Developmental programming of hypertension and kidney disease.
Developmental programming of hypertension and kidney disease.
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DOI：
10.1155/2012/760580
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发表时间：
2012
影响因子：
2.1
通讯作者：
Yosypiv IV
中科院分区：
文献类型：
--
作者：
Chong E;Yosypiv IV
越来越多的证据支持这一概念，即胚胎发育“敏感”时期子宫内环境的变化或出生后婴儿饮食的变化会影响发育中的个体，导致生命后期的总体健康改变。这种现象被称为“发育规划”或“健康和疾病的发育起源”。妊娠<37周的早产婴儿或出生时体重<2,500克的低出生体重(LBW)婴儿患高血压、慢性肾病(CKD)、肥胖或2型糖尿病等迟发性疾病的风险会增加。遗传和环境事件都会影响早产儿或低出生体重个体的后续 CKD 和高血压风险。大量观察结果表明，早产儿或低体重儿对后续 CKD 和高血压的易感性至少部分是由肾单位禀赋减少介导的。与最终肾单位数低相关的子宫环境的主要影响因素包括子宫胎盘功能不全、母亲低蛋白饮食、高血糖、维生素A缺乏、内源性糖皮质激素的暴露或中断以及乙醇暴露。本文讨论了早产、低出生体重、宫内环境和婴儿喂养对晚年高血压和肾脏疾病发展的影响，并探讨了肾脏在高血压和慢性肾病发展规划中的作用。
A growing body of evidence supports the concept that changes in the intrauterine milieu during “sensitive” periods of embryonic development or in infant diet after birth affect the developing individual, resulting in general health alterations later in life. This phenomenon is referred to as “developmental programming” or “developmental origins of health and disease.” The risk of developing late-onset diseases such as hypertension, chronic kidney disease (CKD), obesity or type 2 diabetes is increased in infants born prematurely at <37 weeks of gestation or in low birth weight (LBW) infants weighing <2,500 g at birth. Both genetic and environmental events contribute to the programming of subsequent risks of CKD and hypertension in premature or LBW individuals. A number of observations suggest that susceptibility to subsequent CKD and hypertension in premature or LBW infants is mediated, at least in part, by reduced nephron endowment. The major factors influencing in utero environment that are associated with a low final nephron number include uteroplacental insufficiency, maternal low-protein diet, hyperglycemia, vitamin A deficiency, exposure to or interruption of endogenous glucocorticoids, and ethanol exposure. This paper discusses the effect of premature birth, LBW, intrauterine milieu, and infant feeding on the development of hypertension and renal disease in later life as well as examines the role of the kidney in developmental programming of hypertension and CKD.