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Nsanya MK, Abramson R, Kisigo GA, Hickner A, Nyanza EC, Peck RN, Kapiga SH. Hypertension among adolescents in sub-Saharan Africa: a systematic review. Front Cardiovasc Med 2023; 10:1251817. [PMID: 38155990 PMCID: PMC10754047 DOI: 10.3389/fcvm.2023.1251817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 10/18/2023] [Indexed: 12/30/2023] Open
Abstract
Introduction Hypertension (HTN) among adolescents is common in high-income countries, and leads to increased premature cardiovascular diseases (CVD). In sub-Saharan Africa (SSA), the prevalence of HTN among adolescents, associated risk factors and CVD complications are not well-described. Such data is needed for planning public health programs to prevent premature CVD in SSA. Methods We systematically searched 5 databases (MEDLINE, Embase, Google Scholar, Web of Science, and African Index Medicus) from their establishment to December 2021. Key search terms were: adolescent, arterial hypertension, and names of the 48 countries in SSA. We used Covidence® to manage the search results. The review was registered in the Open Science Framework (OSF) https://osf.io/p5sbt/. Results We identified 4,008 articles out of which we screened 3,088 abstracts, and reviewed 583 full-text articles. We finally included 92 articles that were published between 1968 to December 2021. The majority were cross-sectional studies (80%) and conducted in school settings (78%). The risk of bias was low for 59 studies (64.1%), moderate for 29 studies (31.5%), and high for 4 studies (4.3%). Overall, the prevalence of HTN varied widely from 0.18% to 34.0% with a median (IQR) of 5.5% (3.1%, 11.1%). It was relatively higher in studies using automated blood pressure (BP) devices, and in studies defining HTN using thresholds based on percentile BP distribution for one's height, age, and sex. In addition, the prevalence of HTN was significantly higher in studies from Southern Africa region of SSA and positively correlated with the year of publication. Across studies, traditional risk factors such as age, sex, body mass index, and physical inactivity, were commonly found to be associated with HTN. In contrast, non-traditional risk factors related to poverty and tropical diseases were rarely assessed. Only three studies investigated the CVD complications related to HTN in the study population. Conclusion The prevalence of HTN among adolescents in SSA is high indicating that this is a major health problem. Data on non-traditional risk factors and complications are scarce. Longitudinal studies are needed to clearly define the rates, causes, and complications of HTN. Systematic Review Registration https://osf.io/p5sbt/, identifier (10.17605/OSF.IO/P5SBT).
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Affiliation(s)
- Mussa K Nsanya
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
| | - Rachel Abramson
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Godfrey A Kisigo
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Andy Hickner
- Weill Cornell Medicine - Cornell University, New York, NY, United States
| | - Elias C Nyanza
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Robert N Peck
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Weill Cornell Medicine - Cornell University, New York, NY, United States
- Catholic University of Health and Allied Sciences, School of Public Health, Mwanza, Tanzania
| | - Saidi H Kapiga
- Mwanza Intervention Trials Unit/National Institute for Medical Research, Mwanza, Tanzania
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Grunnet LG, Bygbjerg IC, Mutabingwa TK, Lajeunesse-Trempe F, Nielsen J, Schmiegelow C, Vaag AA, Ramaiya K, Christensen DL. Influence of placental and peripheral malaria exposure in fetal life on cardiometabolic traits in adult offspring. BMJ Open Diabetes Res Care 2022; 10:e002639. [PMID: 35379692 PMCID: PMC8981354 DOI: 10.1136/bmjdrc-2021-002639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/13/2022] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Fetal malaria exposure may lead to intrauterine growth restriction and increase the risk of developing diabetes and cardiovascular diseases in adulthood. We investigated the extent to which fetal peripheral and placental malaria exposure impacts insulin sensitivity and secretion, body composition and cardiometabolic health 20 years after in utero malaria exposure. RESEARCH DESIGN AND METHODS We traced 101 men and women in Muheza district, Tanga region whose mothers participated in a malaria chemosuppression during a pregnancy study in 1989-1992. All potential participants were screened for malaria, hepatitis B and HIV to ascertain study eligibility. Seventy-six individuals (44 men, 32 women) were included in this cohort study. The participants underwent a thorough clinical examination including anthropometric measurements, ultrasound scanning for abdominal fat distribution, blood pressure, 75 g oral glucose tolerance test, an intravenous glucose tolerance test followed by a hyperinsulinemic euglycemic clamp and a submaximal exercise test. RESULTS Offspring exposed to placental malaria during pregnancy had significantly higher 30-minute plasma post-glucose load levels, but no significant difference in peripheral insulin resistance, insulin secretion or other cardiometabolic traits compared with non-exposed individuals. CONCLUSIONS Using the state-of-the-art euglycemic clamp technique, we were unable to prove our a priori primary hypothesis of peripheral insulin resistance in young adult offspring of pregnancies affected by malaria. However, the subtle elevations of plasma glucose might represent an early risk marker for later development of type 2 diabetes if combined with aging and a more obesogenic living environment.
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Affiliation(s)
- Louise G Grunnet
- Clinical Prevention Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Ib C Bygbjerg
- Global Health Section, University of Copenhagen, Copenhagen, Denmark
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Theonest K Mutabingwa
- Faculty of Medicine, Hubert Kairuki Memorial University, Dar es Salaam, United Republic of Tanzania
| | | | - Jannie Nielsen
- Global Health Section, University of Copenhagen, Copenhagen, Denmark
- Hubert Department of Gobal Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Christentze Schmiegelow
- Centre for Medical Parasitology, Department of Immunology and Microbiology, University of Copenhagen, Copenhagen, Denmark
| | - Allan A Vaag
- Clinical Prevention Research, Steno Diabetes Center Copenhagen, Gentofte, Denmark
| | - Kaushik Ramaiya
- Shree Hindu Mandal Hospital, Dar es Salaam, United Republic of Tanzania
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Abidha CA, Amoako YA, Nyamekye RK, Bedu-Addo G, Grziwotz F, Mockenhaupt FP, Telschow A, Danquah I. Fasting blood glucose in a Ghanaian adult is causally affected by malaria parasite load: a mechanistic case study using convergent cross mapping. Malar J 2022; 21:93. [PMID: 35303892 PMCID: PMC8932323 DOI: 10.1186/s12936-022-04076-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/06/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Adults with diabetes mellitus (DM) in malaria-endemic areas might be more susceptible to Plasmodium infection than healthy individuals. Herein, the study was aimed at verifying the hypothesis that increased fasting blood glucose (FBG) promotes parasite growth as reflected by increased parasite density. METHODS Seven adults without DM were recruited in rural Ghana to determine the relationships between FBG and malaria parasite load. Socio-economic data were recorded in questionnaire-based interviews. Over a period of 6 weeks, FBG and Plasmodium sp. Infection were measured in peripheral blood samples photometrically and by polymerase chain reaction (PCR)-assays, respectively. Daily physical activity and weather data were documented via smartphone recording. For the complex natural systems of homeostatic glucose control and Plasmodium sp. life cycle, empirical dynamic modelling was applied. RESULTS At baseline, four men and three women (median age, 33 years; interquartile range, 30-48) showed a median FBG of 5.5 (5.1-6.0 mmol/L); one participant had an asymptomatic Plasmodium sp. infection (parasite density: 240/µL). In this participant, convergent cross mapping (CCM) for 34 consecutive days, showed that FBG was causally affected by parasite density (p < 0.02), while the reciprocal relationship was not discernible (p > 0.05). Additionally, daily ambient temperature affected parasite density (p < 0.01). CONCLUSION In this study population living in a malaria-endemic area, time series analyses were successfully piloted for the relationships between FBG and Plasmodium sp. density. Longer observation periods and larger samples are required to confirm these findings and determine the direction of causality.
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Affiliation(s)
- Carol A Abidha
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany.
| | - Yaw Ampem Amoako
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | | | - George Bedu-Addo
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Florian Grziwotz
- Institute for Evolution and Biodiversity, Westfälische Wilhelms-Universität Münster, Münster, Germany
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Arndt Telschow
- Institute for Evolution and Biodiversity, Westfälische Wilhelms-Universität Münster, Münster, Germany
- Institute for Environmental Systems Research, Osnabrück University, Osnabrück, Germany
| | - Ina Danquah
- Faculty of Medicine and University Hospital, Heidelberg Institute of Global Health (HIGH), Heidelberg University, Heidelberg, Germany
- Department Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany
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Epidemiological links between malaria parasitaemia and hypertension: findings from a population-based survey in rural Côte d'Ivoire. J Hypertens 2020; 37:1384-1392. [PMID: 30801386 PMCID: PMC6587219 DOI: 10.1097/hjh.0000000000002071] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Background: Although potential links between malaria parasitaemia and hypertension have been hypothesized, there is paucity of epidemiologic evidence on this link. We investigated in a population-based survey, the association between malaria parasitaemia and hypertension in Ivorian adults. Methods: We estimated the adjusted odds ratios (OR) and 95% confidence intervals (CI) of hypertension in relation to malaria parasitaemia using multinomial regression, in 997 randomly selected adults in the ‘Côte d’Ivoire Dual Burden of Disease Study’ (CoDuBu), in south-central Côte d’Ivoire. We defined malaria parasitaemia as a positive rapid diagnostic test or identification of Plasmodium spp. on microscopy. Using the mean of the last two of three blood pressure (BP) measurements and questionnaire data, we defined hypertension as SBP at least 140 mmHg or DBP at least 90 mmHg or clinician-diagnosed hypertension. Results: Prevalence of malaria parasitaemia and hypertension were 10 and 22%, respectively. Malaria parasitaemia was negatively associated with hypertension in participants with body temperature 36.5 °C or less [OR 0.23 (95% CI 0.06–0.84)]. Contrastingly, microscopic malaria parasitaemia showed positive associations with hypertension in participants with elevated body temperature [>36.5 °C; OR: 2.93 (95% CI 0.94–9.14)]. Participants having microscopic malaria parasitaemia with elevated body temperature had three-fold higher odds of hypertension [OR: 3.37 (95% CI 1.12–10.0)] than malaria parasitaemia-negatives with lower body temperature. Conclusion: Malaria parasitaemia and hypertension are prevalent and seemingly linked comorbidities in African settings. This link may depend on malaria parasitaemia symptomaticity/latency where individuals with more latent/asymptomatic malaria parasitaemia have lower risk of hypertension and those with more acute/symptomatic malaria parasitaemia have a tendency toward higher BP. The cross-sectional nature of the study limited the distinction of short-term BP elevation (interim pathophysiological stress) from hypertension development. Future longitudinal studies considering malaria/hypertension phenotypes and host molecular variations are needed to clarify involved biological mechanisms, toward comorbidity management.
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Graßmann S, Pivovarova-Ramich O, Henze A, Raila J, Ampem Amoako Y, King Nyamekye R, Bedu-Addo G, Mockenhaupt FP, Schulze MB, Danquah I. SNP rs6564851 in the BCO1 Gene Is Associated with Varying Provitamin a Plasma Concentrations but Not with Retinol Concentrations among Adolescents from Rural Ghana. Nutrients 2020; 12:E1786. [PMID: 32560166 PMCID: PMC7353293 DOI: 10.3390/nu12061786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 11/16/2022] Open
Abstract
In sub-Saharan Africa, vitamin A deficiency constitutes a severe health problem despite various supplementation and food fortification programs. Given that the intake of preformed vitamin A from animal products remains low in these countries, an efficient metabolization of plant-based provitamin A carotenoids is essential. Previously, adolescents in rural Ghana have shown high total plasma carotenoid concentrations, while 36% had a vitamin A deficiency (defined as plasma retinol < 0.7 µmol/L). Hence, the aim of this cross-sectional study was to identify the relationships between variants in the β-carotene 15,15'-oxygenase (BCO1) gene and plasma carotenoid concentrations among 189 15-year-old girls and boys in rural Ghana. BCO1 rs6564851, rs7500996, rs10048138 and PKD1L2 rs6420424, and rs8044334 were typed, and carotenoid concentrations were compared among the different genotypes. G allele carriers of rs6564851 (53%) showed higher plasma carotenoid concentrations than T allele carriers (median (interquartile range): 3.07 (2.17-4.02) vs. 2.59 (2.21-3.50) µmol/L, p-value = 0.0424). This was not explained by differences in socio-demographic or dietary factors. In contrast, no differences in plasma retinol concentrations were observed between these genotypes. Pending verification in independent populations, the low conversion efficiency of provitamin A carotenoids among rs6564851 G allele carriers may undermine existing fortification and supplementation programs to improve the vitamin A status in sub-Saharan Africa.
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Affiliation(s)
- Sophie Graßmann
- Department Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), 14558 Nuthetal, Germany; (S.G.); (M.B.S.)
| | - Olga Pivovarova-Ramich
- Research Group Molecular Nutritional Medicine, Department of Molecular Toxicology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), 14558 Nuthetal, Germany;
- Department of Endocrinology, Diabetes and Nutrition, Charité—Universitaetsmedizin Berlin, 13125 Berlin, Germany
- German Center for Diabetes Research (DZD), 85764 Munich-Neuherberg, Germany
| | - Andrea Henze
- Junior Research Group ProAID, Institute of Nutritional Science, Potsdam University, 14558 Nuthetal, Germany;
| | - Jens Raila
- Physiology and Pathophysiology of Nutrition, Institute of Nutrition Science, Potsdam University, 14558 Nuthetal, Germany;
| | - Yaw Ampem Amoako
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology (KNUST), P.O. Box 1934 Kumasi, Ghana; (Y.A.A.); (G.B.-A.)
| | | | - George Bedu-Addo
- Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology (KNUST), P.O. Box 1934 Kumasi, Ghana; (Y.A.A.); (G.B.-A.)
| | - Frank P. Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité—Universitaetsmedizin Berlin, 13353 Berlin, Germany;
| | - Matthias B. Schulze
- Department Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), 14558 Nuthetal, Germany; (S.G.); (M.B.S.)
| | - Ina Danquah
- Department Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), 14558 Nuthetal, Germany; (S.G.); (M.B.S.)
- Heidelberg Institute of Global Health (HIGH), Universitaetsklinikum Heidelberg, 69120 Heidelberg, Germany
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Wells JCK. Developmental plasticity as adaptation: adjusting to the external environment under the imprint of maternal capital. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180122. [PMID: 30966888 DOI: 10.1098/rstb.2018.0122] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Plasticity is assumed to enable beneficial adjustment to the environment. In this context, developmental plasticity is generally approached within a two-stage framework, whereby adjustments to ecological cues in stage 1 are exposed to selection in stage 2. This conceptual approach may have limitations, because in species providing parental investment, particularly placental mammals such as humans, initial adjustments are not to the environment directly, but rather to the niche generated by parental phenotype (in mammals, primarily that of the mother). Only as maternal investment is withdrawn is the developing organism exposed directly to prevailing ecological conditions. A three-stage model may therefore be preferable, where developmental trajectory first adjusts to maternal investment, then to the external environment. Each offspring experiences a trade-off, benefitting from maternal investment during the most vulnerable stages of development, at the cost of exposure to investment strategies that maximize maternal fitness. Maternal life-history trade-offs impact the magnitude and schedule of her investment in her offspring, generating lifelong effects on traits related to health outcomes. Understanding the imprint of maternal capital on offspring is particularly important in species demonstrating social hierarchy. Interventions targeting maternal capital might offer new opportunities to improve health outcomes of both mother and offspring. This article is part of the theme issue 'Developing differences: early-life effects and evolutionary medicine'.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, UCL Great Ormond Street Institute of Child Health , 30 Guilford Street, London WC 1N 1EH , UK
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Eze IC, Essé C, Bassa FK, Koné S, Acka F, Schindler C, Imboden M, Laubhouet-Koffi V, Kouassi D, N'Goran EK, Utzinger J, Bonfoh B, Probst-Hensch N. Asymptomatic Plasmodium infection and glycemic control in adults: Results from a population-based survey in south-central Côte d'Ivoire. Diabetes Res Clin Pract 2019; 156:107845. [PMID: 31520711 DOI: 10.1016/j.diabres.2019.107845] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Revised: 08/14/2019] [Accepted: 09/06/2019] [Indexed: 02/03/2023]
Abstract
AIMS We investigated the cross-sectional associations of Plasmodium infection (PI) with fasting glucose (FG) and glycated hemoglobin (HbA1c) in malaria-endemic south-central Côte d'Ivoire. METHODS We studied 979 participants (non-pregnant; no treated diabetes; 51% males; 18-87 years) of the Côte d'Ivoire Dual Burden of Disease study. Fasting venous blood was obtained for PI, FG, and HbA1c assessment. We defined PI as a positive malaria rapid diagnostic test (RDT) or microscopic identification of Plasmodium species. We applied multivariable linear regressions to assess beta coefficients (β) and 95% confidence intervals (CIs) of PI positivity for FG and HbA1c independent of diabetes risk factors. RESULTS Prevalence of PI was 10.1% (5.5% microscopy; 9.7% RDT) without clinical fever. Prevalence of FG-based prediabetes (45.8%) and diabetes (3.6%) were considerably higher than HbA1c-based values (2.7% and 0.7%, respectively). PI was independently associated with FG among participants with higher body temperature (β 0.34, 95% CI 0.06-0.63, pheterogeneity = 0.028), or family history of diabetes (β 0.88, 95% CI 0.28-1.47, pheterogeneity = 0.009). Similar patterns observed with HbA1c were obliterated on accounting for FG. We also observed consistent associations with parasite density. CONCLUSIONS FG-based diabetes diagnosis in the presence of asymptomatic PI may misclassify or overestimate diabetes burden in malaria-endemic settings. Longitudinal studies are needed to confirm these findings and determine the risk for diabetes.
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Affiliation(s)
- Ikenna C Eze
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Clémence Essé
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Institut d'Ethnologie, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Fidèle K Bassa
- Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Siaka Koné
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Félix Acka
- Institut National de Santé Publique, Abidjan, Côte d'Ivoire
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Véronique Laubhouet-Koffi
- Ligue Ivoirienne contre l'Hypertension Artérielle et les Maladies Cardiovasculaires, Abidjan, Côte d'Ivoire
| | - Dinard Kouassi
- Institut National de Santé Publique, Abidjan, Côte d'Ivoire
| | - Eliézer K N'Goran
- Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire; Unité de Formation et de Recherche Biosciences, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Jürg Utzinger
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Bassirou Bonfoh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland; Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, Abidjan, Côte d'Ivoire
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
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Fernandez-Twinn DS, Hjort L, Novakovic B, Ozanne SE, Saffery R. Intrauterine programming of obesity and type 2 diabetes. Diabetologia 2019; 62:1789-1801. [PMID: 31451874 PMCID: PMC6731191 DOI: 10.1007/s00125-019-4951-9] [Citation(s) in RCA: 149] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/05/2019] [Indexed: 12/16/2022]
Abstract
The type 2 diabetes epidemic and one of its predisposing factors, obesity, are major influences on global health and economic burden. It is accepted that genetics and the current environment contribute to this epidemic; however, in the last two decades, both human and animal studies have consolidated considerable evidence supporting the 'developmental programming' of these conditions, specifically by the intrauterine environment. Here, we review the various in utero exposures that are linked to offspring obesity and diabetes in later life, including epidemiological insights gained from natural historical events, such as the Dutch Hunger Winter, the Chinese famine and the more recent Quebec Ice Storm. We also describe the effects of gestational exposure to endocrine disruptors, maternal infection and smoking to the fetus in relation to metabolic programming. Causal evidence from animal studies, motivated by human observations, is also discussed, as well as some of the proposed underlying molecular mechanisms for developmental programming of obesity and type 2 diabetes, including epigenetics (e.g. DNA methylation and histone modifications) and microRNA interactions. Finally, we examine the effects of non-pharmacological interventions, such as improving maternal dietary habits and/or increasing physical activity, on the offspring epigenome and metabolic outcomes.
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Affiliation(s)
- Denise S Fernandez-Twinn
- Metabolic Research Laboratories and MRC Metabolic Diseases Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Level 4, Box 289, Addenbrooke's Treatment Centre, Cambridge, CB2 0QQ, UK
| | - Line Hjort
- Department of Endocrinology, the Diabetes and Bone-metabolic Research Unit, Rigshospitalet, Copenhagen, Denmark
- Department of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark
| | - Boris Novakovic
- Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia
| | - Susan E Ozanne
- Metabolic Research Laboratories and MRC Metabolic Diseases Unit, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Addenbrooke's Hospital, Level 4, Box 289, Addenbrooke's Treatment Centre, Cambridge, CB2 0QQ, UK.
| | - Richard Saffery
- Murdoch Children's Research Institute, Royal Children's Hospital, Flemington Road, Parkville, VIC, 3052, Australia.
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Utomo DAM, Andriolo V, Bärnighausen T, Danquah I. Linking malaria in pregnancy with dietary behavior of the next generation. Brain Behav Immun 2019; 80:1-3. [PMID: 31181345 DOI: 10.1016/j.bbi.2019.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/06/2019] [Indexed: 10/26/2022] Open
Affiliation(s)
- Diah Ayu Mumpuni Utomo
- Institute of Tropical Medicine and International Health Berlin, Charité - Universitaetsmedizin Berlin, Berlin, Germany
| | - Violetta Andriolo
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany; Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA; Africa Health Research Institute (AHRI), Somkhele and Durban, South Africa
| | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DIfE), Nuthetal, Germany; Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
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