Fetal origins of adult disease?

Maternal dietary fatty acid composition and content prior to and during pregnancy and lactation influences serum profile, liver phenotype and hepatic miRNA expression in young male and female offspring

This study aimed to investigate whether modifying the pre-gestational lipid content could mitigate metabolic damage in offspring from dams exposed to a high-fat (HF) diet before conception and during pregnancy and lactation, with a focus on sex-specific outcomes. Specific effects of maternal normolipidic diets on offspring were also assessed. Female Wistar rats received control (C) or HF diets before conception. During pregnancy and lactation, females were distributed in five groups: C-C, HF-HF, HF-C, HF-saturated (HF-S) or HF-polyunsaturated n-3 group (HF-P). Saturated and PUFA n-3 diets were normolipidic. In 21-day-old offspring, corporal parameters, adiposity, serum metabolites, OGTT, liver phenotype, and miR-34a-5p hepatic expression were determined. Pre-gestational HF diet impaired glycemic response in females, independent of any change in body weight. Female and male offspring from dams continuously exposed to HF diet exhibited hyperglycemia, increased adiposity, and disrupted serum lipid profiles. Male offspring showed increased hepatic fat accumulation and miR-34a-5p expression. Shifting maternal dietary lipid content to normolipidic diets restored offspring's phenotype; however, decreased SIRT1, IRβ and IRS1 expression in offspring from dams exposed to HF diet before conception suggested early indicators of glucose metabolism damage. Our findings indicated a pronounced metabolic impact on males. In conclusion, glucose tolerance impairment in females before conception disturbed intrauterine environment, influencing in offspring's phenotype. Modifying maternal dietary lipid content mitigated effects of pre-gestational HF diet exposure on young offspring. Nevertheless, decreased hepatic levels of critical insulin signaling proteins indicated that independently of the maternal diet, pre-existing HF diet-induced glucose intolerance before conception may adversely program the offspring's phenotype.

Causal effects of time-varying body size on selected autoimmune disorders: a life course Mendelian randomisation study

BACKGROUND

Based on Barker's hypothesis, some studies investigated the associations between birth weight and several disorders. Apart from issues with statistical power and well-known shortcomings of the observational study design, there are no studies accounting for changes in weight-related body size over the life course regarding rheumatoid arthritis, psoriasis, psoriatic arthritis and multiple sclerosis.

METHODS

Using genetic information of up to 806 834 participants, this study investigated the associations between time-varying weight-related body size from birth to adulthood and the mentioned autoimmune diseases. Performing Mendelian randomisation (MR), the radial inverse-variance weighted approach was used iteratively in primary analyses. Robustness of the results was confirmed in several sensitivity analyses. Potential time-dependent mediation mechanisms were identified through network-clustering and assessed using multivariable MR.

RESULTS

Genetically predicted birth weight (fetal effect) was positively associated with rheumatoid arthritis (OR 1.44; 95% CI 1.17 to 1.77; Padj =0.005) but not with psoriasis, psoriatic arthritis or multiple sclerosis. This association was found to be mediated by body mass index (BMI) in adulthood (OR 1.45; 95% CI 1.14 to 1.84; Padj =0.019) rather than childhood. The direct effect of birth weight attenuated (OR 1.19; 95% CI 0.88 to 1.62); Padj =1) after adjustment for time-varying BMI.

CONCLUSION

Increased birth weight appears to be a risk factor for later manifestation of rheumatoid arthritis due to both fetal genetic components and high BMI persisting into adulthood. Approaches to prevent and minimise the risk of rheumatoid arthritis could include preventing obesity in adults with high birth weight.

Childhood Hyperlipidemia and its Association with Early Growth Among Full-Term-Born Children at 5 to 6 Years of Age in China

OBJECTIVE

This study's aim was to assess the prevalence of hyperlipidemia and its association with birth weight and BMI at 2 years of age and 5 to 6 years of age in full-term-born children.

METHODS

A population-based, large-scale survey of hyperlipidemia was conducted. Information on 12,701 children aged 5 to 6 years was retrospectively collected from electronic health care records.

RESULTS

The rate of high total cholesterol (≥5.18 mmol/L) and/or high triglycerides (≥1.70 mmol/L) was 10.2%. The multivariate-adjusted odds ratios of high total cholesterol and/or triglycerides were 1.33 (1.04-1.69), 1.00, and 0.95 (0.81-1.11) based on birth weight groups (small for gestational age [SGA], appropriate for gestational age, and large for gestational age); 1.06 (0.77-1.45), 1.00, and 0.99 (0.88-1.11) based on BMI groups at around 2 years of age (<10th, 10th to <75th, and ≥75th percentiles); and 1.56 (1.08-2.25), 1.00, and 1.71 (1.44-2.03) based on BMI groups at 5 to 6 years of age (<-2 SD, -2 SD to <2 SD and ≥2 SD), respectively. In the SGA group, hyperlipidemia was not associated with BMI at 2 years of age but was significantly associated with having underweight or obesity at 5 to <6 years of age.

CONCLUSIONS

SGA infants are at an increased risk for childhood hyperlipidemia, and catch-up growth before the age of 2 years would not affect this risk. For SGA infants, having underweight or obesity after 2 years of age can increase the risk of childhood hyperlipidemia.

Fluoride Exposure in Early Life as the Possible Root Cause of Disease In Later Life

Fluoride, one of the most celebrated ingredients for the prevention of dental caries in the 20th century, has also been controversial for its use in dentifrices and other applications. In the current review, we have concentrated primarily on early-life exposure to fluoride and how it may affect the various organs. The most recent controversial aspects of fluoride are related to toxicity of the developing brain and how it may possibly result in the decrease of intelligence quotient (IQ), autism, and calcification of the pineal gland. In addition, it has been reported to have possible effects on bone and thyroid glands. If nutritional stress is applied during a critical period of growth and development, the organ(s) and/or body will never recover once they pass through the critical period. For example, if animals are force-fed during experiments, they will simply get fat but never reach the normal size. Although early-life fluoride exposure causing fluorosis is well reported in the literature, the dental profession considers it primarily as an esthetic rather than a serious systemic problem. In the current review, we wanted to raise the possibility of future disease as a result of early-life exposure to fluoride. It is not currently known how fluoride will become a cause of future disease. Studies of other nutritional factors have shown that the effects of early nutritional stress are a cause of disease in later life.

Influence of maternal consumption of different types of fatty acids during pregnancy and lactation on lipid and glucose metabolism of the 21-day-old male offspring in rats

We evaluated the impacts of maternal consumption of different types of fatty acids during pregnancy and lactation on the lipid and glucose metabolism of 21-day-old offspring. Rats received either control (C), saturated (SFAs), trans (TFAs) or n - 3 polyunsaturated (PUFAs) normolipidic diets throughout pregnancy and lactation. 21-day old male pups constituted the groups: C21, S21, T21 and PUFA21. At 21st day, serum parameters, hepatic triacylglycerol (TAG) deposition, oral glucose tolerance test (OGTT) and liver protein expressions were investigated. We found a decrease in serum concentrations of TAG, total cholesterol and FFA as well as in hepatic TAG content and baseline glycaemia, accompanied by an increase in catalase expression in PUFA21 group. In T21 group, OGTT showed slight disturbance in glucose homeostasis. Summarily, while early exposure to TFAs-based diets seems to harm pups' glucose homeostasis, maternal consumption of n - 3 PUFAs can improve lipid metabolism, TAG hepatic accumulation and catalase protein expression in 21-day-old offspring.

Early exposure to distinct sources of lipids affects differently the development and hepatic inflammatory profiles of 21-day-old rat offspring

Introduction

Maternal diet composition of fatty acids during pregnancy and lactation seems to modify the fetal programming, epigenetic pattern and offspring phenotype.

Aim

Herein, we investigated the effects of maternal consumption of normal-fat diets with distinct lipid sources during pregnancy and lactation on the somatic development and proinflammatory status of 21-day-old rat offspring.

Materials and Methods

On the first day of pregnancy, female Wistar rats were divided into four groups as follows: soybean oil (M-SO), lard (M-L), hydrogenated vegetable fat (M-HVF) and fish oil (M-FO). Diets were maintained during pregnancy and lactation. Male offspring constituted the SO, L, HVF and FO groups. Pups were weighed and measured weekly. Lipopolysaccharide serum concentration was determined. Tumor necrosis factor alpha, interleukin (IL)-6 and IL-10 in the liver were evaluated by enzyme-linked immunosorbent assay. Liver gene expressions were determined by real-time polymerase chain reaction. Protein expressions in the liver were analyzed by Western blotting.

Results

We observed an increase in body weight and adiposity in L and HVF groups. Moreover, HVF group showed an increase in the toll-like receptor 4 mRNA levels, IL10Rα and phosphorylated form of IκB kinase (IKK; p-IKKα+β) protein expression. The FO group presented a decrease in body weight, relative weight of retroperitoneal adipose tissue, ADIPOR2 gene expression, lipopolysaccharide and p-IKKα+β and phosphorylated form of nuclear transcription factor kappa B (NFκB) p50 (p-NFκB p50) protein expression.

Conclusion

Summarily, whereas maternal intake of normal-fat diets based on L and HVF appear to affect the somatic development negatively, only early exposure to HVF impairs the pups’ proinflammatory status. In contrast, maternal diets based on FO during pregnancy and lactation have been more beneficial to the adiposity and toll-like receptor 4 signaling pathway of the 21-day-old rat offspring, particularly when compared to L or HVF diets.

Low-birth-weight, but not catch-up growth, correlates with insulin resistance and resistin level in SGA infants at 12 months

OBJECTIVE

To investigate the insulin resistance status in SGA infants at 12 months and its relationship with auxological and metabolic parameters.

METHODS

One group of 45 SGA and one of 50 appropriate for gestational age infants were followed from birth to the end of the first year of life. At 12 months, skinfold thickness, waist circumference, and blood levels of glucose, insulin, adiponectin, leptin, resistin, visfatin, retinol-binding protein 4, IGFs, lipids profile were determined, and the HOMA-IR index was calculated.

RESULTS

The SGAs had increased insulin (5.2 ± 2.7 versus 2.9 ± 2.4 μIU/ml, p = 0.012) and HOMA-IR (1.09 ± 0.9 versus 0.59 ± 0.55, p = 0.016). In multiple regression, insulin resistance indices were independently correlated with low-birth-weight (β = -2.92, p = 0.015 for insulin, β = -2.98, p = 0.011 for HOMA-IR) but not with catch-up growth in either height or weight or any other metabolic parameter. Resistin was higher in the SGAs (5.1 ± 2.1 versus 3.9 ± 2.1 ng/ml, p = 0.03) and independently correlated with low-birth-weight but not insulin resistance. Resistin was negatively correlated with total cholesterol (R = -0.33, p = 0.007) and positively with lipoprotein(a) (R = 0.49, p = 0.001).

CONCLUSION

Low-birth-weight, but not catch-up growth or adiposity tissue hormones, was correlated with insulin resistance at 12 months in non-obese SGA infants. The higher resistin in SGA infants and its correlation with total cholesterol and lipoprotein(a) need further clarification.

Maternal Supplementation with Oligofructose (10%) during Pregnancy and Lactation Leads to Increased Pro-Inflammatory Status of the 21-D-Old Offspring

Previously, we showed that oligofructose (10%) supplementation during pregnancy and lactation increased endotoxemia in 21-d-old pups. The present study evaluated the effect of 10% oligofructose diet supplementation during pregnancy and lactation in the presence or absence of hydrogenated vegetable fat on the pro-inflammatory status of 21-d-old offspring. On the first day of pregnancy, female Wistar rats were divided into the following groups: control diet (C), control diet supplemented with 10% oligofructose (CF), diet enriched with hydrogenated vegetable fat (T) or diet enriched with hydrogenated vegetable fat supplemented with 10% oligofructose (TF). Diets were maintained during pregnancy and lactation. Serum TNF-α (tumor necrosis factor alpha) was assessed using a specific kit. Protein expression was determined by Western Blotting, and the relative mRNA levels were analyzed by RT-PCR (real-time polymerase chain reaction). We observed that 10% oligofructose supplementation during pregnancy and lactation increased offspring’s IL-6R (interleukin-6 receptor) mRNA levels in the liver and RET (retroperitoneal white adipose tissue) and decreased ADIPOR2 (adiponectin receptor 2) and ADIPOR1 (adiponectin receptor 1) gene expression in liver and EDL (extensor digital longus)/ SOL (soleus) muscles of CF group. Additionally, TF group presented with increased serum TNF-α, protein expression of p-NFκBp65 (phosphorylated form of nuclear factor kappa B p65 subunit) in liver and IL-6R mRNA levels in RET. These findings were accompanied by decreased levels of ADIPOR1 mRNA in the EDL and SOL muscles of the TF group. In conclusion, supplementing the dam’s diet with 10% of oligofructose during pregnancy and lactation, independent of hydrogenated vegetable fat addition, contributes to the increased pro-inflammatory status of 21-d-old offspring, possibly through the activation of the TLR4 (toll like receptor 4) pathway.

Type of fatty acids in maternal diets during pregnancy and/or lactation and metabolic consequences of the offspring

During pregnancy and/or lactation, maternal nutrition is related to the adequate development of the fetus, newborn and future adult, likely by modifications in fetal programming and epigenetic regulation. Fetal programming is characterized by adaptive responses to specific environmental conditions during early life stages, which may alter gene expression and permanently affect the structure and function of several organs and tissues, thus influencing the susceptibility to metabolic disorders. Regarding lipid metabolism during the first two trimesters of pregnancy, the maternal body accumulates fat, whereas in late pregnancy, the lipolytic activity in the maternal adipose tissue is increased. However, an excess or deficiency of certain fatty acids may lead to adverse consequences to the fetuses and newborns. Fetal exposure to trans fatty acids appears to promote early deleterious effects in the offspring's health, thereby increasing the individual risk for developing metabolic diseases throughout life. Similarly, the maternal intake of saturated fatty acids seems to trigger alterations in the liver and adipose tissue function associated with insulin resistance and diabetes. The polyunsaturated fatty acids (PUFAs), particularly long-chain PUFAs (long-chain PUFA-arachidonic acid, eicosapentaenoic acid and docosahexaenoic acid), play an important and beneficial physiologic role in the offspring who receive this fatty acid during critical periods of development. Therefore, the maternal nutritional condition and fatty acid intake during pregnancy and/or lactation are critical factors that are strongly associated with normal fetal and postnatal development, which influence the modifications in fetal programming and in the individual risk for developing metabolic diseases throughout life.

Oligofructose supplementation during pregnancy and lactation impairs offspring development and alters the intestinal properties of 21-d-old pups

BACKGROUND

Previously, we showed that the intake of trans fatty acids during pregnancy and lactation triggers a pro-inflammatory status in the offspring. On the other hand, prebiotics can alter the intestinal environment, reducing serum lipopolysaccharides (LPS) concentrations. This study evaluated the effect of the oligofructose 10% diet supplementation in the presence or absence of hydrogenated vegetable fat during pregnancy and lactation on the development, endotoxemia and bacterial composition of 21-d-old offspring.

METHODS

On the first day of pregnancy rats were divided into four groups: control diet (C), control diet supplemented with 10% oligofructose (CF), diet enriched with hydrogenated vegetable fat, rich in TFA (T) or diet enriched with hydrogenated vegetable fat supplemented with 10% oligofructose (TF). Diets were maintained during pregnancy and lactation. At birth, 7th, 14th and 21th, pups were weighed and length was measured. Serum concentrations of LPS and free fatty acids (FFA) were performed by specific kits. Bacterial DNA present in faeces was determined by real-time PCR. Data were expressed as mean ± standard error of the mean and the statistical analysis was realized by ANOVA two-way and ANOVA for repeated measures. p < 0.05 was considered significant.

RESULTS

We observed that the oligofructose (10%) supplementation during pregnancy and lactation reduced body weight, body weight gain, length and serum FFA in the CF and TF group compared to C and T group respectively, of the 21-day-old offspring, accompanied by an increase in serum LPS and genomic DNA levels of lactobacillus spp. on faeces of the CF group in relation to C group.

CONCLUSION

In conclusion, dam's diet supplementation with 10% of oligofructose during pregnancy and lactation, independent of addition with hydrogenated vegetable fat, harms the offspring development, alters the bacterial composition and increases the serum concentrations of lipopolysaccharides in 21d-old pups.

Oligofructose supplementation (10%) during pregnancy and lactation does not change the inflammatory effect of concurrent trans fatty acid ingestion on 21-day-old offspring

Background

Previously, we demonstrated that trans fatty acid ingestion during pregnancy and lactation caused a pro-inflammatory effect on the newborn. The opposite effect was described for gestational prebiotic intake. In the present study, we examined whether supplementation of the diet of the dams with 10% of oligofructose with or without hydrogenated vegetable fat during pregnancy and lactation affected the pro-inflammatory status on the pups at age 21 days.

Methods

On the first day of pregnancy, rats were divided into four groups, each of which received one of four diets: a control diet (C group), a control diet supplemented with 10% oligofructose (CF group), a diet enriched with hydrogenated vegetable fat containing trans fatty acids (T group) or a diet enriched with hydrogenated vegetable fat containing trans fatty acids supplemented with 10% oligofructose (TF group). The pups were weighed at birth and at 7, 14 and 21 days of life and were euthanized on post-natal day 21. The serum glucose, insulin and adiponectin concentrations were analyzed. The IL-6, IL-10 and TNF-α contents of the retroperitoneal white adipose tissue, liver, soleus and extensor digital longus muscles were analyzed by ELISA. The results are presented as the means ± standard error of the mean. Statistical significance was assessed using two-way ANOVA, followed by Tukey's test and considered significant at p < 0.05

Results

The body weights of the 21-day old pups in the CF and TF groups were significant lower than those of the C (27% and 21%) and T (25% and 19%, respectively) groups. The serum levels of adiponectin in the CF, T and TF groups were lower than in the C group (41%; 34% and 31%, respectively). In the retroperitoneal adipose tissue, the IL-6 content was increased in TF group relative to the C and CF groups (74% for both), and the TNF-α content was higher in the T and TF groups than in the C group (62% and 98%, respectively). In the liver, the TNF-α (56% and 104%) and IL-10 (52% and 73%) contents were increased in the CF group relative to the C and TF groups.

Conclusions

Supplementation of the diet of the dams with 10% of oligofructose during pregnancy and lactation, independent of supplementation with hydrogenated vegetable fat, adversely affected the development of the offspring and contributed to development of a pro-inflammatory status in the pups on postnatal day 21.

Hydrogenated fat intake during pregnancy and lactation caused increase in TRAF-6 and reduced AdipoR1 in white adipose tissue, but not in muscle of 21 days old offspring rats

Background

Although lipids transfer through placenta is very limited, modification in dietary fatty acids can lead to implications in fetal and postnatal development. Trans fatty acid (TFA) intake during gestation and lactation have been reported to promote dyslipidemia and increase in pro- inflammatory adipokines in offspring. The aim of this study was to evaluate whether the alterations on pro-inflammatory cytokines and dyslipidemia observed previously in 21-d-old offspring of rats fed a diet containing hydrogenated vegetable fat during gestation and lactation were related to alterations in TLR-4, TRAF-6 and adipo-R1 receptor in white adipose tissue and muscle. On the first day of gestation, rats were randomly divided into two groups: (C) received a control diet, and (T) received a diet enriched with hydrogenated vegetable fat, rich in trans fatty acids. The diets were maintained throughout gestation and lactation. Each mother was given eight male pups. On the 21st day of life the offspring were killed. Blood, soleus and extensor digital longus (EDL) muscles, and retroperitoneal (RET) white adipose tissue were collected.

Results

21-d-old of T rats had higher serum triacylglycerols, cholesterol, and insulin. The Adipo R1 protein expression was lower in RET and higher in EDL of T group than C. TLR-4 protein content in all studied tissues were similar between groups, the same was verified in TRAF-6 protein expression in soleus and EDL. However, TRAF-6 protein expression in RET was higher in T than C.

Conclusion

These results demonstrated that maternal ingestion of hydrogenated vegetable fat rich in TFAs during gestation and lactation decrease in Adipo R1 protein expression and increase in TRAF-6 protein expression in retroperitoneal adipose tissue, but not in skeletal muscle, which could contributed for hyperinsulinemia and dyslipidemia observed in their 21-d-old offspring.

Prospects for epigenetic epidemiology

Epigenetic modification can mediate environmental influences on gene expression and can modulate the disease risk associated with genetic variation. Epigenetic analysis therefore holds substantial promise for identifying mechanisms through which genetic and environmental factors jointly contribute to disease risk. The spatial and temporal variance in epigenetic profile is of particular relevance for developmental epidemiology and the study of aging, including the variable age at onset for many common diseases. This review serves as a general introduction to the topic by describing epigenetic mechanisms, with a focus on DNA methylation; genetic and environmental factors that influence DNA methylation; epigenetic influences on development, aging, and disease; and current methodology for measuring epigenetic profile. Methodological considerations for epidemiologic studies that seek to include epigenetic analysis are also discussed.

Growth hormone treatment for short stature in children born small for gestational age

Children born small for gestational age (SGA) who do not show catch-up in the first 2 years generally remain short for life. Although the majority of children born SGA are not growth hormone (GH) deficient, GH treatment is known to improve average growth in these children.Early studies using GH in children born SGA demonstrated increased height velocity, but these effects tended to be short-term with effects decreasing when GH treatment stopped. With refined GH regimens, significant effects on height have been shown, with gains of approximately 1 standard deviation score after 2 years. Studies have also shown that long-term continuous GH therapy can significantly increase final height to within the normal range. GH treatment of children born SGA does not appear to unduly affect bone age or pubertal development. Growth prediction models have been used to identify various factors involved in the response to GH therapy with age at start, treatment duration, and GH dose showing strong effects. Genetic factors such as the exon 3 deletion of the GH receptor may contribute to short stature of children born SGA and may also be involved in the responsiveness to GH treatment, but there remain other unknown genetic and/or environmental factors. No unexpected safety concerns have arisen in GH therapy trials. In particular, no long-term adverse effects have been seen for glucose metabolism, and positive effects have been shown for lipid profiles and blood pressure.GH treatment in short children born SGA has shown a beneficial, growth-promoting effect in both the short-and long-term, and has become a recognized indication in both the US and Europe. Further studies on individualized treatment regimens and long-term safety are ongoing.

Is birthweight associated with risk of rheumatoid arthritis? Data from a large cohort study

OBJECTIVES

The "fetal origins of adult disease" hypothesis suggests the uterine environment can influence the susceptibility of a fetus to future disease. We examine whether the fetal environment, as reflected by birthweight, could modulate an individual's future risk of rheumatoid arthritis (RA).

METHODS

The relationship between birthweight and the risk of incident RA was studied in 87 077 women followed prospectively in the Nurses' Health Study cohort. New cases of RA diagnosed between 1976 and 2002 were confirmed in 619 women. The association between birthweight and the future development of RA was studied in age-adjusted and Cox proportional hazard models adjusting for age and potential confounders, including history of maternal diabetes, childhood socioeconomic status, prematurity, maternal and paternal smoking, as well as additionally adjusting for risk factors for RA including smoking, age at menarche, use of oral contraceptives, use of post-menopausal hormones, total lifetime breastfeeding, and body mass index (BMI) at age 18.

RESULTS

In an age-adjusted model, birthweight >4.54 kg vs birthweight 3.2-3.85 kg was associated with a two-fold increased risk of RA (relative risk (RR) = 2.1, 95% CI 1.4 to 3.3). Further adjusting for potential confounders and risk factors did not change this relationship (RR = 2.0, 95% CI 1.3 to 3.0). Findings were similar when we limited cases to those with rheumatoid factor positive RA (RR = 2.1, 95% CI = 1.2 to 3.6).

CONCLUSIONS

In this large prospective cohort, birthweight >4.54 kg was associated with a two-fold increased risk of adult onset RA, compared with those of average birthweight. Further study of this observation may provide insight into the pathogenesis of RA.

Hydrogenated fat diet intake during pregnancy and lactation modifies the PAI-1 gene expression in white adipose tissue of offspring in adult life

We examine whether feeding pregnant and lactating rats hydrogenated fats rich in trans fatty acids modifies the plasma lipid profiles and the expression of adipokines involved with insulin resistance and cardiovascular disease in their 90-day-old offspring. Pregnant and lactating Wistar rats were fed with either a control diet (C group) or one enriched with hydrogenated vegetable fat (T group). Upon weaning, the male pups were sorted into four groups: CC, mothers were receiving C and pups were kept on C; CT, mothers were receiving C and pups were fed with T; TT, mothers were receiving T and pups were kept on T; TC, mothers were receiving T and pups were fed with C. Pups' food intake and body weight were quantified weekly and the pups were killed at day 90 of life by decapitation. Blood and carcass as well as retroperitoneal, epididymal, and subcutaneous white adipose tissues were collected. Food intake and body weight were lower in TC and TT, and metabolic efficiency was reduced in TT. Offspring of TT and TC rats had increased white adipose tissue PAI-1 gene expression. Insulin receptor was higher in TT than other groups. Ingestion of hydrogenated vegetable fat by the mother during gestation and lactation could promote deleterious consequences, even after the withdrawal of the causal factor.

Hydrogenated fat intake during pregnancy and lactation modifies serum lipid profile and adipokine mRNA in 21-day-old rats

OBJECTIVE

We examined whether feeding pregnant and lactating rats hydrogenated fats rich in trans-fatty acids modifies the plasma lipid profiles and the expression of adipokines involved with insulin resistance and cardiovascular disease in their 21-d-old offspring.

METHODS

Pregnant and lactating Wistar rats were fed with a control diet (C group) or one enriched with hydrogenated vegetable fat (T group). After delivery, male offspring were weighed weekly and killed at day 21 of life by decapitation. Blood and retroperitoneal, epididymal, and subcutaneous white adipose tissues were collected.

RESULTS

Offspring of T-group rats had increased serum triacylglycerols and cholesterol, white adipose tissue plasminogen activator inhibitor-1, and tumor necrosis factor-alpha gene expression, and carcass lipid content and decreased blood leptin and adiponectin and adiponectin gene expression.

CONCLUSION

Ingestion of hydrogenated vegetable fat by the mother during gestation and lactation alters the blood lipid profiles and the expression of proinflammatory adipokynes by the adipose tissue of offspring aged 21 d.

Studies of twins: what can they tell us about the fetal origins of adult disease?

There has been much interest in evidence that people with lower birthweight have higher risk of adult cardiovascular disease, but the causal pathways underlying such observations are uncertain. Study of twins offers an opportunity to shed light on the underlying causal pathways, in particular by investigating the role of 'shared' factors vs. factors affecting each individual fetus. This involves comparing results of within-cohort vs. within-pair analyses. Twins share many factors during gestation but birthweight discordance (difference in birthweight within a twin pair) cannot be determined by these shared factors and must relate to factors affecting growth of each individual fetus. If associations seen in a cohort of twins remain in within-pair analyses, then factors specific to each individual must be involved in the underlying causal pathways. Conversely, if the relationships disappear or substantially diminish in within-pair analyses, then factors common to the pair must be involved. Comparison of findings in monozygotic vs. dizygotic twins may provide insights into the role of genetic factors, although issues related to chorionicity need to be taken into account. We tabulate published data and conclude that differences in methodology and analyses preclude informative meta-analysis, and that analysis of pooled data would provide more useful information.

The impact of birth weight on coronary heart disease morbidity and mortality in a birth cohort followed up for 85 years: a population-based study of men born in 1913

OBJECTIVES

To analyse whether there is a relationship between birth weight on the one hand and coronary heart disease (CHD) and cardiovascular disease (CVD) mortality and morbidity on the other, whether such a relationship is influenced by potential modifying factors from the time of birth, adult height and the presence of diabetes, and what significance these possible associations might have for the CHD and CVD rates in the general population.

DESIGN

Population-based birth cohort.

SETTING

Sweden.

SUBJECTS

A total of 1319 singleton men born in 1913, surviving until age 20 and from then on followed until 85 years of age.

MAIN OUTCOME MEASURES

CHD and CVD mortality and morbidity events.

RESULTS

The gestational age adjusted CHD and CVD mortality and morbidity hazard ratios were virtually unaffected by birth weight. Taking possible effect-modifying variables into account did not change the results. The population attributable risk percentage for CHD and CVD mortality and morbidity due to a birth weight <or=3000 g was 1% or less.

CONCLUSIONS

Birth weight did not significantly affect CHD or CVD mortality or morbidity. A birth weight <or=3000 g contributes little to the burden of CHD and CVD on a community level.

Birth weight and cardiovascular risk factors in a cohort followed until 80 years of age: the study of men born in 1913

OBJECTIVES

To analyse whether there is a relation-ship between birth weight and cardiovascular risk factors given the influence of potential modifying factors from birth time, former generations and adult life.

DESIGN

Population-based cohort followed until 80 years of age.

SETTING

Sweden.

SUBJECTS

A total of 478 singleton men born in 1913 and participating in a population study in Gothenburg, Sweden, from age 50.

MAIN OUTCOME MEASURES

Systolic blood pressure (SBP), antihypertensive treatment, incident diabetes mellitus, and serum total cholesterol, serum triglycerides and waist circumference as both continuous variables and in the highest quintiles of their distributions.

RESULTS

After adjustment for the influence of birth time variables, hereditary factors and anthropometric and socio-economic adult life variables, SBP decreased by 3.7 mmHg per 1000 g increase of birth weight, the prevalence of antihypertensive treatment decreased by 32%, diabetes decreased by 53%, serum total cholesterol decreased by 0.20 mmol L(-1) and being in the top quintile of serum cholesterol decreased by 23%. The population risk percentage due to a birth weight < or =3000 g was for all three outcomes 3.8% and for antihypertensive treatment, diabetes and cholesterol 0.2, 18 and 2.5%, respectively.

CONCLUSIONS

Low birth weight thus seems to affect the development of increasing SBP, antihypertensive treatment, diabetes and high cholesterol even when potential effect modifiers from birth time, former generations and adult life were taken into account. In the general population, the risk percentage due to a birth weight < or =3000 g was largest for diabetes.

Programming the cardiovascular system, kidney and the brain--a review

The concept that 'life before birth' or the 'first environment' is important in determining subsequent risk for the development of cardiovascular/metabolic disease is now gaining acceptance. There are substantial data from animal experiments that complement and enhance the epidemiological data from human studies. We argue that any factor which disrupts nephrogenesis, and lowers nephron number, during the period of active nephrogenesis, will induce malapadaptive changes in the future functioning of that kidney and predispose to the onset of adult hypertension. Such factors include exposure of the mother, to a particular low-protein diet, excess synthetic or natural glucocorticoid at certain critical periods, mild vitamin A deficiency, elevated blood glucose, unilateral nephrectomy during the period of nephrogenesis, as well as the deletion of one allele of a gene (GDNF) involved in normal metanephric development. All of these stresses are associated with a reduction (20-40 per cent) in total nephron number in the adult, and the development of hypertension. In some hypertensive models, (rats) there is evidence of alterations in the components of the hippocampal/hypothalamic/pituitary/adrenal axis, whereas in others (sheep) there are alterations in the expression of angiotensinogen (hypothalamus) and angiotensin II receptor type I (AT(1)) in the medulla oblongata. The surprising finding is that the period when the kidney and brain are most vulnerable is very early in development, when both organs are in an extremely primitive state of development.

Kidney development and the fetal programming of adult disease

Recent evidence, from both epidemiological and animal experimental studies, suggest that the very first environment, the intrauterine, is extremely important in determining the future health of the individual. Genetic and 'lifestyle' factors impinge on, and can exacerbate, a 'programming' effect of an adverse fetal environment. In this review, we present compelling evidence to suggest that one of the major organs affected by an unfavourable prenatal environment is the kidney. Many of the factors that can affect fetal renal development (i.e. exposure to excess glucocorticoids, insufficient vitamin A, protein/calorie malnutrition (in rats) and alterations in the intrarenal renin angiotensinogen system), also produce hypertension in the adult animal. When nephron number is compromised during kidney development, maladaptive functional changes occur and can lead, eventually, to hypertension and/or renal disease. Surprisingly, it is during the very earliest stages of kidney development that the vulnerability to these effects occurs.

Programming of the fetal suprachiasmatic nucleus and subsequent adult rhythmicity

The suprachiasmatic nucleus (SCN) is the site of the generation and entrainment of circadian rhythms. Similar to other structures, it develops throughout gestation but is still immature for some time after. This suggests that the SCN could be vulnerable to maternal influences, such as poor nutrition, stress and drugs, all of which can affect neuronal development. Evidence is accumulating that suggests that this is the case, with body size at birth influencing melatonin production in adult humans and maternal malnutrition, and stress affecting sleep in rodents. Interestingly, the maternal environment affects the phase of rhythms and the response of the circadian timing system to light pulses. The nature of these changes in adult rhythmicity is similar to those commonly associated with depression in humans. Thus, abnormal fetal programming might predispose adults to depressive illness.

Parental genotypes in the risk of a complex disease

Our understanding of the genetic etiology of complex disorders is still elusive. According to the common-variant/common-disease hypothesis, frequent functional polymorphisms are the best candidates for disease-susceptibility alleles. Implicitly, we also assume that disease-susceptibility alleles are preferentially transmitted from parents to the affected offspring and that this effect can be captured by the transmission/disequilibrium test (TDT). However, our study of genetic predisposition to childhood acute lymphoblastic leukemia suggests that a focus on the patient's genotype might, in certain instances, be misleading. Our results indicate that, at least at some loci, parental genetics might be of primary importance in predicting the risk of cancer in this pediatric model of a complex disease. Consequently, in addition to TDT, other complementary strategies will need to be simultaneously applied to dissect genetic predisposition to complex disorders.