Developmental origins of health and disease theory in cardiology
Developmental origins of health and disease theory in cardiology
复制标题
DOI：
10.1016/j.jjcc.2020.02.003
复制
发表时间：
2020-07-01
影响因子：
2.5
通讯作者：
Fukuoka, Hideoki
中科院分区：
文献类型：
--
作者：
Arima, Yuichiro;Fukuoka, Hideoki
许多流行病学和动物研究表明，出生体重与成年后生活方式相关疾病（如心血管疾病、糖尿病和/或慢性肾病）的发病率呈负相关。低出生体重发生在许多不良的宫内环境中，包括营养不良、吸烟、饮酒或压力。健康和疾病的发育起源（DOHaD）理论基于这样的概念，即生活方式相关疾病的起源是在受精、胚胎、胎儿和新生儿阶段通过基因和环境（营养、压力或环境化学物质）之间的相互关系形成的。成人疾病在分娩后面临异常环境，如营养过剩，压力过大或缺乏锻炼。疾病通过这两种侮辱发展。这一概念最初被称为“巴克假说”。“大卫巴克发现了出生体重较低与缺血性心脏病死亡率较高之间的关系。以前的流行病学研究发现，在早期生活中暴露于饥荒的人在成年后患心血管疾病的风险更高。然而，在胎儿生命期间改变生长后，在其整个生命周期中永久改变个体的结构，生理和内分泌状态的确切机制尚不完全清楚。流行病学研究，包括对胎儿或婴儿期营养不良人群的前瞻性队列和观察性分析，揭示了出生体重较低与成人心血管风险较高之间的密切关系。表观遗传学研究的最新进展揭示了强烈的遗传关联。激素调节和表观遗传修饰对于器官的正常发育和生理功能具有重要作用。易感性的分子机制被认为是表观遗传学修饰，它们的失调与疾病易感性的获得有关。本文就DOHaD的概念及相关的临床和基础研究作一综述。(C)2020年由Elsevier Ltd代表日本心脏病学院出版。
Numerous epidemiological and animal studies disclosed that birth weight is inversely associated with the incidence of the lifestyle-related disorders in adult life, such as cardiovascular disease, diabetes, and /or chronic kidney disease. Lower birth weight occurs in numerous undesired intrauterine environments including malnutrition, smoking, alcohol consumption, or stress.The Developmental Origin of Health and Disease (DOHaD) theory is based on the concept that the origins of lifestyle-related disease is formed at the time of fertilization, embryonic, fetal, and neonatal stages by the interrelation between genes and the environments (nutrition, stress, or environmental chemicals). Adult disease develops after delivery facing to abnormal environments such as over-nutrition, much stress, or lack of exercise. Disease develops through these two insults. This concept was first proposed as the "Barker Hypothesis." David Barker had discovered the relation between the lower birth weight and the higher prevalence of ischemic heart disease mortality. Previous epidemiologic studies have found the people exposed to famine during early life had higher risks of cardiovascular diseases in adulthood. Yet, the exact mechanisms that permanently change the structure, physiology, and endocrine status of an individual across their lifespan following altered growth during fetal life are not entirely clear. Epidemiological studies including prospective cohort and observational analysis of the people exposed to malnutrition during fetal or infancy have disclosed the strong relation between the lower birth weight and the higher cardiovascular risks in adults. Recent progress of epigenetic studies unveiled strong genetic association. Hormonal regulation and epigenetic modifications have an important role for proper organ development and physiological functions. The molecular mechanism of predisposition is supposed to be the epigenetics modifications.Their dysregulation is related to the acquisition of the disease-susceptible trait. In this review, we overview the concept of DOHaD and introduce related clinical and basic research. (C) 2020 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.