The developmental origins of insulin resistance
The developmental origins of insulin resistance
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DOI：
10.1159/000089311
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发表时间：
2005-01-01
期刊：
影响因子：
--
通讯作者：
Barker, DJP
中科院分区：
文献类型：
--
作者：
Barker, DJP
直到最近，退化性疾病的主要原因被认为是在成年生活中起作用，并加速破坏性过程，如动脉粥样硬化的形成和血压升高。然而，最近的观察表明，患有冠心病的人在胎儿期和儿童期的生长与其他人不同，这导致了这种疾病的新“发育”模型。低出生体重已被证明与冠心病、2型糖尿病和葡萄糖耐量改变的发病率增加有关。这些与低出生体重的相关性延伸到出生体重的正常范围，反映了胎儿生长缓慢，而不是早产。这些关联被认为是发育可塑性的结果，即一种基因型可以在发育过程中响应不同的环境条件而产生一系列不同的生理或形态状态的现象。最近的观察表明，低出生体重、2岁时的瘦弱和2岁后体重指数（BMI）的增加均与以后生活中胰岛素抵抗的发展有关。因此，预防大部分2型糖尿病和其他与胰岛素抵抗相关的疾病可能取决于发育期间的干预措施。这些措施包括通过良好的婴儿喂养方法保护婴儿在出生后的头2年内的生长，并防止2岁后体重指数迅速增加。改善胎儿营养仍然是一个重要的长期目标。版权所有（c）2005 S. Karger AG，巴塞尔。
Until recently, the principal causes of degenerative disease were thought to act in adult life and to accelerate destructive processes, such as the formation of atheroma and rise in blood pressure. Recent observations that people who develop coronary heart disease grow differently to other people during fetal life and childhood have, however, led to a new 'developmental' model for the disease. Low birthweight has been shown to be associated with increased rates of coronary heart disease, type 2 diabetes mellitus and altered glucose tolerance. These associations with low birthweight extend across the normal range of birthweight and reflect slow fetal growth rather than premature birth. The associations are thought to be consequences of developmental plasticity, the phenomenon by which one genotype can give rise to a range of different physiological or morphological states in response to different environmental conditions during development. Recent observations suggest that low birthweight, thinness at 2 years of age and an increase in body mass index (BMI) after the age of 2 years are each associated with the development of insulin resistance in later life. The prevention of a substantial proportion of type 2 diabetes and other disorders linked to insulin resistance may, therefore, depend on interventions during development. These include protecting the growth of babies during the first 2 years after birth by good infant feeding practices and preventing a rapid increase in BMI after the age of 2 years. Improving fetal nutrition remains an important long-term goal. Copyright (c) 2005 S. Karger AG, Basel.