Abstract-An endothelial nitric oxide synthase (eNOS) gene polymorphism (Glu298Asp) has been associated with cardiovascular disease. We investigated whether carriage of the polymorphism was associated with functional changes in the endothelium, and how genotype altered the harmful and beneficial impact of environmental influences on the endothelium. Endothelium-dependent, flow-mediated brachial artery dilatation (FMD) and endothelium-independent dilatation response to glyceryl trinitrate were measured using high-resolution ultrasound in 248 subjects (131 female, 117 male, aged 20 to 28) genotyped for the Glu298Asp polymorphism. Vascular function was compared between genotype groups and interactions with the proatherogenic risk factor, smoking, and the antiatherogenic influence of n-3 fatty acids (n-3FA) were investigated. Vascular function was not related to genotype in the group as a whole or within sexes. However, among males, smoking was associated with lower FMD in Asp298 carriers (nonsmokers 0.125Ϯ0.085 mm versus smokers 0.070Ϯ0.060 mm, Pϭ0.006) but not in Glu298 homozygotes (nonsmokers 0.103Ϯ0.090 mm versus smokers 0.124Ϯ0.106, Pϭ0.5). In the whole group, n-3FA levels were positively related to FMD in Asp298 carriers (reg coeffϭ0.023 mm/%, Pϭ0.04, rϭ0.20) but not in Glu298 homozygotes (reg coeffϭϪ0.019 mm/%, Pϭ0.1). These differences between genotype groups were significant in interaction models. The Glu298Asp polymorphism is associated with differences in endothelial responses to both smoking and n-3 FA in healthy young subjects. These findings raise the possibility of genotype-specific prevention strategies in cardiovascular disease.

Social jetlag may be an important and measurable public health target in children.

In young smokers and those with higher fasting insulin, glucose or triglyceride concentrations (factors associated with endothelial dysfunction), n-3 fatty acid levels were positively associated with flow-mediated dilatation. This raises the possibility that physiological levels of circulating n-3 fatty acids may protect the endothelium from early adulthood.

Antenatal mental health requires at least as much attention and resourcing as mental health in the postpartum period. Services need to specifically target Māori women, young women and women with a prior history of depression.

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