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肥胖母亲对子代的血脂异常、胰岛素抵抗和胎盘代谢损伤。

Dyslipidemia, insulin resistance, and impairment of placental metabolism in the offspring of obese mothers.

机构信息

Knight Cardiovascular Institute, School of Medicine, Oregon Health & Science University, Portland, OR, USA.

Department of OB/GYN, Oregon Health & Science University, Portland, OR, USA.

出版信息

J Dev Orig Health Dis. 2021 Oct;12(5):738-747. doi: 10.1017/S2040174420001026. Epub 2020 Nov 13.

Abstract

Obesity is a chronic condition associated with dyslipidemia and insulin resistance. Here, we show that the offspring of obese mothers are dyslipidemic and insulin resistant from the outset.Maternal and cord blood and placental tissues were collected following C-section at term. Patients were grouped as being normal weight (NW, BMI = 18-24.9) or obese (OB, BMI ≥ 30), and separated by fetal sex. We measured plasma lipids, insulin, and glucose in maternal and cord blood. Insulin resistance was quantified using the HOMA-IR. Placental markers of lipid and energy metabolism and relevant metabolites were measured by western blot and metabolomics, respectively.For OB women, total cholesterol was decreased in both maternal and cord blood, while HDL was decreased only in cord blood, independent of sex. In babies born to OB women, cord blood insulin and insulin resistance were increased. Placental protein expression of the energy and lipid metabolism regulators PGC1α, and SIRT3, ERRα, CPT1α, and CPT2 decreased with maternal obesity in a sex-dependent manner (P < 0.05). Metabolomics showed lower levels of acylcarnitines C16:0, C18:2, and C20:4 in OB women's placentas, suggesting a decrease in β-oxidation. Glutamine, glutamate, alpha-ketoglutarate (αKG), and 2-hydroxyglutarate (2-HG) were increased, and the glutamine-to-glutamate ratio decreased (P < 0.05), in OB placentas, suggesting induction of glutamate into αKG conversion to maintain a normal metabolic flux.Newly-born offspring of obese mothers begin their lives dyslipidemic and insulin resistant. If not inherited genetically, such major metabolic perturbations might be explained by abnormal placental metabolism with potential long-term adverse consequences for the offspring's health and wellbeing.

摘要

肥胖是一种与血脂异常和胰岛素抵抗相关的慢性疾病。在这里,我们表明肥胖母亲的后代从一开始就存在血脂异常和胰岛素抵抗。

在足月剖宫产时收集产妇和脐带血以及胎盘组织。根据 BMI 将患者分为正常体重组(NW,BMI=18-24.9)和肥胖组(OB,BMI≥30),并按胎儿性别进行分组。我们测量了产妇和脐带血中的血浆脂质、胰岛素和血糖。使用 HOMA-IR 量化胰岛素抵抗。通过 Western blot 和代谢组学分别测量胎盘脂质和能量代谢标志物以及相关代谢物。

对于 OB 女性,无论是产妇还是脐带血中的总胆固醇均降低,而高密度脂蛋白仅在脐带血中降低,与性别无关。在 OB 女性所生的婴儿中,脐带血中的胰岛素和胰岛素抵抗增加。与母体肥胖相关的能量和脂质代谢调节剂 PGC1α、SIRT3、ERRα、CPT1α 和 CPT2 的胎盘蛋白表达在胎儿性别依赖性方面降低(P<0.05)。代谢组学显示 OB 女性的胎盘中的酰基辅酶 A C16:0、C18:2 和 C20:4 水平降低,表明β氧化减少。谷氨酸、α-酮戊二酸(αKG)和 2-羟基戊二酸(2-HG)增加,而 OB 胎盘中的谷氨酰胺-谷氨酸比率降低(P<0.05),表明谷氨酸进入αKG 转化以维持正常代谢通量。

肥胖母亲的新生儿从出生开始就存在血脂异常和胰岛素抵抗。如果不是遗传的,这种主要的代谢紊乱可能是由于胎盘代谢异常引起的,这可能对后代的健康和福祉产生长期的不利影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f72/8606174/c234684c9005/nihms-1639548-f0001.jpg

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