Long-term cardiometabolic health in people born after assisted reproductive technology: a multi-cohort analysis.
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Elhakeem Ahmed, Taylor Amy E, Inskip Hazel M, Huang Jonathan Y, Mansell Toby, Rodrigues Carina, Asta Federica, Blaauwendraad Sophia M, Håberg Siri E, Halliday Jane, Harskamp-van Ginkel Margreet W, He Jian-Rong, Jaddoe Vincent W V, Lewis Sharon, Maher Gillian M, Manios Yannis, McCarthy Fergus P, Reiss Irwin K M, Rusconi Franca, Salika Theodosia, Tafflet Muriel, Qiu Xiu, Åsvold Bjørn O, Burgner David, Chan Jerry K Y, Gagliardi Luigi, Gaillard Romy, Heude Barbara, Magnus Maria C, Moschonis George, Murray Deirdre, Nelson Scott M, Porta Daniela, Saffery Richard, Barros Henrique, Eriksson Johan G, Vrijkotte Tanja G M, Lawlor Deborah A
Аннотация
METHODS AND RESULTS: Differences in systolic (SBP) and diastolic blood pressure (DBP), heart rate (HR), lipids, and hyperglycaemic/insulin resistance markers were examined using multiple linear regression models in 14 population-based birth cohorts in Europe, Australia, and Singapore, and results were combined using meta-analysis. Change in cardiometabolic outcomes from 2 to 26 years was examined using trajectory modelling of four cohorts with repeated measures. 35 938 (654 ART) offspring were included in the meta-analysis. Mean age ranged from 13 months to 27.4 years but was <10 years in 11/14 cohorts. Meta-analysis found no statistical difference (ART minus NC) in SBP (-0.53 mmHg; 95% CI:-1.59 to 0.53), DBP (-0.24 mmHg; -0.83 to 0.35), or HR (0.02 beat/min; -0.91 to 0.94). Total cholesterol (2.59%; 0.10-5.07), HDL cholesterol (4.16%; 2.52-5.81), LDL cholesterol (4.95%; 0.47-9.43) were statistically significantly higher in ART-conceived vs. NC offspring. No statistical difference was seen for triglycerides (TG), glucose, insulin, and glycated haemoglobin. Long-term follow-up of 17 244 (244 ART) births identified statistically significant associations between ART and lower predicted SBP/DBP in childhood, and subtle trajectories to higher SBP and TG in young adulthood; however, most differences were not statistically significant.
CONCLUSION: These findings of small and statistically non-significant differences in offspring cardiometabolic outcomes should reassure people receiving ART. Longer-term follow-up is warranted to investigate changes over adulthood in the risks of hypertension, dyslipidaemia, and preclinical and clinical cardiovascular disease.