Endocan: A biomarker for endothelial dysfunction and inflammation, linking maternal obesity and pediatric obesity in a cohort of preterm neonates

E Holthaus; M O'Neill; W Jeske; P DeChristopher; J Goodman; L Glynn; S Levin; J Muraskas

doi:10.1016/j.ejogrb.2024.04.013

Endocan: A biomarker for endothelial dysfunction and inflammation, linking maternal obesity and pediatric obesity in a cohort of preterm neonates

Eur J Obstet Gynecol Reprod Biol. 2024 Apr 12:297:132-137. doi: 10.1016/j.ejogrb.2024.04.013. Online ahead of print.

Authors

E Holthaus¹, M O'Neill², W Jeske³, P DeChristopher⁴, J Goodman⁵, L Glynn⁶, S Levin⁷, J Muraskas⁸

Affiliations

¹ Maternal Fetal Medicine, Loyola University Medical Center, 2160 S. 1(st) Ave, Maywood, IL 60153, USA. Electronic address: Emily.Holthaus@UTSouthwestern.edu.
² Loyola University Stritch School of Medicine, 2160 S. 1(st) Ave, Maywood, IL 60153, USA.
³ Thoracic and Cardiovascular Surgery, Cell and Molecular Physiology, Loyola University Chicago, 2160 S. 1(st) Ave, Maywood, IL 60153, USA.
⁴ Pathology and Laboratory Medicine, Transfusion Medicine. Loyola University Medical Center, 2160 S. 1(st) Ave, Maywood, IL 60153, USA.
⁵ Maternal Fetal Medicine, University of Missouri School of Medicine, MU Women's Hospital, 404 N Keene St, Columbia, MO 65201, USA.
⁶ Pediatric Surgery, NYU Langone Hospital, 120 Mineola Blvd, Suite 210, Mineola, NY 11501, USA.
⁷ Neonatal Perinatal. University of Oklahoma College of Medicine, 1200 North Everett Drive, ETNP 7504, Oklahoma City, OK, 73104, USA.
⁸ Neonatal-Perinatal Research, Neonatology, Loyola University Medical Center, 2160 S. 1(st) Ave, Maywood, IL 60153, USA.

PMID: 38626514
DOI: 10.1016/j.ejogrb.2024.04.013

Abstract

Objectives: Numerous animal and epidemiologic studies have demonstrated a positive association between maternal obesity in pregnancy and obesity in offspring. The biologic mechanisms of this association remain under investigation. One proposed mechanism includes fetoplacental endothelial dysfunction secondary to inflammation. Endocan is a relatively new biomarker for endothelial dysfunction and inflammation. Our objectives were to examine (1) the association between maternal obesity and neonatal serum endocan at birth, and (2) the association between neonatal serum endocan at birth and pediatric obesity at 24-36 months of age.

Study design: This was a secondary analysis of a prospective cohort of neonates born < 33 weeks gestation. Serum endocan was collected within 48 hours of birth. Serum endocan levels were compared in neonates born to obese mothers vs. those born to non-obese mothers. BMI data were retrospectively collected from cohort neonates between 24 and 36 months of age.

Results: The analysis included 120 mother/neonate dyads. Neonates born to obese mothers had higher median serum endocan at birth compared to neonates born to non-obese mothers (299 ng/L [205-586] vs. 251 ng/L [164-339], p = 0.045). In a linear regression modeled on neonatal serum endocan level, maternal obesity had a statistically significant positive association (p = 0.021). Higher mean serum endocan level at birth was associated with pediatric obesity between 24 and 36 months (obese vs. non-obese offspring; 574 ng/L (222) vs. 321 ng/L (166), p = 0.005).

Conclusions: In our cohort of preterm neonates, elevated serum endocan at birth was associated with both maternal obesity and downstream pediatric obesity. More research is needed to understand intergenerational transmission of obesity. A large focus has been on epigenetic modification. Endothelial dysfunction and inflammation may play important roles in these pathways. Effective biomarkers, including endocan, may also serve as intermediate outcomes in future pregnancy research.

Keywords: Endothelial dysfunction; Fetal development; Fetal programming; Maternal obesity; Pediatric obesity.