Key Laboratory of Study and Discovery of Small Targeted Molecules of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China.
Institute of Nutritional Science, University of Potsdam, Nuthetal.
J Hypertens. 2019 Nov;37(11):2123-2134. doi: 10.1097/HJH.0000000000002156.
: Low birth weight (LBW) is associated with diseases in adulthood. The birthweight attributed risk is independent of confounding such as gestational age, sex of the newborn but also social factors. The birthweight attributed risk for diseases in later life holds for the whole spectrum of birthweight. This raises the question what pathophysiological principle is actually behind the association. In this review, we provide evidence that LBW is a surrogate of insulin resistance. Insulin resistance has been identified as a key factor leading to type 2 diabetes, cardiovascular disease as well as kidney diseases. We first provide evidence linking LBW to insulin resistance during intrauterine life. This might be caused by both genetic (genetic variations of genes controlling glucose homeostasis) and/or environmental factors (due to alterations of macronutrition and micronutrition of the mother during pregnancy, but also effects of paternal nutrition prior to conception) leading via epigenetic modifications to early life insulin resistance and alterations of intrauterine growth, as insulin is a growth factor in early life. LBW is rather a surrogate of insulin resistance in early life - either due to inborn genetic or environmental reasons - rather than a player on its own.
低出生体重（LBW）与成年期疾病有关。出生体重归因风险独立于混杂因素，如胎龄、新生儿性别，但也包括社会因素。出生体重归因于晚年疾病的风险适用于整个出生体重谱。这就提出了一个问题，即这种关联背后的病理生理原理实际上是什么。在这篇综述中，我们提供了证据表明 LBW 是胰岛素抵抗的替代物。胰岛素抵抗已被确定为导致 2 型糖尿病、心血管疾病和肾脏疾病的关键因素。我们首先提供了在宫内生活中将 LBW 与胰岛素抵抗联系起来的证据。这可能是由遗传因素（控制葡萄糖稳态的基因的遗传变异）和/或环境因素（由于母亲在怀孕期间宏量营养素和微量营养素的改变，以及受孕前父亲营养的影响）引起的，通过表观遗传修饰导致早期生活中的胰岛素抵抗和宫内生长的改变，因为胰岛素是生命早期的生长因子。LBW 更多的是早期生活中胰岛素抵抗的替代物 - 无论是由于先天遗传还是环境原因 - 而不是自身的参与者。
