Cardiovascular Risk Factors and Their Relationship with Vascular Dysfunction in South African Children of African Ancestry

Matjuda, Edna N.; Engwa, Godwill Azeh; Anye, Samuel Nkeh Chungag; Nkeh-Chungag, Benedicta N.; Goswami, Nandu

doi:10.3390/jcm10020354

Cited by 14 publications

(11 citation statements)

References 54 publications

(65 reference statements)

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“…A limitation maybe also be that the risk of metabolic syndrome in the offspring may be over-estimated or underestimated when using cut-offs for cardio-metabolic risk from publications from Western world. This will be minimized by ensuring that ethnicity and sex are taken into account when interpreting the results [ 58 – 60 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES)

Nkeh-Chungag

Engwa

Businge

et al. 2021

BMC Cardiovasc Disord

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Background The risk of cardiovascular diseases (CVDs) is becoming more prevalent in pregnant women though not much data is available for pregnant women with human immunodeficiency virus (HIV). Foetoplacental vascular endothelial dysfunction is thought to be at the origin of chronic diseases such as diabetes and obesity later on in life. Because HIV and anti-retroviral treatment (ARTs) are associated with endothelial dysfunction, children exposed in utero to these conditions may be at greater risk of developing CVDs. Despite the high prevalence of HIV in pregnant South African women, little is known about the effects of ART on the cardiovascular health of the mother and offspring. Hence, the proposed study intends to investigate how HIV/ARTs may affect the cardiovascular health of the mother and offspring at different time points during the pregnancy and up to 2 years after birth. Methods A longitudinal case–control study in HIV positive pregnant women on ART and HIV negative pregnant women will be conducted. All pregnant women will be assessed for cardio-metabolic risk factors and markers (lipids, anthropometric and glycaemic indies, oxidative stress), hemodynamic status (blood pressure parameters) and vascular function (arterial compliance, retinal microvasculature, uterine artery mean pulsatility index). Child health will be monitored in utero and postnatally via routine foetal health screening, placental integrity, anthropometry, blood pressure parameters, markers of oxidative stress and endothelial function in cord blood and cardiovascular epigenetic markers in urine. Discussion There is a paucity of studies in South Africa and sub-Sahara Africa as a whole that utilised a longitudinal study model to assess the effects of ARTs on vascular endothelial changes in pregnant women living with HIV and the cardiometabolic health of their offspring. This study will therefore help to monitor changes in cardiometabolic risk during pregnancy and in children exposed in utero to HIV-infection and ART use. Findings from this study will provide useful information for developing guidelines on the use of ARTs in pregnancy and management of cardiometabolic health of the offspring of HIV positive mothers.

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Section: Discussionmentioning

confidence: 99%

Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES)

Nkeh-Chungag

Engwa

Businge

et al. 2021

BMC Cardiovasc Disord

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“…Blood and cord blood sample will be collected from pregnant women and early morning mid-stream urine samples will be collected from their offspring by the research nurse. These samples will be used to measure oxidative stress markers [lipid peroxidation, total antioxidant capacity, and 8-hydoxyl-2-deoxyguanine (8-OHdG)], lipid profile markers (total cholesterol, triglycerides, LDL-cholesterol, and HDL-cholesterol), insulin resistance markers [fasting glucose, insuli, and glycated haemoglobin (HbA1c)], endothelial function markers [endocan, nitric oxide (NO), and asymmetric dimethyl arginine (ADMA)] and renal function markers [glomerular filtration rate (GFR), creatinine and albumin] ( 37 , 38 ). Fasting glucose and insulin will be used to calculate the homeostatic model assessment of insulin resistance (HOMA-IR) while urinary albumin and creatinine will be used to calculate the albumin to creatinine ratio (ACR) ( 37 , 38 ).…”

Section: Methods and Analysismentioning

confidence: 99%

Assessment of the Cardiovascular Risk Profile of Infants Exposed to Pre-eclampsia in-utero: A Prospective Case-Control Study in South African Children of African Ancestry

Nkeh-Chungag

Engwa

Businge

et al. 2021

Front. Cardiovasc. Med.

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Background: It has been reported that maternal gestational environment may be programmed to have a significant impact on foetal and offspring health later in life. Studies have shown that children born to pre-eclamptic mothers are prone to obesity, hypertension, and diabetes in their adult life. However, such findings are yet to be established in an African population. This protocol is for a study aiming to investigate the relationship between pre-eclampsia (PE) and cardiovascular risk in children born to pre-eclamptic mothers in a South African population of African descents.Methods: A prospective case-control design will be employed to recruit pre-eclamptic and normotensive pregnant women and their offspring after birth. Pregnant women will be assessed for cardiovascular risk factors including PE, obesity, haemodynamics, lipids, glycaemic indices, oxidative stress, and vascular function at 30 weeks of gestation. The cardiovascular risk profile of their offspring will be assessed at birth and 6 weeks later. The difference in cardiovascular risk profile between children born to the pre-eclamptic and normotensive mothers will be compared and the correlation between maternal and offspring cardiovascular risks will be investigated.Discussion: This will be the first prospective study to assess the in-utero effect of cardiovascular risk in offspring born to pre-eclamptic women of African ancestry. It is expected that findings from this study will provide information on the cardiovascular effect of in-utero exposure to PE in a population of African ancestry. This knowledge will advise policy on the management of women with PE with a view of protecting cardiovascular health in offspring.

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“…Arterial plaque and intima-media reflect the anatomical structure, while stiffness reflects the function of the arteries. All these are subclinical detectors for cardiovascular disease and a good way to predict future cardiovascular events [ 157 , 158 ].…”

Section: Measurements (Assessment) Of Vascular Functionmentioning

confidence: 99%

Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis

Hedar

Stradner

Roessler

et al. 2021

JCM

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Autoimmune rheumatic diseases (AIRDs) with unknown etiology are increasing in incidence and prevalence. Up to 5% of the population is affected. AIRDs include rheumatoid arthritis, system lupus erythematosus, systemic sclerosis, and Sjögren’s syndrome. In patients with autoimmune diseases, the immune system attacks structures of its own body, leading to widespread tissue and organ damage, which, in turn, is associated with increased morbidity and mortality. One third of the mortality associated with autoimmune diseases is due to cardiovascular diseases. Atherosclerosis is considered the main underlying cause of cardiovascular diseases. Currently, because of finding macrophages and lymphocytes at the atheroma, atherosclerosis is considered a chronic immune-inflammatory disease. In active inflammation, the liberation of inflammatory mediators such as tumor necrotic factor alpha (TNFa), interleukine-6 (IL-6), IL-1 and other factors like T and B cells, play a major role in the atheroma formation. In addition, antioxidized, low-density lipoprotein (LDL) antibodies, antinuclear antibodies (ANA), and rheumatoid factor (RF) are higher in the atherosclerotic patients. Traditional risk factors like gender, age, hypercholesterolemia, smoking, diabetes mellitus, and hypertension, however, do not alone explain the risk of atherosclerosis present in autoimmune diseases. This review examines the role of chronic inflammation in the etiology—and progression—of atherosclerosis in autoimmune rheumatic diseases. In addition, discussed here in detail are the possible effects of autoimmune rheumatic diseases that can affect vascular function. We present here the current findings from studies that assessed vascular function changes using state-of-the-art techniques and innovative endothelial function biomarkers.

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Cardiovascular Risk Factors and Their Relationship with Vascular Dysfunction in South African Children of African Ancestry

Cited by 14 publications

References 54 publications

Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES)

Assessment of the impact of HIV infection and anti-retroviral treatment on the cardiometabolic health of pregnant mothers and their offspring (ARTMOMSBABES)

Assessment of the Cardiovascular Risk Profile of Infants Exposed to Pre-eclampsia in-utero: A Prospective Case-Control Study in South African Children of African Ancestry

Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis

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