Division of Endocrinology, Department of Pediatrics, Center for Clinical and Translational Research, The Ohio State University College of Medicine, Columbus, Ohio, USA.
Semin Reprod Med. 2011 May;29(3):266-76. doi: 10.1055/s-0031-1275521. Epub 2011 Jul 18.
Epidemiological studies have suggested that metabolic programming is one of the critical factors contributing to the etiology of obesity as well as concurrent increase in related chronic diseases (e.g., type 2 diabetes and cardiovascular disease). Metabolic programming is the phenomenon whereby a nutritional stress/stimulus applied during critical periods of early development permanently alters an organism's physiology and metabolism, the consequences of which are often observed much later in life. The idea of metabolic programming originated from the fetal origins hypothesis proposed by Barker in which he suggested that disproportionate size at birth of the newborn due to an adverse intrauterine environment correlated well with an increased risk of adult-onset ill health outcomes (type 2 diabetes, hypertension, and cardiovascular disease). The fetal origins hypothesis, proposed by Barker, suggests that adequate nutrition during fetal development is critical. Overnutrition is a form of malnutrition that has increased in the United States over the past several decades in which nutrients are oversupplied relative to the amounts required for normal growth, development, and metabolism. Evidence for the effects of maternal obesity and overnutrition on metabolic programming is reviewed during critical prenatal, perinatal, and postnatal periods.
流行病学研究表明，代谢编程是导致肥胖以及相关慢性疾病（如 2 型糖尿病和心血管疾病）发生的关键因素之一。代谢编程是指在早期发育的关键时期施加的营养压力/刺激会永久改变生物体的生理和代谢，其后果通常在生命后期才会显现。代谢编程的概念源于 Barker 提出的胎儿起源假说，他认为由于宫内环境不良导致新生儿出生时不成比例的大小，与成年后出现健康问题（2 型糖尿病、高血压和心血管疾病）的风险增加密切相关。Barker 提出的胎儿起源假说表明，胎儿发育期间的充足营养至关重要。营养过剩是美国过去几十年中出现的一种营养不良形式，其中营养素的供应相对于正常生长、发育和代谢所需的量过多。本文综述了母体肥胖和营养过剩对关键产前、围产期和产后代谢编程的影响。
