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Nguyen LT, Pollock CA, Saad S. Nutrition and Developmental Origins of Kidney Disease. Nutrients 2023; 15:4207. [PMID: 37836490 PMCID: PMC10574202 DOI: 10.3390/nu15194207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
The developmental programming hypothesis proposes that adverse environmental insults during critical developmental periods increase the risk of diseases later in life. The kidneys are deemed susceptible to such a process, although the exact mechanisms remain elusive. Many factors have been reported to contribute to the developmental origin of chronic kidney diseases (CKD), among which peri-gestational nutrition has a central role, affecting kidney development and metabolism. Physiologically, the link between malnutrition, reduced glomerular numbers, and increased blood pressure is key in the developmental programming of CKD. However, recent studies regarding oxidative stress, mitochondrial dysfunction, epigenetic modifications, and metabolic changes have revealed potential novel pathways for therapeutic intervention. This review will discuss the role of imbalanced nutrition in the development of CKD.
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Affiliation(s)
- Long T. Nguyen
- Renal Research Group, Kolling Institute, St. Leonards, NSW 2065, Australia; (C.A.P.); (S.S.)
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Al-Jorani H, Jensen RC, Jonasson MTE, Birukov A, Schmedes AV, Christesen HT, Dreyer AF, Jensen TK, Glintborg D, Jensen BL, Andersen MS. Higher Maternal Cortisol Associated With Lower Blood Pressure in Offspring From 3 Months to 5 Years of Age in the Odense Child Cohort. Hypertension 2023; 80:828-836. [PMID: 36802792 DOI: 10.1161/hypertensionaha.122.20265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Synthetic glucocorticoid exposure in late pregnancy may be associated with higher blood pressure in offspring. We hypothesized that endogenous cortisol in pregnancy relates to offspring blood pressure (OBP). OBJECTIVE To investigate associations between maternal cortisol status in third trimester pregnancy and OBP. METHODS We included 1317 mother-child pairs from Odense Child Cohort, an observational prospective cohort. Serum (s-) cortisol and 24-hour urine (u-) cortisol and cortisone were assessed in gestational week 28. Offspring systolic blood pressure and diastolic blood pressure were measured at age 3, 18 months, and 3 and 5 years. Associations between maternal cortisol and OBP were examined by mixed effects linear models. RESULTS All significant associations between maternal cortisol and OBP were negative. In boys in pooled analyses, 1 nmol/L increase in maternal s-cortisol was associated with average decrease in systolic blood pressure (β=-0.003 mmHg [95% CI, -0.005 to -0.0003]) and diastolic blood pressure (β=-0.002 mmHg [95% CI, -0.004 to -0.0004]) after adjusting for confounders. At 3 months of age, higher maternal s-cortisol was significantly associated with lower systolic blood pressure (β=-0.01 mmHg [95% CI, -0.01 to -0.004]) and diastolic blood pressure (β=-0.010 mmHg [95% CI, -0.012 to -0.011]) in boys after adjusting for confounders, which remained significant after adjusting for potential intermediate factors. CONCLUSIONS We found temporal sex dimorphic negative associations between maternal s-cortisol levels and OBP, with significant findings in boys. We conclude that physiological maternal cortisol is not a risk factor for higher blood pressure in offspring up to 5 years of age.
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Affiliation(s)
- Hajir Al-Jorani
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Richard Christian Jensen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.).,Department of Clinical Pharmacology, Pharmacy and Environmental Medicine (R.C.J., T.K.J.), University of Southern Denmark, Odense, Denmark
| | - Mikaela T E Jonasson
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Anna Birukov
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany (A.B.)
| | - Anne Vibeke Schmedes
- Department of Biochemistry and Immunology, Lillebaelt Hospital, Vejle, Denmark (A.V.S.)
| | - Henrik Thybo Christesen
- Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.T.C., T.K.J.)
| | - Anja F Dreyer
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Tina K Jensen
- Department of Clinical Pharmacology, Pharmacy and Environmental Medicine (R.C.J., T.K.J.), University of Southern Denmark, Odense, Denmark.,Odense Child Cohort, Hans Christian Andersen Children's Hospital, Odense University Hospital, Denmark (H.T.C., T.K.J.)
| | - Dorte Glintborg
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
| | - Boye L Jensen
- Institute for Molecular Medicine (B.L.J.), University of Southern Denmark, Odense, Denmark
| | - Marianne S Andersen
- Department of Endocrinology, Odense University Hospital, Odense, Denmark (H.A.-J., R.C.J., M.T.E.J., A.F.D., D.G., M.S.A.)
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Programming by maternal obesity: a pathway to poor cardiometabolic health in the offspring. Proc Nutr Soc 2022; 81:227-242. [DOI: 10.1017/s0029665122001914] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There is an ever increasing prevalence of maternal obesity worldwide such that in many populations over half of women enter pregnancy either overweight or obese. This review aims to summarise the impact of maternal obesity on offspring cardiometabolic outcomes. Maternal obesity is associated with increased risk of adverse maternal and pregnancy outcomes. However, beyond this exposure to maternal obesity during development also increases the risk of her offspring developing long-term adverse cardiometabolic outcomes throughout their adult life. Both human studies and those in experimental animal models have shown that maternal obesity can programme increased risk of offspring developing obesity and adipose tissue dysfunction; type 2 diabetes with peripheral insulin resistance and β-cell dysfunction; CVD with impaired cardiac structure and function and hypertension via impaired vascular and kidney function. As female offspring themselves are therefore likely to enter pregnancy with poor cardiometabolic health this can lead to an inter-generational cycle perpetuating the transmission of poor cardiometabolic health across generations. Maternal exercise interventions have the potential to mitigate some of the adverse effects of maternal obesity on offspring health, although further studies into long-term outcomes and how these translate to a clinical context are still required.
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