Lewis Rohan M, Desoye Gernot
Faculty of Medicine, University of Southampton, Southampton, UK.
Ann Nutr Metab. 2017;70(3):228-231. doi: 10.1159/000463397. Epub 2017 Mar 17.
The increasing incidence of childhood obesity is a significant public health challenge, the consequences of which extend across the life course.
Diet and exercise are clearly the major contributors to childhood obesity, but the factors predisposing to obesity may become established in the womb. Worryingly maternal overnutrition, in particular when it leads to obesity and diabetes, perpetuate an intergenerational cycle of obesity through its effects on placental function and fetal metabolism. This review will address the ways in which the placental lipid and fatty acid transfer may lay the foundations for obesity in the context of maternal overnutrition. Key Messages: (1) Metabolic changes associated with maternal obesity affect placental nutrient handling. (2) Altered placental nutrient handling may induce pro-adipogenic changes in the fetus, in particular increased fetal insulin. (3) Understanding the effects of maternal obesity on the placenta will aid the development of effective interventions to optimise pregnancy outcomes.
儿童肥胖发病率不断上升是一项重大的公共卫生挑战,其后果会贯穿一生。
饮食和运动显然是儿童肥胖的主要成因,但导致肥胖的因素可能在子宫内就已形成。令人担忧的是,母亲营养过剩,尤其是当其导致肥胖和糖尿病时,会通过对胎盘功能和胎儿代谢的影响,使肥胖的代际循环持续下去。本综述将探讨在母亲营养过剩的情况下,胎盘脂质和脂肪酸转运可能为肥胖奠定基础的方式。关键信息:(1)与母亲肥胖相关的代谢变化会影响胎盘对营养物质的处理。(2)胎盘营养物质处理的改变可能会在胎儿体内诱发促脂肪生成的变化,尤其是胎儿胰岛素增加。(3)了解母亲肥胖对胎盘的影响将有助于开发有效的干预措施,以优化妊娠结局。