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产前营养因素与神经发育障碍:一项叙述性综述

Prenatal Nutritional Factors and Neurodevelopmental Disorders: A Narrative Review.

作者信息

Cernigliaro Federica, Santangelo Andrea, Nardello Rosaria, Lo Cascio Salvatore, D'Agostino Sofia, Correnti Edvige, Marchese Francesca, Pitino Renata, Valdese Silvia, Rizzo Carmelo, Raieli Vincenzo, Santangelo Giuseppe

机构信息

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities "G. D'Alessandro", University of Palermo, 90127 Palermo, Italy.

Pediatrics Department, AOUP Santa Chiara Hospital, 56126 Pisa, Italy.

出版信息

Life (Basel). 2024 Aug 29;14(9):1084. doi: 10.3390/life14091084.

Abstract

According to the DSM-5, neurodevelopmental disorders represent a group of heterogeneous conditions, with onset during the developmental period, characterized by an alteration of communication and social skills, learning, adaptive behavior, executive functions, and psychomotor skills. These deficits determine an impairment of personal, social, scholastic, or occupational functioning. Neurodevelopmental disorders are characterized by an increased incidence and a multifactorial etiology, including genetic and environmental components. Data largely explain the role of genetic and environmental factors, also through epigenetic modifications such as DNA methylation and miRNA. Despite genetic factors, nutritional factors also play a significant role in the pathophysiology of these disorders, both in the prenatal and postnatal period, underscoring that the control of modifiable factors could decrease the incidence of neurodevelopmental disorders. The preventive role of nutrition is widely studied as regards many chronic diseases, such as diabetes, hypertension, and cancer, but actually we also know the effects of nutrition on embryonic brain development and the influence of prenatal and preconceptional nutrition in predisposition to various pathologies. These factors are not limited only to a correct caloric intake and a good BMI, but rather to an adequate and balanced intake of macro and micronutrients, the type of diet, and other elements such as exposure to heavy metals. This review represents an analysis of the literature as regards the physiopathological mechanisms by which food influences our state of health, especially in the age of development (from birth to adolescence), through prenatal and preconceptional changes, underlying how controlling these nutritional factors should improve mothers' nutritional state to significantly reduce the risk of neurodevelopmental disorders in offspring. We searched key words such as "maternal nutrition and neurodevelopmental disorders" on Pubmed and Google Scholar, selecting the main reviews and excluding individual cases. Therefore, nutrigenetics and nutrigenomics teach us the importance of personalized nutrition for good health. So future perspectives may include well-established reference values in order to determine the correct nutritional intake of mothers through food and integration.

摘要

根据《精神疾病诊断与统计手册》第五版(DSM - 5),神经发育障碍是一组异质性疾病,在发育期间起病,其特征为沟通和社交技能、学习、适应性行为、执行功能及精神运动技能的改变。这些缺陷会导致个人、社交、学业或职业功能受损。神经发育障碍的特点是发病率增加且病因多因素,包括遗传和环境因素。大量数据通过DNA甲基化和微小RNA等表观遗传修饰,很大程度上解释了遗传和环境因素的作用。尽管存在遗传因素,但营养因素在这些疾病的病理生理学中,无论在产前还是产后阶段都起着重要作用,这突出表明对可改变因素的控制可以降低神经发育障碍的发病率。营养的预防作用在许多慢性疾病如糖尿病、高血压和癌症方面得到了广泛研究,但实际上我们也了解营养对胚胎脑发育的影响以及产前和孕前营养对易患各种疾病的影响。这些因素不仅限于正确的热量摄入和良好的体重指数,还包括宏量和微量营养素的充足且均衡摄入、饮食类型以及其他因素,如接触重金属。本综述分析了有关食物影响我们健康状况的生理病理机制的文献,特别是在发育阶段(从出生到青春期),通过产前和孕前的变化,强调了控制这些营养因素应如何改善母亲的营养状况,以显著降低后代患神经发育障碍的风险。我们在PubMed和谷歌学术上搜索了“母亲营养与神经发育障碍”等关键词,选择了主要综述并排除了个别案例。因此,营养遗传学和营养基因组学让我们认识到个性化营养对健康的重要性。所以未来的展望可能包括确定完善的参考值,以便通过食物和补充剂来确定母亲正确的营养摄入量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e14d/11433086/34332f62b9ba/life-14-01084-g001.jpg

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