Lucas Alan
The MRC Childhood Nutrition Research Centre, Institute of Child Health, London, UK.
Nestle Nutr Workshop Ser Pediatr Program. 2010;65:1-9; discussion 9-11. doi: 10.1159/000281107. Epub 2010 Jan 29.
Whilst growth and its derangement in disease have been a long-standing focus in pediatrics, increasing evidence points to a further, fundamental role of early growth in the programming of later health. In studies on animals and humans, rapid early growth is associated with higher risk of obesity and cardiovascular disease, and in animals, senescence and life span - a concept encapsulated in the postnatal growth acceleration hypothesis. This hypothesis explains the benefits of breastfeeding to infants for reduced cardiovascular disease risk in terms of their slower early growth and the fetal origins hypothesis in terms of the adverse postnatal catch-up growth in infants born small. Early growth, notably prior to full term, also influences brain development and cognition - and emerging evidence suggests diverse, broader effects, for instance cancer and the onset of puberty. Understanding the mechanisms, triggers and windows for such effects is important, given the major public health implications, including potential new opportunities for primary prevention of adult disease.
虽然生长及其在疾病中的紊乱一直是儿科学的长期关注点，但越来越多的证据表明，早期生长在后期健康的编程中具有更根本的作用。在对动物和人类的研究中，早期快速生长与肥胖和心血管疾病的较高风险相关，在动物中还与衰老和寿命相关——这一概念包含在出生后生长加速假说中。该假说从婴儿早期生长较慢的角度解释了母乳喂养对婴儿降低心血管疾病风险的益处，从出生时体重小的婴儿出生后不良追赶生长的角度解释了胎儿起源假说。早期生长，尤其是足月前的生长，也会影响大脑发育和认知——新出现的证据表明其具有多种更广泛的影响，例如癌症和青春期的开始。鉴于其对公共卫生的重大影响，包括对成人疾病一级预防的潜在新机会，了解这些影响的机制、触发因素和窗口期非常重要。
