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Impact of cesarean section on metabolic syndrome components in offspring rats

Pediatric Research (2024)Cite this article

Abstract

Introduction

Epidemiological evidence suggests an association between CS and offspring metabolic syndrome (MetS), but whether a causal relationship exists is unknown.

Methods

In this study, timed-mated Wistar rat dams were randomly assigned to cesarean section (CS), vaginal delivery (VD), and surrogate groups. The offspring from both CS and VD groups were reared by surrogate dams until weaning, and weaned male offspring from both groups were randomly assigned to receive normal diet (ND) or high-fat/high-fructose diet (HFF) ad libitum for 39 weeks.

Results

By the end of study, CS-ND offspring gained 17.8% more weight than VD-ND offspring, while CS-HFF offspring gained 36.4% more weight than VD-HFF offspring. Compared with VD-ND offspring, CS-ND offspring tended to have increased triglycerides (0.27 mmol/l, 95% CI, 0.05 to 0.50), total cholesterol (0.30 mmol/l, −0.08 to 0.68), and fasting plasma glucose (FPG) (0.30 mmol/l, −0.01 to 0.60); more pronounced differences were observed between CS-HFF and VD-HFF offspring in these indicators (triglyceride, 0.66 mmol/l, 0.35 to 0.97; total cholesterol, 0.46 mmol/l, 0.13 to 0.79; and FPG, 0.55 mmol/l, 0.13 to 0.98).

Conclusions

CS offspring were more prone to adverse metabolic profile and HFF might exacerbate this condition, indicating the association between CS and MetS is likely to be causal.

Impact

  • Whether the observed associations between CS and MetS in non-randomized human studies are causally relevant remains undetermined.

  • Compared with vaginally born offspring rats, CS born offspring gained more body weight and tended to have compromised lipid profiles and abnormal insulin sensitivity, suggesting a causal relationship between CS and MetS that may be further amplified by a high-fat/high-fructose diet.

  • Due to the high prevalence of CS births globally, greater clinical consideration must be given to the potential adverse effects of CS, and whether these risks should be made known to patients in clinical practice merits evaluation.

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Fig. 1: Study scheme of the intervention timeline in pregnant dams from pregnancy to delivery and in CS and VD offspring from 0 to 39 weeks post-weaning.
Fig. 2: Body weight gain (g)  from 0 to 32 weeks post-weaning.
Fig. 3: Blood lipids (mmol/l) from 0 to 39 weeks post-weaning.
Fig. 4: Insulin resistance measures.

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Data availability

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This research was funded by the National Natural Science Foundation of China (grant number 81273163).

Author information

Author notes

  1. These authors contributed equally: Mingxuan Zhang, Mengjiao Liu.

Authors and Affiliations

  1. Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health, School of Public Health, Peking University Health Science Center, 100191, Beijing, China

    Mingxuan Zhang, Yu-Bo Zhou, Hong-Tian Li & Jian-Meng Liu

  2. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, 100191, Beijing, China

    Mingxuan Zhang, Yu-Bo Zhou, Hong-Tian Li & Jian-Meng Liu

  3. School of Public Health, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China

    Mengjiao Liu

  4. Jiangxi Provincial Key Laboratory of Preventive Medicine, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China

    Mengjiao Liu

  5. School of Public Health, Hangzhou Normal University, Hangzhou, China

    Long Zhang

  6. Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University Health Science Center, 100191, Beijing, China

    Zhangjian Chen

  7. Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, 100191, Beijing, China

    Hong-Tian Li & Jian-Meng Liu

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Contributions

HT Li and JM Liu conceived the study; HT Li, YB Zhou, MJ Liu and JM Liu proposed the initial research plan; MJ Liu and L Zhang conducted the animal experiment; MX Zhang and HT Li analyzed all data, performed all statistical analyses, and wrote the manuscript; all authors critically reviewed the manuscript; HT Li and YB Zhou had primary responsibility for the final content; all authors have read and agreed to the final manuscript.

Corresponding authors

Correspondence to Yu-Bo Zhou or Hong-Tian Li.

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Ethical approval

The animal study protocol was approved by the animal Care and Use Committee of Peking University Health Science Center (SYXK (jing) 2011-0039).

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Zhang, M., Liu, M., Zhang, L. et al. Impact of cesarean section on metabolic syndrome components in offspring rats. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03079-6

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  • DOI: https://doi.org/10.1038/s41390-024-03079-6

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