Developmental Origins of Obesity: Programmed Adipogenesis
Developmental Origins of Obesity: Programmed Adipogenesis
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DOI：
10.1007/s11892-012-0344-x
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发表时间：
2013-02-01
影响因子：
4.2
通讯作者：
Ross, Michael G.
中科院分区：
文献类型：
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作者：
Desai, Mina;Beall, Marie;Ross, Michael G.
代谢综合征的流行，包括孕妇中肥胖和妊娠糖尿病（GDM）患病率的显著增加，是一个重大的公共卫生问题。越来越多的人认识到，成人肥胖的风险显然受到产前和婴儿环境暴露的影响，特别是营养。这一原则是发展性方案拟订的根本基础。低出生体重，加上婴儿追赶性生长，与成人肥胖的重大风险有关。暴露于母亲肥胖，伴或不伴GDM，或具有高出生体重也代表儿童和成人肥胖的风险增加。动物模型复制了人类流行病学的发现，并阐明了潜在的编程机制，包括改变器官发育，细胞信号转导反应和表观遗传修饰。产前保健在优化孕产妇、胎儿和新生儿健康方面取得了长足进步，现在有机会开始预防或减少儿童/成人肥胖的干预措施。整合最佳妊娠营养和体重增加，GDM管理和新生儿喂养策略与成人肥胖的长期后果的指南仍有待阐明。
The metabolic syndrome epidemic, including a marked increase in the prevalence of obesity and gestational diabetes mellitus (GDM) among pregnant women, represents a significant public health problem. There is increasing recognition that the risk of adult obesity is clearly influenced by prenatal and infant environmental exposures, particularly nutrition. This tenet is the fundamental basis of developmental programming. Low birth weight, together with infant catch-up growth, is associated with a significant risk of adult obesity. Exposure to maternal obesity, with or without GDM, or having a high birth weight also represents an increased risk for childhood and adult obesity. Animal models have replicated human epidemiologic findings and elucidated potential programming mechanisms that include altered organ development, cellular signaling responses, and epigenetic modifications. Prenatal care has made great strides in optimizing maternal, fetal, and neonatal health, and now has the opportunity to begin interventions which prevent or reduce childhood/adult obesity. Guidelines that integrate optimal pregnancy nutrition and weight gain, management of GDM, and newborn feeding strategies with long-term consequences on adult obesity, remain to be elucidated.