Calkins Kara, Devaskar Sherin U
Department of Pediatrics, David Geffen School of Medicine, UCLA, Los Angeles, CA, USA.
Curr Probl Pediatr Adolesc Health Care. 2011 Jul;41(6):158-76. doi: 10.1016/j.cppeds.2011.01.001.
Dr. David Barker first popularized the concept of fetal origins of adult disease (FOAD). Since its inception, FOAD has received considerable attention. The FOAD hypothesis holds that events during early development have a profound impact on one's risk for development of future adult disease. Low birth weight, a surrogate marker of poor fetal growth and nutrition, is linked to coronary artery disease, hypertension, obesity, and insulin resistance. Clues originally arose from large 20th century, European birth registries. Today, large, diverse human cohorts and various animal models have extensively replicated these original observations. This review focuses on the pathogenesis related to FOAD and examines Dr. David Barker's landmark studies, along with additional human and animal model data. Implications of the FOAD extend beyond the low birth weight population and include babies exposed to stress, both nutritional and nonnutritional, during different critical periods of development, which ultimately result in a disease state. By understanding FOAD, health care professionals and policy makers will make this issue a high health care priority and implement preventive measures and treatment for those at higher risk for chronic diseases.
大卫·巴克博士首次使成人疾病的胎儿起源（FOAD）这一概念广为人知。自其提出以来，FOAD受到了广泛关注。FOAD假说认为，早期发育过程中的事件对一个人未来患成人疾病的风险有着深远影响。低出生体重是胎儿生长和营养不良的一个替代指标，与冠状动脉疾病、高血压、肥胖症和胰岛素抵抗有关。最初的线索来自20世纪欧洲的大型出生登记处。如今，大量不同的人类队列和各种动物模型广泛地重复了这些最初的观察结果。这篇综述聚焦于与FOAD相关的发病机制，并审视了大卫·巴克博士的标志性研究以及其他人类和动物模型数据。FOAD的影响不仅限于低出生体重人群，还包括在不同关键发育时期受到营养和非营养压力影响的婴儿，这些最终会导致疾病状态。通过了解FOAD，医疗保健专业人员和政策制定者将把这个问题作为医疗保健的高度优先事项，并为那些患慢性病风险较高的人实施预防措施和治疗。
