In this study, we aimed to determine echocardiographic reference values and parametric Z scores e... more In this study, we aimed to determine echocardiographic reference values and parametric Z scores equations for PWD velocities and TDI velocities in a healthy pediatric population using a complete and standardized approach for regression modeling, detection of residual biases, and assessment of adequate Z score distribution. Methods Population and Recruitment Subjects from age 1 to 18 years, without heart disease, were prospectively recruited for this study from local schools, as volunteers and Background-In pediatric echocardiography, pulse wave Doppler, and tissue Doppler imaging velocities are widely used to assess cardiac function. Current reference values and Z scores, allowing adjustment for growth are limited by inconsistent methodologies and small sample size. Using a standardized approach for parametric modeling and Z score quality assessment, we propose new pediatric reference values and Z score equations for most left ventricular pulse wave Doppler and tissue Doppler imaging measurements. Methods and Results-Two hundred thirty-three healthy pediatric subjects 1 to 18 years of age were prospectively recruited. Thirteen pulse wave Doppler and 14 tissue Doppler imaging measurements were recorded. Normalization for growth was done via a complete and standardized approach for parametric nonlinear regression modeling. Several analyses were performed to ensure adequate Z score distribution and to detect potential residual associations with growth or residual heteroscedasticity. Most measurements adopted a nonlinear relationship with growth and displayed significant heteroscedasticity. Compared with age, height, and weight, normalization for body surface area was most efficient in removing the effect of growth. Generally, polynomial and allometric models yielded adequate goodness-of-fit. Residual values for several measurements had significant departure from the normal distribution, which could be corrected using logarithmic or reciprocal transformation. Overall, weighted parametric nonlinear models allowed us to compute Z score equations with adequate normal distribution and without residual association with growth. Conclusions-We present Z scores for normalized pulse wave Doppler and tissue Doppler imaging in pediatric echocardiography. Further studies are needed to define the threshold beyond which health becomes a disease by integrating other important factors such as ventricular morphology, loading conditions, and heart rate.
Journal of The American Society of Echocardiography, Aug 1, 2016
Background: In pediatric echocardiography, myocardial strain measurements are likely influenced b... more Background: In pediatric echocardiography, myocardial strain measurements are likely influenced by cardiac size and growth in healthy children. The application of this technique in clinical practice has been hampered by the lack of good normal reference values for the pediatric population. The aim of this study was to determine reference values and Z score equations for left ventricular systolic circumferential and longitudinal strain in a healthy pediatric population. Methods: Two hundred thirty-three healthy subjects 1 to 18 years of age were prospectively recruited. Left ventricular systolic longitudinal and circumferential strain measurements were recorded using two-dimensional speckle-tracking. Normalization for body size was performed using parametric nonlinear regression modeling. Several analyses were performed to detect potential residual associations with body size, residual heteroscedasticity, or departure from an adequate Z score distribution. Results: There were weak but statistically significant nonlinear associations between body size and most strain values. Body surface area was superior to adjust for body size compared with age, height, and weight. Most strain values displayed a second-order polynomial relationship with body surface area. Z score equations were computed with adequate normal distributions and without residual associations in relation to BSA for most strain parameters. Conclusions: There was a weak but significant influence of body size on most left ventricular circumferential and longitudinal systolic strain parameters used in pediatric echocardiography. Z scores are presented for strain measurements normalized to body surface area and adjusted for heteroscedasticity. The use of these normalized values may reduce the risk for misclassification caused by normal variation in myocardial strain values during growth.
Early childhood healthcare utilization, mortality and welfare interventions were studied among ch... more Early childhood healthcare utilization, mortality and welfare interventions were studied among children of mothers with identified gestational alcohol and ⁄ or substance abuse. Methods: Register-based retrospective cohort study. The exposed cohort consisted of 638 children born to 524 women followed up antenatally 1992-2001 at special outpatient clinics in the capital area of Finland. Nonexposed children (n = 1914) born to control women were matched for maternal age, parity, number of foetuses, month of birth and delivery hospital of the index child. Postnatal data of both cohorts were collected from national registers until 2007. Results: The exposed cohort displayed twice the amount of in-and outpatient hospital care episodes compared with nonexposed children. Differences attributable to exposure were found in categories of conditions originating in the perinatal period, mental and behavioural disorders, and nonspecific factors influencing health status and contact with health services. This was reflected in amounts of reimbursements for drugs of the central nervous system, as well as special care allowances and rehabilitation for mental and behavioural disorders. The highest degree of healthcare utilization was observed among exposed children placed in out-of-home care. One-third of these children received outpatient care and one-tenth required inpatient care for a mental and behavioural disorder. No significant differences were found in early mortality. Conclusion: The exposed children displayed significant neonatal and early mental and behavioural healthcare utilization, and need for significant psychosocial support during their first decade of life.
Background. The aim of the study was to evaluate arterial morphology and function in a national c... more Background. The aim of the study was to evaluate arterial morphology and function in a national cohort of long-term survivors of high-risk neuroblastoma (NBL) treated with high-dose chemotherapy and autologous hematopoietic stem cell transplantation with or without total body irradiation (TBI). Methods and Results. Common carotid, femoral, brachial, and radial artery morphology were assessed with very-high-resolution vascular ultrasound (25-55 MHz), and carotid artery stiffness and brachial artery flowmediated dilatation measured with conventional vascular ultrasound in 19 adult or pubertal (age 22.7 AE 4.9 years, range 16-30) NBL survivors transplanted during 1984-1999 at the mean age of 2.5 AE 1.0 years. Results were compared with 20 age-and sexmatched healthy controls. The cardiovascular risk assessment included history, body mass index, fasting plasma lipids, glucose, and 24-h ambulatory blood pressure (BP). The survivors had consistently smaller arterial lumens, increased carotid intima-media thickness (IMT), plaque formation (N ¼ 3), and stiffness, as well as increased radial artery intima thickness (N ¼ 5) compared with the control group. Survivors displayed higher plasma triglyceride and cholesterol levels, and increased heart rate, as well as increased systolic and diastolic BPs. TBI (N ¼ 10) and a low body surface area were independent predictors for decreased arterial lumen size and increased IMT. Three out of five survivors with subclinical intima thickening had arterial plaques. Plaques occurred only among TBItreated survivors. Conclusions. Long-term childhood cancer survivors treated with TBI during early childhood display significant signs of premature arterial aging during young adulthood. Pediatr Blood Cancer
The aim of this study was to analyze the prevalence of frailty and physical health limitations am... more The aim of this study was to analyze the prevalence of frailty and physical health limitations among long-term survivors of high-risk neuroblastoma (HR NBL) and to investigate whether frail health is associated with variables of cardiovascular function, markers of inflammation and telomere length. A national study cohort of 19 (median age 22, range 16-30 years) long-term (410 years) HR NBL survivors was studied and the findings were compared with 20 age-and sex-matched controls. Frailty was defined as ⩾ 3 of the following conditions: low muscle mass, low energy expenditure, slow running and weakness. The prevalence of frailty was significantly higher among the HR NBL survivors 9/19 (47%) than among the controls (0%). Thirteen (68%) of the survivors reported significant physical health limitations in vigorous activities, as opposed to none of the controls. The HR NBL survivors had significantly shorter telomere length and higher serum levels of high sensitivity C-reactive protein than did the controls. Frail health and poor physical functioning are prevalent among HR NBL survivors and suggest premature aging. Survivors with gonadal damage, very low fat mass percentage, low glycosylated hemoglobin A1c and increased common carotid artery intima-media thickness may be more prone to early aging after high dose therapy.
Obesity is linked to increased arterial size, carotid intima-media thickness and arterial stiffne... more Obesity is linked to increased arterial size, carotid intima-media thickness and arterial stiffness. The effects of obesity and body composition on muscular artery intima-media and adventitia thickness has previously not been established. The aim of this study was to explore associations between carotid and muscular artery wall layer thickness with body composition and cardiovascular risk factors in early middle-aged women. This is a cross-sectional study including 199 women aged 40±4 years. Arterial lumen (LD), intima-media (IMT) and adventitia thickness (AT) were measured from carotid, brachial and radial arteries using ultra-high frequency ultrasound (22-71 MHz). Women with obesity had increased IMT in carotid (0.47 vs 0.45 mm), brachial (0.19 vs 0.17 mm) and radial arteries (0.16 vs 0.15 mm) and increased brachial AT (0.14 vs 0.13 mm). In multiple regression models all arterial LD (β-range 0.02-0.03 mm/kg/m2), IMT (β-range 0.91-3.37 µm/kg/m2), AT (β-range 0.73-1.38 µm/kg/m2) wer...
Studies examining the link between abnormal fetal growth and cardiac changes in childhood have pr... more Studies examining the link between abnormal fetal growth and cardiac changes in childhood have presented conflicting results. We studied the effect of abnormal fetal growth on cardiac morphology and function during childhood, while controlling for body size, composition and postnatal factors. We report on the follow-up of 90 children (median age 5.81 years, IQR 5.67; 5.95) born appropriate for gestational age (AGA, N = 48), small for gestational age (SGA, N = 23), or large for gestational age (LGA, N = 19); SGA and LGA defined as birth weight Z-score < − 2 and > + 2, respectively. We examined the heart using echocardiography, including Doppler and strain imaging, in relation to anthropometrics, body composition, blood pressure, physical activity, and diet. Although groupwise differences in body size decreased during the first year after birth, LGA remained larger at follow-up, with higher lean body mass and BMI, while SGA were smaller. Slight changes in left ventricular diast...
ABSTRACTIntroductionThe dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adver... more ABSTRACTIntroductionThe dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out‐of‐home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring.MethodsThis is a longitudinal register‐based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18–23 years.ResultsThe results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences i...
ABSTRACTObjectivesBoth excessive and restricted fetal growth are associated with changes in cardi... more ABSTRACTObjectivesBoth excessive and restricted fetal growth are associated with changes in cardiac geometry and function at birth. There are significant issues when indexing cardiac parameters for body size in the neonatal period. The aims of this study were to determine to what extent cardiac geometry is dependent on body size in term and preterm neonates with restricted or excessive fetal growth and how this is affected by adiposity.MethodsThis was a cross‐sectional study of neonates born between 31 and 42 weeks of gestation, divided into three groups: (1) small‐for‐gestational age (SGA, birth weight > 2 SD below the mean); (2) large‐for‐gestational age (LGA, birth weight > 2 SD above the mean); and (3) appropriate‐for‐gestational‐age controls (AGA, birth weight ≤ 2 SD from the mean). Cardiac geometry and function were compared between the study groups, adjusting for body size. The potential impact of infant adiposity and maternal disease was assessed.ResultsIn total, 174 n...
Aim: Maternal GDM and obesity is associated with child obesity and cardiovascular risk. The aim o... more Aim: Maternal GDM and obesity is associated with child obesity and cardiovascular risk. The aim of this study was to evaluate muscular artery morphology in the offspring of mothers with obesity and GDM. Methods: In this observational study we assessed 201 mother-child pairs as a subcohort of the Finnish Gestational Diabetes Prevention Study at average 6.1±0.5 years postpartum. The maternal pre-pregnancy BMI was 30.8±5.6 and 96 were diagnosed with GDM. Brachial (BA), Radial (RA) and Femoral (FA) arteries were assessed using very-high resolution ultrasound (25-55MHz). Results: Maternal pre-pregnancy BMI was associated with early child weight gain (BMI z-score 0.45±0.92; p<0.001), body fat percentage (BF%) and lean body mass (LBM). There was no difference in child BMI, LBM, BF% or muscular artery dimensions (lumen, LD; intima-media thickness, IMT) in children of GDM vs. non-GDM mothers. BA, RA and FA dimensions were associated with child BSA, height, weight, and LBM, but not with BF% or maternal pre-pregnancy BMI. IMT was thicker in boys vs. girls. Child LBM was the only independent predictor for muscular artery LD (BA: r 2 ¼0.107, p<0.001; RA: r 2 ¼0.065, p<0.001; FA: r 2 ¼0.057, p<0.001) and IMT (BA: r 2 ¼0.164, p<0.001; RA: r 2 ¼0.021, p¼0.027; FA: r 2 ¼0.048, p¼0.001) in linear regression models. Conclusions: Maternal pre-gestational weight is linked to child adiposity, but no association was seen between maternal obesity/GDM and muscular artery morphology. Muscular artery morphology in childhood is linked with lean body mass, but not with adiposity.
In this study, we aimed to determine echocardiographic reference values and parametric Z scores e... more In this study, we aimed to determine echocardiographic reference values and parametric Z scores equations for PWD velocities and TDI velocities in a healthy pediatric population using a complete and standardized approach for regression modeling, detection of residual biases, and assessment of adequate Z score distribution. Methods Population and Recruitment Subjects from age 1 to 18 years, without heart disease, were prospectively recruited for this study from local schools, as volunteers and Background-In pediatric echocardiography, pulse wave Doppler, and tissue Doppler imaging velocities are widely used to assess cardiac function. Current reference values and Z scores, allowing adjustment for growth are limited by inconsistent methodologies and small sample size. Using a standardized approach for parametric modeling and Z score quality assessment, we propose new pediatric reference values and Z score equations for most left ventricular pulse wave Doppler and tissue Doppler imaging measurements. Methods and Results-Two hundred thirty-three healthy pediatric subjects 1 to 18 years of age were prospectively recruited. Thirteen pulse wave Doppler and 14 tissue Doppler imaging measurements were recorded. Normalization for growth was done via a complete and standardized approach for parametric nonlinear regression modeling. Several analyses were performed to ensure adequate Z score distribution and to detect potential residual associations with growth or residual heteroscedasticity. Most measurements adopted a nonlinear relationship with growth and displayed significant heteroscedasticity. Compared with age, height, and weight, normalization for body surface area was most efficient in removing the effect of growth. Generally, polynomial and allometric models yielded adequate goodness-of-fit. Residual values for several measurements had significant departure from the normal distribution, which could be corrected using logarithmic or reciprocal transformation. Overall, weighted parametric nonlinear models allowed us to compute Z score equations with adequate normal distribution and without residual association with growth. Conclusions-We present Z scores for normalized pulse wave Doppler and tissue Doppler imaging in pediatric echocardiography. Further studies are needed to define the threshold beyond which health becomes a disease by integrating other important factors such as ventricular morphology, loading conditions, and heart rate.
Journal of The American Society of Echocardiography, Aug 1, 2016
Background: In pediatric echocardiography, myocardial strain measurements are likely influenced b... more Background: In pediatric echocardiography, myocardial strain measurements are likely influenced by cardiac size and growth in healthy children. The application of this technique in clinical practice has been hampered by the lack of good normal reference values for the pediatric population. The aim of this study was to determine reference values and Z score equations for left ventricular systolic circumferential and longitudinal strain in a healthy pediatric population. Methods: Two hundred thirty-three healthy subjects 1 to 18 years of age were prospectively recruited. Left ventricular systolic longitudinal and circumferential strain measurements were recorded using two-dimensional speckle-tracking. Normalization for body size was performed using parametric nonlinear regression modeling. Several analyses were performed to detect potential residual associations with body size, residual heteroscedasticity, or departure from an adequate Z score distribution. Results: There were weak but statistically significant nonlinear associations between body size and most strain values. Body surface area was superior to adjust for body size compared with age, height, and weight. Most strain values displayed a second-order polynomial relationship with body surface area. Z score equations were computed with adequate normal distributions and without residual associations in relation to BSA for most strain parameters. Conclusions: There was a weak but significant influence of body size on most left ventricular circumferential and longitudinal systolic strain parameters used in pediatric echocardiography. Z scores are presented for strain measurements normalized to body surface area and adjusted for heteroscedasticity. The use of these normalized values may reduce the risk for misclassification caused by normal variation in myocardial strain values during growth.
Early childhood healthcare utilization, mortality and welfare interventions were studied among ch... more Early childhood healthcare utilization, mortality and welfare interventions were studied among children of mothers with identified gestational alcohol and ⁄ or substance abuse. Methods: Register-based retrospective cohort study. The exposed cohort consisted of 638 children born to 524 women followed up antenatally 1992-2001 at special outpatient clinics in the capital area of Finland. Nonexposed children (n = 1914) born to control women were matched for maternal age, parity, number of foetuses, month of birth and delivery hospital of the index child. Postnatal data of both cohorts were collected from national registers until 2007. Results: The exposed cohort displayed twice the amount of in-and outpatient hospital care episodes compared with nonexposed children. Differences attributable to exposure were found in categories of conditions originating in the perinatal period, mental and behavioural disorders, and nonspecific factors influencing health status and contact with health services. This was reflected in amounts of reimbursements for drugs of the central nervous system, as well as special care allowances and rehabilitation for mental and behavioural disorders. The highest degree of healthcare utilization was observed among exposed children placed in out-of-home care. One-third of these children received outpatient care and one-tenth required inpatient care for a mental and behavioural disorder. No significant differences were found in early mortality. Conclusion: The exposed children displayed significant neonatal and early mental and behavioural healthcare utilization, and need for significant psychosocial support during their first decade of life.
Background. The aim of the study was to evaluate arterial morphology and function in a national c... more Background. The aim of the study was to evaluate arterial morphology and function in a national cohort of long-term survivors of high-risk neuroblastoma (NBL) treated with high-dose chemotherapy and autologous hematopoietic stem cell transplantation with or without total body irradiation (TBI). Methods and Results. Common carotid, femoral, brachial, and radial artery morphology were assessed with very-high-resolution vascular ultrasound (25-55 MHz), and carotid artery stiffness and brachial artery flowmediated dilatation measured with conventional vascular ultrasound in 19 adult or pubertal (age 22.7 AE 4.9 years, range 16-30) NBL survivors transplanted during 1984-1999 at the mean age of 2.5 AE 1.0 years. Results were compared with 20 age-and sexmatched healthy controls. The cardiovascular risk assessment included history, body mass index, fasting plasma lipids, glucose, and 24-h ambulatory blood pressure (BP). The survivors had consistently smaller arterial lumens, increased carotid intima-media thickness (IMT), plaque formation (N ¼ 3), and stiffness, as well as increased radial artery intima thickness (N ¼ 5) compared with the control group. Survivors displayed higher plasma triglyceride and cholesterol levels, and increased heart rate, as well as increased systolic and diastolic BPs. TBI (N ¼ 10) and a low body surface area were independent predictors for decreased arterial lumen size and increased IMT. Three out of five survivors with subclinical intima thickening had arterial plaques. Plaques occurred only among TBItreated survivors. Conclusions. Long-term childhood cancer survivors treated with TBI during early childhood display significant signs of premature arterial aging during young adulthood. Pediatr Blood Cancer
The aim of this study was to analyze the prevalence of frailty and physical health limitations am... more The aim of this study was to analyze the prevalence of frailty and physical health limitations among long-term survivors of high-risk neuroblastoma (HR NBL) and to investigate whether frail health is associated with variables of cardiovascular function, markers of inflammation and telomere length. A national study cohort of 19 (median age 22, range 16-30 years) long-term (410 years) HR NBL survivors was studied and the findings were compared with 20 age-and sex-matched controls. Frailty was defined as ⩾ 3 of the following conditions: low muscle mass, low energy expenditure, slow running and weakness. The prevalence of frailty was significantly higher among the HR NBL survivors 9/19 (47%) than among the controls (0%). Thirteen (68%) of the survivors reported significant physical health limitations in vigorous activities, as opposed to none of the controls. The HR NBL survivors had significantly shorter telomere length and higher serum levels of high sensitivity C-reactive protein than did the controls. Frail health and poor physical functioning are prevalent among HR NBL survivors and suggest premature aging. Survivors with gonadal damage, very low fat mass percentage, low glycosylated hemoglobin A1c and increased common carotid artery intima-media thickness may be more prone to early aging after high dose therapy.
Obesity is linked to increased arterial size, carotid intima-media thickness and arterial stiffne... more Obesity is linked to increased arterial size, carotid intima-media thickness and arterial stiffness. The effects of obesity and body composition on muscular artery intima-media and adventitia thickness has previously not been established. The aim of this study was to explore associations between carotid and muscular artery wall layer thickness with body composition and cardiovascular risk factors in early middle-aged women. This is a cross-sectional study including 199 women aged 40±4 years. Arterial lumen (LD), intima-media (IMT) and adventitia thickness (AT) were measured from carotid, brachial and radial arteries using ultra-high frequency ultrasound (22-71 MHz). Women with obesity had increased IMT in carotid (0.47 vs 0.45 mm), brachial (0.19 vs 0.17 mm) and radial arteries (0.16 vs 0.15 mm) and increased brachial AT (0.14 vs 0.13 mm). In multiple regression models all arterial LD (β-range 0.02-0.03 mm/kg/m2), IMT (β-range 0.91-3.37 µm/kg/m2), AT (β-range 0.73-1.38 µm/kg/m2) wer...
Studies examining the link between abnormal fetal growth and cardiac changes in childhood have pr... more Studies examining the link between abnormal fetal growth and cardiac changes in childhood have presented conflicting results. We studied the effect of abnormal fetal growth on cardiac morphology and function during childhood, while controlling for body size, composition and postnatal factors. We report on the follow-up of 90 children (median age 5.81 years, IQR 5.67; 5.95) born appropriate for gestational age (AGA, N = 48), small for gestational age (SGA, N = 23), or large for gestational age (LGA, N = 19); SGA and LGA defined as birth weight Z-score < − 2 and > + 2, respectively. We examined the heart using echocardiography, including Doppler and strain imaging, in relation to anthropometrics, body composition, blood pressure, physical activity, and diet. Although groupwise differences in body size decreased during the first year after birth, LGA remained larger at follow-up, with higher lean body mass and BMI, while SGA were smaller. Slight changes in left ventricular diast...
ABSTRACTIntroductionThe dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adver... more ABSTRACTIntroductionThe dual impact of prenatal substance exposure (i.e. alcohol/drugs) and adverse postnatal caregiving environment on offspring secondary education completion is an understudied research area. The aim was to investigate the influence of childhood adversities, out‐of‐home care, and offspring's mental and/or behavioural disorders on secondary education completion among prenatally exposed offspring in comparison to matched unexposed offspring.MethodsThis is a longitudinal register‐based matched cohort study in Finland including offspring with a history of prenatal substance exposure and a matched unexposed cohort. The study sample included 283 exposed and 820 unexposed offspring aged 18–23 years.ResultsThe results showed a time lag in secondary education completion and lower educational attainment overall among exposed compared with unexposed (37.8% vs. 51.0%, respectively). The results from the multivariate logistic regression models showed that the differences i...
ABSTRACTObjectivesBoth excessive and restricted fetal growth are associated with changes in cardi... more ABSTRACTObjectivesBoth excessive and restricted fetal growth are associated with changes in cardiac geometry and function at birth. There are significant issues when indexing cardiac parameters for body size in the neonatal period. The aims of this study were to determine to what extent cardiac geometry is dependent on body size in term and preterm neonates with restricted or excessive fetal growth and how this is affected by adiposity.MethodsThis was a cross‐sectional study of neonates born between 31 and 42 weeks of gestation, divided into three groups: (1) small‐for‐gestational age (SGA, birth weight > 2 SD below the mean); (2) large‐for‐gestational age (LGA, birth weight > 2 SD above the mean); and (3) appropriate‐for‐gestational‐age controls (AGA, birth weight ≤ 2 SD from the mean). Cardiac geometry and function were compared between the study groups, adjusting for body size. The potential impact of infant adiposity and maternal disease was assessed.ResultsIn total, 174 n...
Aim: Maternal GDM and obesity is associated with child obesity and cardiovascular risk. The aim o... more Aim: Maternal GDM and obesity is associated with child obesity and cardiovascular risk. The aim of this study was to evaluate muscular artery morphology in the offspring of mothers with obesity and GDM. Methods: In this observational study we assessed 201 mother-child pairs as a subcohort of the Finnish Gestational Diabetes Prevention Study at average 6.1±0.5 years postpartum. The maternal pre-pregnancy BMI was 30.8±5.6 and 96 were diagnosed with GDM. Brachial (BA), Radial (RA) and Femoral (FA) arteries were assessed using very-high resolution ultrasound (25-55MHz). Results: Maternal pre-pregnancy BMI was associated with early child weight gain (BMI z-score 0.45±0.92; p<0.001), body fat percentage (BF%) and lean body mass (LBM). There was no difference in child BMI, LBM, BF% or muscular artery dimensions (lumen, LD; intima-media thickness, IMT) in children of GDM vs. non-GDM mothers. BA, RA and FA dimensions were associated with child BSA, height, weight, and LBM, but not with BF% or maternal pre-pregnancy BMI. IMT was thicker in boys vs. girls. Child LBM was the only independent predictor for muscular artery LD (BA: r 2 ¼0.107, p<0.001; RA: r 2 ¼0.065, p<0.001; FA: r 2 ¼0.057, p<0.001) and IMT (BA: r 2 ¼0.164, p<0.001; RA: r 2 ¼0.021, p¼0.027; FA: r 2 ¼0.048, p¼0.001) in linear regression models. Conclusions: Maternal pre-gestational weight is linked to child adiposity, but no association was seen between maternal obesity/GDM and muscular artery morphology. Muscular artery morphology in childhood is linked with lean body mass, but not with adiposity.
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