The Uterine Environment and Childhood Obesity Risk: Mechanisms and Predictions.
The Uterine Environment and Childhood Obesity Risk: Mechanisms and Predictions.
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DOI：
10.1007/s13668-023-00482-z
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发表时间：
2023-09
影响因子：
4.9
通讯作者：
Aiken, Catherine E.
中科院分区：
文献类型：
--
作者：
Cristian, Andreea;Tarry-Adkins, Jane L.;Aiken, Catherine E.
儿童肥胖是许多人群中日益严重的健康问题，因此迫切需要揭示其潜在机制。一些证据表明，暴露于次优的宫内环境可能会影响胎儿的代谢健康，从而在以后的生活中产生不良后果，包括易患儿童肥胖症。观察性研究表明，胎儿出生体重高低、妊娠期体重过度增加、母亲压力和吸烟等因素都与儿童肥胖风险增加有关。动物模型可以仔细控制遗传背景和产后环境，表明几种不同的机制，包括表观遗传变化、脂肪组织发育失调和食欲编程，可能是儿童肥胖发育编程的关键驱动因素。然而，在人类研究中，遗传学和产后环境的影响更难以作为独立影响来区分，而且低随访率也使研究变得复杂。次优的宫内环境与母体和胎儿遗传学以及产后环境相互作用，导致儿童肥胖的风险。母亲的代谢挑战，例如肥胖和胰岛素抵抗，会增加胎儿过度生长和随后的儿童肥胖的风险。为了保护人群的长期健康，需要将研究重点放在识别和干预儿童肥胖跨代周期的有效方法上。
Childhood obesity is a growing health problem in many populations, hence the urgent need to unravel the underlying mechanisms. Some evidence suggests that exposure to suboptimal intrauterine environments can program foetal metabolic health, with adverse consequences in later life, including susceptibility to childhood obesity. Factors such as high and low foetal birth weight, excessive gestational-weight-gain, maternal stress and smoking are all associated with increased risk of childhood obesity in observational studies. Animal models, where both genetic background and the postnatal environment can be carefully controlled, suggest that several different mechanisms, including epigenetic changes, dysregulation of adipose tissue development and programming of appetite, may be key drivers of developmental programming of childhood obesity. However, the influence of genetics and the post-natal environment are much more difficult to disentangle as independent effects in human studies, which are also complicated by low follow-up rates. Suboptimal intrauterine environments interact with maternal and foetal genetics and with the postnatal environment to contribute to the risk of childhood obesity. Maternal metabolic challenges, for example obesity and insulin resistance, contribute to the risk of foetal overgrowth and subsequent adiposity in childhood. To protect the long-term health of populations, research focusing on effective means of identifying and intervening in the transgenerational cycle of childhood obesity is required.
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