Institute of Developmental Sciences, University of Southampton, Southampton, UK.
Ann Nutr Metab. 2011;58 Suppl 2:8-15. doi: 10.1159/000328033. Epub 2011 Aug 12.
Non-communicable diseases (NCDs), such as cardiovascular disease and type 2 diabetes, constitute the main cause of death worldwide. Eighty percent of these deaths occur in low- and middle-income countries, especially as these countries undergo socio-economic improvement following reductions in the burden of infectious disease. The World Health Organization predicts a substantial increase in the incidence of NCDs over the next decade globally. NCDs are generally preventable, but current approaches are clearly inadequate. New initiatives are needed to implement such prevention, and there needs to be greater recognition that early-life interventions are likely to be the most efficacious. Devising appropriate prevention strategies necessitates an understanding of how the developmental environment influences risk. Progress in this field has been slow due to an excessive emphasis on fixed genomic variations (hard inheritance) as the major determinants of disease susceptibility. However, new evidence demonstrates the much greater importance of early-life developmental factors, involving epigenetic processes and 'soft' inheritance in modulating an individual's vulnerability to NCD. This also offers opportunities for novel epigenetic biomarkers of risk or interventions targeting epigenetic pathways to be devised for use in early life. This may pave the way to much more effective, customised interventions to promote health across the life course.
非传染性疾病（NCDs），如心血管疾病和 2 型糖尿病，构成了全球主要的死亡原因。这些死亡中有 80%发生在中低收入国家，特别是这些国家在传染病负担减轻后经历社会经济改善时。世界卫生组织预计，未来十年全球 NCD 的发病率将大幅上升。NCD 通常是可以预防的，但目前的方法显然不够。需要采取新的举措来实施这种预防措施，并且需要更加认识到，生命早期干预可能是最有效的。制定适当的预防策略需要了解发育环境如何影响风险。由于过分强调固定基因组变异（硬遗传）作为疾病易感性的主要决定因素，该领域的进展一直缓慢。然而，新的证据表明，生命早期发育因素，包括表观遗传过程和“软”遗传在调节个体对 NCD 的易感性方面更为重要。这也为设计用于生命早期的新型表观遗传风险生物标志物或针对表观遗传途径的干预措施提供了机会。这可能为促进整个生命过程的健康提供更有效、更定制化的干预措施铺平道路。
