P4.063: Associations Between Maternal and Infant Adiposity, Lipid Profile, and Apolipoproteins in the ETCHED Life course Study

Background: Dyslipidemia in children and adolescents can be due to both genetic as well as environmental factors such as poor lifestyle, and obesity driven poor metabolic health. Since lipid disorders remain asymptomatic in childhood, early screening is recommended to prevent progression to atherosclerotic cardiovascular disease (ASCVD) later in life. We examined the relationship between adiposity, lipids, and apolipoprotein biomarkers, in maternal-infant dyads presenting for their combined research exams in the Early Tracking of Childhood Health Determinants (ETCHED) life course study currently ongoing in the southwestern United States (US).

Methods: The current analysis includes data, anthropometric measurements, and laboratory tests from maternal-infant pairs at their 12-month post-delivery research visit between February 2023-March 2025. Demographic, clinical, and serum lipid biomarkers (cortisol, cholesterol, triglycerides, apolipoprotein A1, apolipoprotein B) were analyzed from both maternal and infant serum. Two glycemic markers, HbA1c and C-peptide were also included to assess the metabolic profile. Spearman’s partial correlation coefficient was used to investigate pairwise associations between maternal-infant biomarkers adjusted for covariates.

Results: Fifty-nine maternal-infant matched pairs who presented for their 12-month post-delivery combined research examination were included. Mean maternal age was 30.2±5.3 years, majority 69.5% were Hispanic, 15.3% reported American Indian race. In this pregnancy cohort, mean pre-gestational body mass index (BMI) was 32.3 Kg/m2 (SD±7.7), with 57.6% mothers entering pregnancy with obesity and 13.6% had diabetes in pregnancy. Among 59 infants who had complete clinical and laboratory data available at their 12-month exam, majority were female (57.6%), mean age at exam was 12.7 months (SD±1.40). Mean weight-for-length z-score at 12-months was 0.58 (SD±1.38). After adjustment for infant age and sex, partial correlation analysis showed a significant positive relationship between maternal weight at 12-months post-delivery, and infant weight (r=0.38, p< 0.03) obtained at the combined exam (Figure 1). Figure 2a. depicts maternal-infant biomarker correlations, infant cortisol correlated significantly with, maternal cortisol (r=0.42, p< 0.01), maternal apolipoprotein B (r= 0.27, p< 0.05).and maternal triglyceride (r= 0.31, p< 0.05) indicating that maternal dyslipidemia is associated with dyslipidemia in the offspring. Interestingly, a statistically significant correlation was also observed between maternal-infant apolipoprotein A1 levels that has a protective effect from ASCVD (r=0.29, p< 0.05). In Figure 2b.a strong association is observed between infant’s cholesterol and apolipoprotein B levels (r= 0.77, p< 0.001) that is a more sensitive marker for ASCVD. No significant associations are observed between maternal-infant glycemic markers.

Conclusion: In this cross-sectional analysis, we observed an association between maternal and infant adiposity, and lipid markers, and apolipoprotein levels that is evident even at a very young age that is below the current recommended age for lipid screening in children at a high-risk for familial dyslipidemia. This observation could be due to both biological and shared environmental factors and needs further investigation.