Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21200, USA.
J Nutr. 2010 Mar;140(3):437-45. doi: 10.3945/jn.109.116327. Epub 2010 Jan 13.
Early life nutritional exposures, combined with changes in lifestyle in adult life, can result in increased risk of chronic diseases. Although much of the focus on the developmental origins of disease has been on birth size and growth in postnatal life and the availability of energy and protein during these critical developmental periods, micronutrient deficiencies may also play an important role in fetal growth and development. Micronutrient status in fetal and early life may alter metabolism, vasculature, and organ growth and function, leading to increased risk of cardiometabolic disorders, adiposity, altered kidney function, and, ultimately, to type 2 diabetes and cardiovascular diseases. This review elucidates pathways through which micronutrient deficiencies lead to developmental impairment and describes the research to date on the evidence that micronutrient deficiencies in utero influence the development of chronic disease risk. Animal studies, observational human studies examining maternal diet or micronutrient status, and limited data from intervention studies are reviewed. Where data are lacking, plausible mechanisms and pathways of action have been derived from the existing animal and in vitro models. This review fills a critical gap in the literature related to the seminal role of micronutrients in early life and extends the discussion on the developmental origins of health and disease beyond birth size and energy and protein deficiency.
早期生活中的营养暴露，加上成年后生活方式的改变，可能会增加患慢性病的风险。尽管人们对疾病的发育起源的关注主要集中在出生时的大小和出生后生命中的生长以及这些关键发育时期的能量和蛋白质的可获得性上，但微量营养素缺乏也可能在胎儿生长和发育中发挥重要作用。胎儿和生命早期的微量营养素状况可能会改变代谢、血管和器官的生长和功能，从而增加患心血管代谢紊乱、肥胖、肾功能改变以及最终 2 型糖尿病和心血管疾病的风险。这篇综述阐明了微量营养素缺乏导致发育障碍的途径，并描述了迄今为止关于微量营养素缺乏在子宫内影响慢性疾病风险发展的证据的研究。本文回顾了动物研究、观察性人类研究中检查母体饮食或微量营养素状况的研究，以及来自干预研究的有限数据。在缺乏数据的情况下，从现有的动物和体外模型中推导出了合理的机制和作用途径。这篇综述填补了与微量营养素在生命早期的重要作用相关的文献中的一个关键空白，并将健康和疾病的发育起源的讨论扩展到出生时的大小以及能量和蛋白质缺乏之外。
