超重和肥胖孕妇的血脂:对妊娠结局和子代身体组成的影响

Maternal lipids in overweight and obesity: implications for pregnancy outcomes and offspring's body composition.

作者信息

Albrecht Marie, Worthmann Anna, Heeren Jörg, Diemert Anke, Arck Petra Clara

机构信息

Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Junior Research Center for Reproduction: Sexual and Reproductive Health in Overweight and Obesity (SRHOO), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Semin Immunopathol. 2025 Jan 22;47(1):10. doi: 10.1007/s00281-024-01033-6.

Abstract

Overweight and obesity (OWO) are linked to dyslipidemia and low-grade chronic inflammation, which is fueled by lipotoxicity and oxidative stress. In the context of pregnancy, maternal OWO has long been known to negatively impact on pregnancy outcomes and maternal health, as well as to imprint a higher risk for diseases in offspring later in life. Emerging research suggests that individual lipid metabolites, which collectively form the lipidome, may play a causal role in the pathogenesis of OWO-related diseases. This can be applied to the onset of pregnancy complications such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), which in fact occur more frequently in women affected by OWO. In this review, we summarize current knowledge on maternal lipid metabolites in pregnancy and highlight associations between the maternal lipidome and the risk to develop GDM, HDP and childhood OWO. Emerging data underpin that dysregulations in maternal triglyceride, phospholipid and polyunsaturated fatty acid (PUFA) metabolism may play a role in modulating the risk for adverse pregnancy outcomes and childhood OWO, but it is yet premature to convert currently available insights into clinical guidelines. Well-designed large-scale lipidomic studies, combined with translational approaches including animal models of obesity, will likely facilitate the recognition of underling pathways of OWO-related pregnancy complications and child's health outcomes, based on which clinical guidelines and recommendations can be updated.

摘要

超重和肥胖(OWO)与血脂异常和低度慢性炎症相关,而脂毒性和氧化应激会加剧这种炎症。在妊娠背景下,长期以来人们都知道孕妇的超重和肥胖会对妊娠结局和孕产妇健康产生负面影响,还会使后代在日后生活中患疾病的风险增加。新出现的研究表明,共同构成脂质组的单个脂质代谢物可能在OWO相关疾病的发病机制中起因果作用。这一点可应用于妊娠并发症的发生,如妊娠期糖尿病(GDM)和妊娠高血压疾病(HDP),事实上,这些并发症在受OWO影响的女性中更频繁出现。在本综述中,我们总结了目前关于孕期母体脂质代谢物的知识,并强调了母体脂质组与患GDM、HDP以及儿童期OWO风险之间的关联。新出现的数据表明,母体甘油三酯、磷脂和多不饱和脂肪酸(PUFA)代谢失调可能在调节不良妊娠结局和儿童期OWO风险方面发挥作用,但将目前已有的见解转化为临床指南还为时过早。精心设计的大规模脂质组学研究,结合包括肥胖动物模型在内的转化方法,可能会有助于识别与OWO相关的妊娠并发症和儿童健康结局的潜在途径,在此基础上可更新临床指南和建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5052/11754334/a1463ab4865b/281_2024_1033_Fig1_HTML.jpg

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