营养学2013能量1.ppt

冠心病与低出生体重有关 Low birth weight, thinness and short body length at birth are now known to be associated with increased rates of cardiovascular disease and non-insulin dependent diabetes in adult life. The fetal origins hypothesis proposes that these diseases originate through adaptations which the fetus makes when it is undernourished. These adaptations may be cardio-vascular, metabolic or endocrine. They permanently change the structure and function of the body. D.J.P. Barker 早期营养对成年期健康的影响 1. 冠心病人同胞中死产和婴儿死亡率是正常人群2倍 高围产期死亡率地区冠心病死亡率明显增高 印 度 2. 大量调查结果显示全球不同种族中低体重出生与成年后血压升高有密切关系 3. 多项研究结果显示出生低体重人群中2型糖 尿病和葡萄糖耐量异常患者比例明显增加 4. 胎儿期生长受限的个体成人后血清总胆固、LDL-胆固醇、前脂蛋白B、纤维蛋白原等浓度增加 5. 动物实验发现，母鼠受到高浓度雄激素刺激，发生生殖生理学改变，包括 多囊卵巢和无排卵性不孕。下丘脑释放促性腺激素受发育早期雄激素浓度程序化控制. 中国协和医科大学报告: ? 2型糖尿病和糖耐量减低患病率随出生体重生体重指数（PI）和头围测量值的上升而下降； ? 出生消瘦伴有成年肥胖组患病率最高（43%） ? 出生脂肪较多伴有成年消瘦组患病率最低（8.3%） 上海地区报告： ? 低出生体重伴青春期超重者比正常出生体重者患高血压的风险增加4倍 ? 新生儿和婴儿的母乳喂养对成年后免患高血压有保护作用，尤其对收缩压的影响较大 肥胖、冠心病、中风、高血压、2型糖尿病、······与低出生体重有关 在发育阶段单一基因型可对环境变化产生一系列结构和功能上的适应。发育的可塑性是胎儿有可能更好的适应环境。 发育可塑性 成年慢性病胎儿根源的机理研究 真核细胞已经进化出一套复杂的营养状况传感器一方面可以保护其免受急性营养缺乏所引起的损害，另一方面可在某一/一些营养素长期过多或缺乏时产生适应性调节作用 Interactions between nutrients and gene expression in cells The feedback loops of the insulin axis involve a number of different tissues. These tissues learn to communicate with each other during the late fetal and early postnatal stages of development. Proposed mechanisms for fetal growth restriction in underfed and overfed dams. 发育期间胎儿对不良营养环境适应性代谢变化可导致其子代出现“节约表型” 代谢“程序”与子代出生后营养环境不匹配将会对其产生不利健康的影响 alterations in fetal nutrition and endocrine status may result in developmental adaptations that permanently change the structure, physiology, and metabolism of the offspring, thereby predisposing individuals to metabolic, endocrine, and cardiovascular diseases in adult life. Nutrition is the major intrauterine environmental factor that alters expression of the fetal genome and may have lifelong cons