Atherosclerosis is born in the womb. This is what has been hypothesized in a study recently published in Jama Cardiology and carried out by the Division of Human Pathology, Department of Advanced Biomedical Sciences, University Federico II of Naples, which examined the levels of maternal plasma cholesterol in pregnancy, wondering if they could be able to influence the genes relevant to the metabolism of cholesterol and atherogenesis in the fetus. We talked about it with Dr. Silvia Goggi, dietician at Humanitas San Pio X.
The link between cholesterol and fetal health
In this study, carried out on 78 fetal human aorta samples by the Division of Human Pathology, Department of Advanced Biomedical Sciences, of the Federico II University of Naples, it was found that the influence of maternal cholesterol levels during pregnancy on early atherogenesis in fetal life could have an epigenetic action, i.e. modification of the expression of some genes without alteration of the genetic heritage. Among the possible effects of these epigenetic changes, according to the hypothesis of this study, there would be an increased risk of atherosclerosis and therefore of cardiovascular disease in the children of mothers with hypercholesterolemia. Although there is increasing evidence to suggest a role for maternal total cholesterol and LDL (low-density lipoprotein) cholesterol levels during pregnancy as a risk factor for atherosclerotic disease in offspring, the underlying mechanisms need to be clarified to determine future clinical applications.
Results of the study
Of the 78 samples included in the analysis (59% male and 25-week average fetal age), the level of maternal cholesterol explained a significant percentage of the variance of the fetal aortic lesion, regardless of the effect of the levels of HDL cholesterol, triglycerides, glucose and body mass index of the mothers. In addition, levels of total cholesterol and maternal LDL cholesterol were positively associated with methylation of SREBP2 in fetal aortas, while they were inversely correlated with levels of SREBP2 messenger RNA in fetal aortas.
“The present study provides a rigorous quantitative assessment of the extent of the association of maternal cholesterol levels during pregnancy with fetal aortic lesions and reveals hitherto unknown epigenetic effects of maternal cholesterol on the fetus – said Dr. Goggi -. The effects of the level of maternal cholesterol during pregnancy in primary cardiovascular prevention in the offspring requires further studies of long-term causal relationships, but this offers an interesting starting point to state that too high levels of cholesterol, often due to excessive consumption of products of animal origin, the only ones that contain it – and in particular of meat and cheese – could lay the foundations for ischaemic heart disease already from intrauterine life.
