American Heart Association ideal cardiovascular health score and subclinical atherosclerosis in 22-35-year-old adults conceived with and without assisted reproductive technologies

: Markus Juonala, Sharon Lewis, Robert McLachlan, Karin Hammarberg, Joanne Kennedy, Richard Saffery, John McBain, Liam Welsh, Michael Cheung, Lex W Doyle, David J Amor, David P Burgner, Jane Halliday

Publisher: Oxford University Press

: 2020

: Human Reproduction

: Human reproduction (Oxford, England)

: Hum Reprod

: 35

: 1

: 232

: 239

: 8

: 0268-1161

: 1460-2350

DOI: https://doi.org/10.1093/humrep/dez240

The study cohort for the cross-sectional analyses consisted of 172 ART-conceived and 78 non-ART conceived individuals of same age (range 22-35 years).\nLong-term consequences of ART on cardiovascular health are unknown.\nThere was no difference in AHA ideal health score between the ART and non-ART groups; mean (SD) scores were 4.1(1.4) versus 4.0(1.5), respectively, P = 0.65. No differences were observed between groups for any individual ideal health metric (P always >0.2). AHA score was not associated with cIMT or retinal measures in either group (P always >0.05). An inverse association was observed between AHA score and PWV in the ART group (beta (95% CI) -0.18(-0.26 to -0.10)). A numerically similar relationship was observed in the smaller non-ART group (-0.19(-0.39 to 0.01)).\nCardiovascular risk factor status was evaluated with American Heart Association (AHA) ideal cardiovascular health score consisting of seven factors (body mass index, blood pressure, total cholesterol, glucose, diet and physical activity, non-smoking). Carotid artery intima-media thickness (cIMT), arterial pulse-wave velocity (PWV) and retinal microvascular parameters were evaluated as markers of early atherosclerosis. Group comparisons in continuous variables were performed with t-tests. For categorical variables, comparisons were performed with chi-square tests. The relationships between AHA score and the markers of atherosclerosis were examined with linear regression analyses adjusted for age and sex.\nThese findings suggest that ART-conceived individuals do not have increased vulnerability for cardiovascular risk factors.\nEven though this cohort is among the largest ART studies with extensive cardiovascular data, the sample is still relatively small and the statistical power is limited. As the study population was still in early adulthood, we were not able to evaluate the associations with clinical cardiovascular events, but utilized non-invasive methods to assess early markers of subclinical atherosclerosis.\nThis study was funded by a National Health & Medical Research Council Project Grant (APP1099641), The Royal Children's Hospital Research Foundation, Monash IVF Research and Education Foundation, and Reproductive Biology Unit Sperm Fund, Melbourne IVF. The authors have no conflicts of interest relevant to this article to disclose.\nIs ART related with the association of American Heart Association (AHA) ideal cardiovascular health score and markers of subclinical atherosclerosis?\nThe associations between AHA score and markers of subclinical atherosclerosis in ART and non-ART groups were similar in magnitude.\nSTUDY DESIGN, SIZE, DURATION\nWHAT IS KNOWN ALREADY\nMAIN RESULTS AND THE ROLE OF CHANCE\nPARTICIPANTS/MATERIALS, SETTING, METHODS\nWIDER IMPLICATIONS OF THE FINDINGS\nLIMITATIONS, REASONS FOR CAUTION\nSTUDY FUNDING/COMPETING INTEREST(S)\nSTUDY QUESTION\nSUMMARY ANSWER