Endothelial function and its determinants in children born after maternal bariatric surgery

Area of Science:

• Pediatric Endocrinology
• Cardiovascular Health
• Maternal Health

Background:

• Maternal bariatric surgery (BS) is linked to improved offspring lipid profiles and lower CRP.
• Previous studies suggest potential influences on offspring health, prompting investigation into endothelial function.

Purpose of the Study:

• To investigate the impact of maternal bariatric surgery (BS) before pregnancy on endothelial function in offspring.
• To compare endothelial function (Reactive Hyperemia Index - RHI) in children born to mothers who underwent BS versus those born to overweight/obese (OW/OB) or normal weight (NW) mothers.

Main Methods:

• Evaluated 142 children (median age 10.5 years) using blood analysis, blood pressure (BP) measurement, and peripheral arterial tonometry (PAT).
• Determined the Reactive Hyperemia Index (RHI) in 111 children across three groups: post-maternal BS, maternal OW/OB, and maternal NW.
• Collected data on BP, weight, BMI, and body fat percentage for statistical analysis.

Main Results:

• Children of mothers who underwent BS exhibited higher diastolic blood pressure SDS and lower RHI compared to controls.
• After adjusting for covariates including age, weight SDS, BMI SDS, body fat percentage, and diastolic BP SDS, RHI was comparable across groups.
• This indicates that the observed differences in RHI were primarily associated with increased adiposity and diastolic BP, not a primary vascular dysfunction.

Conclusions:

• Offspring of mothers who underwent bariatric surgery before pregnancy do not exhibit impaired endothelial function before puberty when accounting for elevated diastolic blood pressure and adiposity.
• The cardiovascular vulnerability in these children may be linked to hypertension and adiposity rather than primary vascular dysfunction.
• Emphasizes the importance of preventing obesity and hypertension in at-risk offspring.