Physiological adaption to maternal malaria and other adverse exposure: Low birth weight, functional capacity, and possible metabolic disease in adult life
Physiological adaption to maternal malaria and other adverse exposure: Low birth weight, functional capacity, and possible metabolic disease in adult life
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DOI：
10.1016/s0020-7292(11)60006-4
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发表时间：
2011-11-01
影响因子：
3.8
通讯作者：
Bygbjerg, Ib C.
中科院分区：
文献类型：
--
作者：
Christensen, Dirk L.;Kapur, Anil;Bygbjerg, Ib C.
健康和疾病的发展根源概念以及非传染性疾病在低收入和中等收入国家的流行，使人们更加重视出生体重不足问题。大多数将LBW与未来代谢疾病风险联系起来的研究都集中在母亲营养和贫血方面。一些研究表明，LBW与骨骼肌胰岛素抵抗和未来2型糖尿病的风险有关，可能是由于骨骼肌形态和生物化学的永久性改变导致成年后功能能力和体力活动降低。在世界某些地区，怀孕期间感染疟疾是贫血和低出生体重的最常见原因。通过造成营养供应中断以及缺氧，胎盘疟疾和贫血对宫内胎儿发育产生负面影响。因此，子宫内接触胎盘疟疾和随之而来的低出生体重可能会增加成年早期患2型糖尿病的风险。这一点尚未得到系统的调查。在全世界，每年估计有1.25亿例妊娠发生在疟疾流行地区，有很大可能发生宫内生长受限。LBW和随后的代谢功能障碍风险，包括2型糖尿病：这种潜在的联系也为通过在怀孕期间更加关注疟疾来早期预防未来的代谢疾病提供了机会。(C)2011年国际妇产科联合会。由Elsevier爱尔兰有限公司出版。保留所有权利。
The concept of developmental origins of health and disease and the epidemic of noncommunicable diseases in low- and middle-income countries has increased the focus on low birth weight (LBW). Most studies linking LBW to future risk of metabolic diseases have focused on maternal nutrition and anemia. Several studies have shown that LBW is linked to skeletal muscle insulin resistance and future risk of type 2 diabetes, possibly caused by permanent modifications in skeletal muscle morphology and biochemistry leading to lowered functional capacity and physical activity in adult life. In some parts of the world, malaria infection during pregnancy is the most common cause of anemia and LBW. By causing disruption to nutrient supply, as well as hypoxia, placental malaria and anemia negatively impact intrauterine fetal development. Thus, in utero exposure to placental malaria and consequent LBW may impart a higher risk of developing type 2 diabetes in early adult life. This has not been investigated systematically. Worldwide, an estimated 125 million pregnancies occur annually in malarial areas with a vast potential for intrauterine growth restriction. LBW, and subsequent risk of metabolic dysfunction, including type 2 diabetes: this potential link also opens an opportunity for early prevention of future metabolic diseases by paying greater attention to malaria during pregnancy. (C) 2011 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.