass index, smoking status, and genetic variants known to be associated with LDL level – most notably familial hypercholesterolemia – maternal dyslipidemia pre pregnancy remained associated with a highly significant 3.7-fold increased risk of dyslipidemia in young-adult offspring (P = .004).
In contrast, high paternal LDL pre pregnancy was not associated with increased odds of adult dyslipidemia in the offspring. And neither high maternal nor paternal LDL measured 20 years after childbirth was linked to increased likelihood of dyslipidemia in 20-year-old children in the fully adjusted multivariate logistic regression analysis.
The Framingham Heart Study is funded by the National Institutes of Health. Dr. Mendelson reported having no financial conflicts of interest.