Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Diabetes Unit, King Edward Memorial Hospital Research Centre, Rasta Peth, Pune, 411011, India.
Diabetologia. 2019 Oct;62(10):1773-1778. doi: 10.1007/s00125-019-4930-1. Epub 2019 Aug 27.
The Developmental Origins of Health and Disease (DOHaD) paradigm posits that a mismatch between circumstances at or around conception and in later life leads to metabolic dysregulation and the development of obesity and diabetes. In this review we highlight three strands of evidence: prospective studies of patterns of growth from birth to adulthood, historical studies of exposure to famine at defined points during gestation and early life, and nutrition intervention studies. We conclude that, while much is still unknown, it is becoming clearer that the combination of early-life undernutrition and later development of obesity is associated with increased risk of diabetes. There is a need to support public health programmes aimed at intergenerational (primordial) prevention of diabetes and other non-communicable disease.
健康与疾病的发育起源（DOHaD）假说认为，受孕时或受孕前后的环境与生命后期的环境之间不匹配会导致代谢失调，并引发肥胖和糖尿病。在这篇综述中，我们强调了三个方面的证据：从出生到成年的生长模式的前瞻性研究、在妊娠和生命早期特定时间点暴露于饥荒的历史研究以及营养干预研究。我们的结论是，尽管仍有许多未知，但越来越清楚的是，生命早期营养不良与后来肥胖的结合与糖尿病风险的增加有关。需要支持旨在预防糖尿病和其他非传染性疾病的跨代（原始）的公共卫生计划。
