Epidemic of cardiometabolic diseases: a Latin American point of view.
Epidemic of cardiometabolic diseases: a Latin American point of view.
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DOI：
10.1177/1753944711403189
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发表时间：
2011-04-01
影响因子：
2.3
通讯作者：
Lopez-Lopez, Jose
中科院分区：
文献类型：
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作者：
Lopez-Jaramillo, Patricio;Lahera, Vicente;Lopez-Lopez, Jose
早期营养不良对随后的心脏代谢疾病（CMD）发病率有不同的影响。胎儿期和新生儿期对CMD相关系统的发育和生长至关重要。目前在拉丁美洲观察到的高血压、代谢综合征、2型糖尿病、肾衰竭和心力衰竭发生率的增加可能是胎儿和早期生活的营养环境与成人环境之间差异的结果。这种差异导致了主体的胎儿编程与新生活方式强加造成的成人环境之间的不匹配。关于首次心肌梗死（INTERHEART）和中风（INTERSTROKE）心血管危险因素的两项最大的国际研究表明，在拉丁美洲，可归因人群风险最高的因素是腹部肥胖。较早的编程和较晚的腹部肥胖之间的冲突使该人群对发展为低程度炎症状态、胰岛素抵抗和CMD的流行更敏感，从而导致较低水平的腹部肥胖。遗传和环境因素所起的相对作用以及两者之间的相互作用仍然是争论的主题。我们回顾了拉丁美洲孕产妇营养不良、早期生长限制、表观遗传适应与腹部肥胖和CMD后期发生之间的关系。
Poor early nutrition has varying effects on subsequent cardiometabolic disease (CMD) rates. Fetal and neonatal periods are critical for the development and growth of the systems involved in CMD. The increased rates of hypertension, metabolic syndrome, diabetes mellitus type 2, renal failure and heart failure observed nowadays in Latin America could be the result of the discrepancy between the nutritional environment during fetal and early life and the adult environment. This discrepancy causes a mismatch between the fetal programming of the subject and its adult circumstances created by the imposition of new life styles. The two largest international studies on cardiovascular risk factors for a first myocardial infarction (INTERHEART) and stroke (INTERSTROKE) demonstrated that in Latin America the factor with the highest attributable population risk was abdominal obesity. The conflict between the earlier programming and the later presence of abdominal obesity produced a higher sensitivity of this population to develop a state of low-degree inflammation, insulin resistance and the epidemic of CMD to lower levels of abdominal adiposity. The relative roles played by genetic and environmental factors and the interaction between the two are the still subjects of great debate. We have reviewed the relationship between maternal malnutrition, early growth restriction, epigenetic adaptations, and the later occurrence of abdominal obesity and CMD in Latin America.