Maternal adipose tissue response to nicotine administration in the pregnant rat: effects on fetal body fat and cellularity

Long-term adverse influence of smoking during pregnancy on height and body size of offspring at ten years old in the UK Biobank cohort

Background

To explore the long-term relationship between maternal smoking during pregnancy and early childhood growth in the UK Biobank cohort.

Methods

To estimate the effect of maternal smoking during pregnancy on offspring height and body size at ten years old, we performed binary logistic analyses and reported odds ratios (OR) as well as 95% confidence intervals (95%CIs). We also implemented the cross-contextual comparison study to examine whether such influence could be repeatedly observed among three different ethnicities in the UK Biobank cohort (n = 22,140 for White, n = 7094 for South Asian, and n = 5000 for Black). In particular, we conducted the sibling cohort study in White sibling cohort (n = 9953 for height and n = 7239 for body size) to control for unmeasured familial confounders.

Results

We discovered that children whose mothers smoked during pregnancy had greater risk of being shorter or plumper at age ten in the full UK Biobank White cohort, with 15.3% (95% CIs: 13.0%∼17.7%) higher risk for height and 32.4% (95%CIs: 29.5%∼35.4%) larger risk for body size. Similar associations were identified in the South Asian and Black ethnicities. These associations were robust and remained significant in the White sibling cohort (12.6% [95%CIs: 5.0%∼20.3%] for height and 36.1% [95%CIs: 26.3%∼45.9%] for body size) after controlling for family factors.

Conclusion

This study robustly confirms that maternal smoking during pregnancy can promote height deficit and obesity for offspring at ten years old. Our findings strongly encourage mothers to quit smoking during pregnancy for improving growth and development of offspring.

Tobacco smoking and breastfeeding: Effect on the lactation process, breast milk composition and infant development. A critical review

Approximately 10% of women report smoking during pregnancy. The number of breastfeeding women who relapse back to smoking is even greater. Smoking may cause adverse changes to the milk's composition by not only reducing its protective properties, but also by affecting the infant's health. The pathophysiological mechanisms underlying these adverse effects are not entirely known. This article is a review of previous reports about the effects of smoking on the lactation process, breast milk composition and infant development. A systematic search for English language articles published until 2015 was made, using a MEDLINE data. The key search terms were "smoking and breastfeeding", "smoking and lactation", "smoking and milk composition", "nicotine and breast milk". Studies have shown that nicotine levels in breast milk of women who smoke are three times higher than those in the plasma levels. Breast milk volume is reduced and the duration of lactation period is shorter. Smoking causes adverse changes to the milk's composition by not only reducing its protective properties, but also affecting infants' response to breastfeeding and to breast milk.

Effects of prenatal and lactation nicotine exposure on glucose homeostasis, lipogenesis and lipid metabolic profiles in mothers and offspring

There is increasing evidence suggesting that maternal nicotine (NIC) exposure alone can lead to many deleterious consequences in the fetus. In this study, we aimed to evaluate the effects of prenatal and lactation NIC exposure on glucose homeostasis, lipogenesis and lipid metabolism in mothers and pups. After maternal NIC exposure (from gestational day 9 to weaning), NIC mothers showed lower body weight, decreased parametrial white adipose tissue (pWAT) and inguinal WAT weights, lower homeostasis model assessment of beta cell function, higher serum total cholesterol (TC) and low-density lipoprotein cholesterol levels, higher Castelli index values, lower hepatic mRNA levels of sterol regulatory element binding protein-1c (SREBP1c), lipoprotein lipase, acetyl-CoA carboxylase, fatty acid synthase (FAS) and glucose transporters 4 (GLUT4), as well as lower SREBP1c, FAS, leptin and GLUT4 mRNA levels in pWAT. However, female NIC pups presented higher body weights and serum TC levels, and increased trends for high density lipoprotein-cholesterol and Castelli index I. Male NIC pups had higher body weight, serum TC levels and Castelli index I values, and lower glycemia levels. Additionally, hepatic and adipose FAS gene expression from the female NIC pups presented a decreasing trend, while the male NIC pups had lower hepatic FAS expression and higher adipose FAS expression. In conclusion, prenatal and lactation NIC exposure induced deleterious effects on the glucose homeostasis, lipogenesis and lipid metabolism in both mothers and pups, which may promote several important metabolic disorders in the progeny. Additionally, there are gender-specific effects on pups.

Fetal and neonatal exposure to nicotine leads to augmented hepatic and circulating triglycerides in adult male offspring due to increased expression of fatty acid synthase

While nicotine replacement therapy is assumed to be a safer alternative to smoking during pregnancy, the long-term consequences for the offspring remain elusive. Animal studies now suggest that maternal nicotine exposure during perinatal life leads to a wide range of adverse outcomes for the offspring including increased adiposity. The focus of this study was to investigate if nicotine exposure during pregnancy and lactation leads to alterations in hepatic triglyceride synthesis. Female Wistar rats were randomly assigned to receive daily subcutaneous injections of saline (vehicle) or nicotine bitartrate (1mg/kg/day) for two weeks prior to mating until weaning. At postnatal day 180 (PND 180), nicotine exposed offspring exhibited significantly elevated levels of circulating and hepatic triglycerides in the male offspring. This was concomitant with increased expression of fatty acid synthase (FAS), the critical hepatic enzyme in de novo triglyceride synthesis. Given that FAS is regulated by the nuclear receptor Liver X receptor (LXRα), we measured LXRα expression in both control and nicotine-exposed offspring. Nicotine exposure during pregnancy and lactation led to an increase in hepatic LXRα protein expression and enriched binding to the putative LXRE element on the FAS promoter in PND 180 male offspring. This was also associated with significantly enhanced acetylation of histone H3 [K9,14] surrounding the FAS promoter, a hallmark of chromatin activation. Collectively, these findings suggest that nicotine exposure during pregnancy and lactation leads to an increase in circulating and hepatic triglycerides long-term via changes in the transcriptional and epigenetic regulation of the hepatic lipogenic pathway.

Nicotine-induced retardation of chondrogenesis through down-regulation of IGF-1 signaling pathway to inhibit matrix synthesis of growth plate chondrocytes in fetal rats

Previous studies have confirmed that maternal tobacco smoking causes intrauterine growth retardation (IUGR) and skeletal growth retardation. Among a multitude of chemicals associated with cigarette smoking, nicotine is one of the leading candidates for causing low birth weights. However, the possible mechanism of delayed chondrogenesis by prenatal nicotine exposure remains unclear. We investigated the effects of nicotine on fetal growth plate chondrocytes in vivo and in vitro. Rats were given 2.0 mg/kg·d of nicotine subcutaneously from gestational days 11 to 20. Prenatal nicotine exposure increased the levels of fetal blood corticosterone and resulted in fetal skeletal growth retardation. Moreover, nicotine exposure induced the inhibition of matrix synthesis and down-regulation of insulin-like growth factor 1 (IGF-1) signaling in fetal growth plates. The effects of nicotine on growth plates were studied in vitro by exposing fetal growth plate chondrocytes to 0, 1, 10, or 100 μM of nicotine for 10 days. Nicotine inhibited matrix synthesis and down-regulated IGF-1 signaling in chondrocytes in a concentration-dependent manner. These results suggest that prenatal nicotine exposure induces delayed chondrogenesis and that the mechanism may involve the down-regulation of IGF-1 signaling and the inhibition of matrix synthesis by growth plate chondrocytes. The present study aids in the characterization of delayed chondrogenesis caused by prenatal nicotine exposure, which might suggest a candidate mechanism for intrauterine origins of osteoporosis and osteoarthritis.

Evaluation of the association between maternal smoking, childhood obesity, and metabolic disorders: a national toxicology program workshop review

BACKGROUND

An emerging literature suggests that environmental chemicals may play a role in the development of childhood obesity and metabolic disorders, especially when exposure occurs early in life.

OBJECTIVE

Here we assess the association between these health outcomes and exposure to maternal smoking during pregnancy as part of a broader effort to develop a research agenda to better understand the role of environmental chemicals as potential risk factors for obesity and metabolic disorders.

METHODS

PubMed was searched up to 8 March 2012 for epidemiological and experimental animal studies related to maternal smoking or nicotine exposure during pregnancy and childhood obesity or metabolic disorders at any age. A total of 101 studies-83 in humans and 18 in animals-were identified as the primary literature.

DISCUSSION

Current epidemiological data support a positive association between maternal smoking and increased risk of obesity or overweight in offspring. The data strongly suggest a causal relation, although the possibility that the association is attributable to unmeasured residual confounding cannot be completely ruled out. This conclusion is supported by findings from laboratory animals exposed to nicotine during development. The existing literature on human exposures does not support an association between maternal smoking during pregnancy and type 1 diabetes in offspring. Too few human studies have assessed outcomes related to type 2 diabetes or metabolic syndrome to reach conclusions based on patterns of findings. There may be a number of mechanistic pathways important for the development of aberrant metabolic outcomes following perinatal exposure to cigarette smoke, which remain largely unexplored.

CONCLUSIONS

From a toxicological perspective, the linkages between maternal smoking during pregnancy and childhood overweight/obesity provide proof-of-concept of how early-life exposure to an environmental toxicant can be a risk factor for childhood obesity.

Obesity and endocrine dysfunction programmed by maternal smoking in pregnancy and lactation

Obesity is a global epidemic, and maternal smoking has been shown to be associated with the development of childhood obesity. Overall, approximately 40% of children worldwide are exposed to tobacco smoke at home. It is well known that environmental changes within a critical window of development, such as gestation or lactation, can initiate permanent alterations in metabolism that lead to diseases in adulthood, a phenomenon called programming. It is known that programming is based on epigenetic alterations (changes in DNA methylation, histone acetylation, or small interfering RNA expression) that change the expression pattern of several genes. However, little is known concerning the mechanisms by which smoke exposure in neonatal life programs the adipose tissue and endocrine function. Here, we review several epidemiological and experimental studies that confirm the association between maternal nicotine or tobacco exposure during gestation or lactation and the development of obesity and endocrine dysfunction. For example, a positive correlation was demonstrated in rodents between increased serum leptin in the neonatal period and exposure of the mothers to nicotine during lactation, and the further development of leptin and insulin resistance, and thyroid and adrenal dysfunction, in adulthood in the same offspring. Thus, a smoke-free environment during the lactation period is essential to improving health outcomes in adulthood and reducing the risk for future diseases. An understanding of the pathophysiological mechanisms underlying the effects of smoking on programming can provide new insights into therapeutic strategies for obesity.

Prenatal Exposure to Nicotine Causes Postnatal Obesity and Altered Perivascular Adipose Tissue Function

OBJECTIVE

Recent epidemiological studies have shown that there is an increased risk of obesity and hypertension in children born to women who smoked during pregnancy. The aim of this study was to examine the effect of fetal and neonatal exposure to nicotine, the major addictive component of cigarette smoke, on postnatal adiposity and blood vessel function.

RESEARCH METHODS AND PROCEDURES

Female Wistar rats were given nicotine or saline (vehicle) during pregnancy and lactation. Postnatal growth was determined in the male offspring from weaning until 26 weeks of age. At 26 weeks of age, fat pad weight and the function of the perivascular adipose tissue (PVAT) in the thoracic aorta and mesenteric arteries were examined.

RESULTS

Exposure to nicotine resulted in increased postnatal body weight and fat pad weight and an increased amount of PVAT in the offspring. Contraction of the aorta induced by phenylephrine was significantly attenuated in the presence of PVAT, whereas this effect was not observed in the aortic rings from the offspring of nicotine-exposed dams. Phenylephrine-induced contraction without PVAT was not different between saline- and nicotine-exposed rats. Transfer of solution incubated with PVAT-intact aorta to PVAT-free aorta induced a marked relaxation response in the rats from saline-exposed dams, but this relaxation response was significantly impaired in the rats from nicotine-exposed dams.

DISCUSSION

Our results showed that prenatal nicotine exposure increased adiposity and caused an alteration in the modulatory function of PVAT on vascular relaxation response, thus providing insight into the mechanisms underlying the increased prevalence of obesity and hypertension in children exposed to cigarette smoke in utero.

Role of environmental chemicals in diabetes and obesity: a National Toxicology Program workshop review

BACKGROUND

There has been increasing interest in the concept that exposures to environmental chemicals may be contributing factors to the epidemics of diabetes and obesity. On 11-13 January 2011, the National Institute of Environmental Health Sciences (NIEHS) Division of the National Toxicology Program (NTP) organized a workshop to evaluate the current state of the science on these topics of increasing public health concern.

OBJECTIVE

The main objective of the workshop was to develop recommendations for a research agenda after completing a critical analysis of the literature for humans and experimental animals exposed to certain environmental chemicals. The environmental exposures considered at the workshop were arsenic, persistent organic pollutants, maternal smoking/nicotine, organotins, phthalates, bisphenol A, and pesticides. High-throughput screening data from Toxicology in the 21st Century (Tox21) were also considered as a way to evaluate potential cellular pathways and generate -hypotheses for testing which and how certain chemicals might perturb biological processes related to diabetes and obesity.

CONCLUSIONS

Overall, the review of the existing literature identified linkages between several of the environmental exposures and type 2 diabetes. There was also support for the "developmental obesogen" hypothesis, which suggests that chemical exposures may increase the risk of obesity by altering the differentiation of adipocytes or the development of neural circuits that regulate feeding behavior. The effects may be most apparent when the developmental exposure is combined with consumption of a high-calorie, high-carbohydrate, or high-fat diet later in life. Research on environmental chemical exposures and type 1 diabetes was very limited. This lack of research was considered a critical data gap. In this workshop review, we outline the major themes that emerged from the workshop and discuss activities that NIEHS/NTP is undertaking to address research recommendations. This review also serves as an introduction to an upcoming series of articles that review the literature regarding specific exposures and outcomes in more detail.

Long-term consequences of fetal and neonatal nicotine exposure: a critical review

Cigarette smoking during pregnancy is associated with numerous obstetrical, fetal, and developmental complications, as well as an increased risk of adverse health consequences in the adult offspring. Nicotine replacement therapy (NRT) has been developed as a pharmacotherapy for smoking cessation and is considered to be a safer alternative for women to smoking during pregnancy. The safety of NRT use during pregnancy has been evaluated in a limited number of short-term human trials, but there is currently no information on the long-term effects of developmental nicotine exposure in humans. However, animal studies suggest that nicotine alone may be a key chemical responsible for many of the long-term effects associated with maternal cigarette smoking on the offspring, such as impaired fertility, type 2 diabetes, obesity, hypertension, neurobehavioral defects, and respiratory dysfunction. This review will examine the long-term effects of fetal and neonatal nicotine exposure on postnatal health.

Maternal smoking cessation in early pregnancy and offspring weight status at four years of age. A prospective birth cohort study

BACKGROUND

Maternal smoking during pregnancy is associated with fetal growth restriction, but also with increased risk for overweight in childhood. If the mother stops smoking in early pregnancy fetal growth is not restricted, but whether the risk for later overweight persists is unclear.

AIM

To study if four year old children of mothers who stopped smoking in early pregnancy have higher mean body mass index (BMI) and/or increased odds of being overweight compared with children of non-smokers.

STUDY DESIGN

Prospective population based study on Norwegian mothers and children.

SUBJECTS

Among 711 children available for analysis, 540 were children of never smoking mothers, 114 of mothers who stopped smoking in early pregnancy, and 57 of mothers who continued to smoke throughout pregnancy.

OUTCOME MEASURES

BMI and overweight defined by international criteria at age four.

RESULTS

Compared with children of never smoking mothers, children of smoking mothers had higher mean BMI (mean difference: 0.47; 95% CI: 0.10, 0.84 kg/m(2)), whereas mean BMI was not higher among children of mothers who stopped smoking (mean difference: 0.02; 95% CI: -0.24, 0.28 kg/m(2). Similarly, children of smoking mothers had increased odds for overweight (adjusted OR: 2.83; 95% CI: 1.13, 7.10), whereas children of mothers who stopped smoking did not have increased odds (adjusted OR: 1.29; 95% CI: 0.62, 2.68) compared with children of never smoking mothers.

CONCLUSIONS

In this study, the association between smoking exposure and childhood overweight did not persist in children of mothers who stopped smoking early in pregnancy.

Prenatal nicotine exposure alters early pancreatic islet and adipose tissue development with consequences on the control of body weight and glucose metabolism later in life

Despite medical advice, 20-30% of female smokers continue to smoke during pregnancy. Epidemiological studies have associated maternal smoking with increased risk of obesity and type-2 diabetes in the offspring. In the present study, we investigated the impact of prenatal nicotine exposure (3 mg/kg in Sprague Dawley rats via osmotic Alzet minipumps) on the early endocrine pancreas and adipose tissue development in rat pups before weaning. Body weight, fat deposition, food intake and food efficiency, cold tolerance, spontaneous physical activity, glucose utilization, and insulin sensitivity were also examined at adulthood. Prenatal nicotine exposure led to a decrease in endocrine pancreatic islet size and number at 7 d of life (postnatal d 7), which corroborates with a decrease in gene expression of specific transcription factors such as pancreatic and duodenal homeobox 1, Pax-6, Nkx6.1, and of hormones such as insulin and glucagon. The prenatal nicotine exposure also led to an increase in epididymal white adipose tissue weight at weaning (postnatal d 21), and marked hypertrophy of adipocytes, with increased gene expression of proadipogenic transcription factors such as CAAT-enhancer-binding protein-alpha, peroxisome proliferator activated receptor-gamma, and sterol regulatory element binding protein-1C. These early tissue alterations led to significant metabolic consequences, as shown by increased body weight and fat deposition, increased food efficiency on high-fat diet, cold intolerance, reduced physical activity, and glucose intolerance combined with insulin resistance observed at adulthood. These results prove a direct association between fetal nicotine exposure and offspring metabolic syndrome with early signs of dysregulations of adipose tissue and pancreatic development.

Maternal smoking during pregnancy and child overweight: systematic review and meta-analysis

OBJECTIVE

Perform a systematic review of studies reporting on the association between maternal prenatal cigarette smoking and child overweight.

DESIGN

Meta-analysis of observational studies.

DATA SOURCES

Medline search and review of reference lists among studies published through June 2006.

REVIEW METHODS

Included studies reported an association between maternal smoking during pregnancy and risk of overweight among children at least 2 years of age. We did not include in the meta-analysis studies that provided only a continuous measure of adiposity, although those studies are discussed separately.

RESULTS

Based on results of 84 563 children reported in 14 observational studies, children whose mothers smoked during pregnancy were at elevated risk for overweight (pooled adjusted odds ratio (OR) 1.50, 95% CI: 1.36, 1.65) at ages 3-33 years, compared with children whose mothers did not smoke during pregnancy. The pooled estimate from unadjusted odds ratios (OR 1.52, 95% CI: 1.36, 1.69) was similar to the adjusted estimate, suggesting that sociodemographic and behavioral differences between smokers and nonsmokers did not explain the observed association. Although we observed evidence for publication bias, simulating a symmetric set of studies yielded a similar estimate (OR 1.40, 95% CI: 1.26, 1.55).

CONCLUSIONS

Prenatal smoking exposure appears to increase rates of overweight in childhood. In parts of the world undergoing the epidemiologic transition, the continuing increase in smoking among young women could contribute to spiraling increases in rates of obesity-related health outcomes in the 21st century.

Fetal and neonatal exposure to nicotine in Wistar rats results in increased beta cell apoptosis at birth and postnatal endocrine and metabolic changes associated with type 2 diabetes

AIMS/HYPOTHESIS

Epidemiological studies report an increased risk of obesity and type 2 diabetes in children born to women who smoked during pregnancy. This study examines the effect of fetal and neonatal exposure to nicotine, the major addictive component of cigarettes, on postnatal growth, adiposity and glucose homeostasis.

METHODS

Female Wistar rats were given either saline (vehicle) or nicotine (1 mg kg(-1) day(-1)) during pregnancy and lactation. Serum and pancreas tissue were collected from the infant rats at birth. Postnatal growth was assessed weekly until the rats reached 26 weeks of age and glucose homeostasis was examined by OGTTs performed at 7 and 26 weeks of age.

RESULTS

Exposure to nicotine resulted in increased postnatal growth and adiposity. Nicotine exposure also resulted in dysglycaemia at 7 and 26 weeks of age. Serum insulin concentrations were decreased in the pups exposed to nicotine at birth. This was associated with increased beta cell apoptosis (pups of saline-treated mothers 8.8+/-1.21% apoptotic beta cells; pups of nicotine-treated mothers 27.8+/-3.1% apoptotic beta cells).

CONCLUSIONS/INTERPRETATION

Fetal and neonatal exposure to nicotine results in metabolic changes in the offspring that are consistent with obesity and type 2 diabetes. We propose that these metabolic changes may be a consequence of the initial insult to the beta cell during fetal life and that this animal model has many characteristics of diabetes in humans.

Postnatal effects of nicotine on incisor development of albino mouse

Young albino mice, 4-days-old, exposed to 0.1% nicotine sulfate on gestational days 6-20 were compared with untreated pups to determine nicotine's effects on the animals. Pregnant mice were given intraperitoneal injections of nicotine at a dose of 1.67 mg/kg/day. Data of pups weight, CRL, distance between the anterior and posterior limbs, maximum head height and width as well as head circumference were collected. The neonates were then decapitated, their entire mandibles were excised, routinely prepared, sectioned and stained with H and E for histologic examination of the developing incisors. All the parameters were significantly reduced in the treated group. Histologically, the processes of odontogenesis appeared retarded in nicotine treated animals, whereas the control group demonstrated normal dentin and enamel formation. Thus nicotine has a detrimental effect on the development of newborn offspring in general and incisor development in particular. This effect begins prenatally and extends postnatally.

Pre- and postnatal carbohydrate metabolism of rat lung tissue. The effect of maternal nicotine exposure

The effect of maternal nicotine exposure on fetal and neonatal lung metabolism was investigated. Nicotine (0.25 and 1.0 mg/kg body weight/day) administered subcutaneously to the mother animal from day 7 of gestation until weaning led to retarded glycogenolysis of fetal lung. This was due to an inhibition of lung glycogen phosphorylase. Exposure until 2 weeks after birth had no effect on the in vitro oxygen consumption of lung tissue, but the total glucose turnover of rat neonates exposed to 0.25 and 1.0 mg nicotine/kg body weight per day was increased to 78.96 +/- 3.92 and 121.09 +/- 7.36 mumol/g per h, respectively, as compared to controls (64.95 +/- 4.56 mumol/g per h). In contrast to the marked increase in total glucose turnover, the in vitro lactate production was significantly lowered, suggesting an inhibition of the glycolytic pathway. The lung lecithin content of control neonates (day 1 post-partum) was 1.94 +/- 0.30 mg/g wet tissue mass. Nicotine administration to the mother resulted in a 92% higher lung lecithin content (3.72 +/- 0.06 mg/g). The results suggest that although nicotine will have no effect on the incidence of respiratory distress syndrome due to a lack of lecithin, it may have a detrimental effect on the functional development of the lung as a result of its inhibitory effect on glucose oxidation via the glycolytic pathway.