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Harvey N, Dennison E, Cooper C. Osteoporosis: a lifecourse approach. J Bone Miner Res 2014; 29:1917-25. [PMID: 24861883 DOI: 10.1002/jbmr.2286] [Citation(s) in RCA: 105] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Revised: 04/25/2014] [Accepted: 05/16/2014] [Indexed: 01/20/2023]
Abstract
It is becoming increasingly apparent that the risk of developing osteoporosis is accrued throughout the entire lifecourse, even from as early as conception. Thus early growth is associated with bone mass at peak and in older age, and risk of hip fracture. Novel findings from mother-offspring cohorts have yielded greater understanding of relationships between patterns of intrauterine and postnatal growth in the context of later bone development. Study of biological samples from these populations has helped characterize potential mechanistic underpinnings, such as epigenetic processes. Global policy has recognized the importance of early growth and nutrition to the risk of developing adult chronic noncommunicable diseases such as osteoporosis; testing of pregnancy interventions aimed at optimizing offspring bone health is now underway. It is hoped that through such programs, novel public health strategies may be established with the ultimate goal of reducing the burden of osteoporotic fracture in older age.
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Affiliation(s)
- Nicholas Harvey
- Medical Research Council (MRC) Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK; National Institute for Health Research (NIHR) Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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2
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Ahlqvist E, Osmark P, Kuulasmaa T, Pilgaard K, Omar B, Brøns C, Kotova O, Zetterqvist AV, Stančáková A, Jonsson A, Hansson O, Kuusisto J, Kieffer TJ, Tuomi T, Isomaa B, Madsbad S, Gomez MF, Poulsen P, Laakso M, Degerman E, Pihlajamäki J, Wierup N, Vaag A, Groop L, Lyssenko V. Link between GIP and osteopontin in adipose tissue and insulin resistance. Diabetes 2013; 62:2088-94. [PMID: 23349498 PMCID: PMC3661641 DOI: 10.2337/db12-0976] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Low-grade inflammation in obesity is associated with accumulation of the macrophage-derived cytokine osteopontin (OPN) in adipose tissue and induction of local as well as systemic insulin resistance. Since glucose-dependent insulinotropic polypeptide (GIP) is a strong stimulator of adipogenesis and may play a role in the development of obesity, we explored whether GIP directly would stimulate OPN expression in adipose tissue and thereby induce insulin resistance. GIP stimulated OPN protein expression in a dose-dependent fashion in rat primary adipocytes. The level of OPN mRNA was higher in adipose tissue of obese individuals (0.13 ± 0.04 vs. 0.04 ± 0.01, P < 0.05) and correlated inversely with measures of insulin sensitivity (r = -0.24, P = 0.001). A common variant of the GIP receptor (GIPR) (rs10423928) gene was associated with a lower amount of the exon 9-containing isoform required for transmembrane activity. Carriers of the A allele with a reduced receptor function showed lower adipose tissue OPN mRNA levels and better insulin sensitivity. Together, these data suggest a role for GIP not only as an incretin hormone but also as a trigger of inflammation and insulin resistance in adipose tissue. Carriers of the GIPR rs10423928 A allele showed protective properties via reduced GIP effects. Identification of this unprecedented link between GIP and OPN in adipose tissue might open new avenues for therapeutic interventions.
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Affiliation(s)
- Emma Ahlqvist
- Department of Clinical Sciences, Diabetes, and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Peter Osmark
- Department of Clinical Sciences, Diabetes, and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Tiina Kuulasmaa
- Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | | | - Bilal Omar
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | | | - Olga Kotova
- Vascular ET-Coupling, Department of Clinical Sciences, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Anna V. Zetterqvist
- Vascular ET-Coupling, Department of Clinical Sciences, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Alena Stančáková
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Anna Jonsson
- Department of Clinical Sciences, Diabetes, and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Ola Hansson
- Department of Clinical Sciences, Diabetes, and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
| | - Johanna Kuusisto
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Timothy J. Kieffer
- Laboratory of Molecular and Cellular Medicine, Department of Cellular and Physiological Sciences, Life Sciences Institute, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tiinamaija Tuomi
- Folkhalsan Research Centre, Helsinki, Finland
- Department of Medicine, Helsinki University Central Hospital, and Research Program of Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Bo Isomaa
- Folkhalsan Research Centre, Helsinki, Finland
- Department of Social Services and Health Care, Jakobstad, Finland
| | - Sten Madsbad
- Department of Endocrinology, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Maria F. Gomez
- Vascular ET-Coupling, Department of Clinical Sciences, University Hospital Malmö, Lund University, Malmö, Sweden
| | | | - Markku Laakso
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Eva Degerman
- Department of Experimental Medical Sciences, Lund University, Lund, Sweden
| | - Jussi Pihlajamäki
- Department of Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Department of Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Nils Wierup
- Unit of Neuroendocrine Cell Biology, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Allan Vaag
- Steno Diabetes Center, Gentofte, Denmark
- Department of Endocrinology, Rigshospitalet and Copenhagen University, Copenhagen, Denmark
| | - Leif Groop
- Department of Clinical Sciences, Diabetes, and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
- Finnish Institute of Molecular Medicine, Helsinki University, Helsinki, Finland
| | - Valeriya Lyssenko
- Department of Clinical Sciences, Diabetes, and Endocrinology, University Hospital Malmö, Lund University, Malmö, Sweden
- Corresponding author: Valeriya Lyssenko,
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Friedrichsen M, Poulsen P, Wojtaszewski J, Hansen PR, Vaag A, Rasmussen HB. Carboxylesterase 1 gene duplication and mRNA expression in adipose tissue are linked to obesity and metabolic function. PLoS One 2013; 8:e56861. [PMID: 23468884 PMCID: PMC3585247 DOI: 10.1371/journal.pone.0056861] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 01/14/2013] [Indexed: 11/19/2022] Open
Abstract
CONTEXT AND AIMS Carboxylesterase 1 (CES1) appears to play an important role in the control of the metabolism of triglycerides and cholesterol in adipocytes and other cell types including hepatocytes. Therefore, it is relevant to gain insights into the genetic versus non-genetic mechanisms involved in the control of CES1 mRNA expression. Here, we investigated CES1 mRNA expression level in adipose tissue and its association with measures of adiposity and metabolic function in a population of elderly twins. Furthermore, the heritability of CES1 mRNA expression level in adipose tissue and the effect of CES1 gene duplication were assessed. METHODOLOGY A total of 295 monozygotic and dizygotic twin subjects (62-83 years) with (n = 48) or without (n = 247) type 2 diabetes mellitus were enrolled in the study. They were subjected to a standard oral glucose tolerance test and excision of abdominal subcutaneous fat biopsies during the fasting state. Levels of CES1 mRNA and copy number of the gene were assessed by quantitative PCR. RESULTS CES1 mRNA expression level in adipose tissue was positively associated with body-mass index (P<0.001), homeostasis model assessment-insulin resistance (P = 0.003) and level of fasting glucose (P = 0.002), insulin (P = 0.006), and triglycerides (P = 0.003). The heritability for the expression of CES1 mRNA in adipose tissue was high. CES1 gene duplication was positively associated with insulin sensitivity (P = 0.05) as well as glucose tolerance (P = 0.03) and negatively associated with homeostasis model assessment-insulin resistance (P = 0.02). Duplication of CES1 was not linked to mRNA level of this gene (P = 0.63). CONCLUSION CES1 mRNA in adipose tissue appears to be under strong genetic control and was associated with measures of metabolic function raising the possibility of a potential role of this enzyme in the development of type 2 diabetes mellitus. Further studies are needed to understand the potential effect of CES1 gene duplication on adipocyte and whole-body metabolic functions.
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Affiliation(s)
- Martin Friedrichsen
- Department of Diabetes and Metabolism, Rigshospitalet, Copenhagen, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | | | - Jørgen Wojtaszewski
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Peter Riis Hansen
- Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, Denmark
| | - Allan Vaag
- Department of Diabetes and Metabolism, Rigshospitalet, Copenhagen, Denmark
| | - Henrik Berg Rasmussen
- Research Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University Hospital, Roskilde, Denmark
- * E-mail:
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Frost M, Petersen I, Brixen K, Beck-Nielsen H, Holst JJ, Christiansen L, Højlund K, Christensen K. Adult glucose metabolism in extremely birthweight-discordant monozygotic twins. Diabetologia 2012; 55:3204-12. [PMID: 22955993 DOI: 10.1007/s00125-012-2695-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Accepted: 06/21/2012] [Indexed: 01/20/2023]
Abstract
AIMS/HYPOTHESIS Low birthweight (BW) is associated with increased risk of type 2 diabetes. We compared glucose metabolism in adult BW-discordant monozygotic (MZ) twins, thereby controlling for genetic factors and rearing environment. METHODS Among 77,885 twins in the Danish Twin Registry, 155 of the most BW-discordant MZ twin pairs (median BW difference 0.5 kg) were assessed using a 2 h oral glucose tolerance test with sampling of plasma (p-)glucose, insulin, C-peptide, glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1. HOMA for beta cell function (HOMA-β) and insulin resistance (HOMA-IR), and also insulin sensitivity index (BIGTT-SI) and acute insulin response (BIGTT-AIR), were calculated. Subgroup analyses were performed in those with: (1) double verification of BW difference; (2) difference in BW >0.5 kg; and (3) no overt metabolic disease (type 2 diabetes, hyperlipidaemia or thyroid disease). RESULTS No intra-pair differences in p-glucose, insulin, C-peptide, incretin hormones, HOMA-β, HOMA-IR or BIGTT-SI were identified. p-Glucose at 120 min was higher in the twins with the highest BW without metabolic disease, and BIGTT-AIR was higher in those with the highest BW although not in pairs with a BW difference of >0.5 kg. CONCLUSIONS/INTERPRETATION BW-discordant MZ twins provide no evidence for a detrimental effect of low BW on glucose metabolism in adulthood once genetic factors and rearing environment are controlled for.
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Affiliation(s)
- M Frost
- The Danish Twin Registry, Department of Epidemiology, University of Southern Denmark, JB Winsløvsvej 9, Odense C, Denmark.
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Phillips DI, Davies MJ, Robinson JS. Fetal Growth and the Fetal Origins Hypothesis in Twins — Problems and Perspectives. ACTA ACUST UNITED AC 2012. [DOI: 10.1375/twin.4.5.327] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractAlthough there is substantial evidence from studies of singletons that small size at birth is linked with long-term adverse health effects, until recently little was known as to whether these associations extend to twins. A review of published studies suggests that at present there is little consistent evidence that birthsize in twins is associated with increased morbidity or morality. While, these findings may reflect methodological limitations, it is also argued that they arise as a consequence of the substantially different biology of fetal growth in twins.
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Leon DA. The Foetal Origins of Adult Disease: Interpreting the Evidence From Twin Studies. ACTA ACUST UNITED AC 2012. [DOI: 10.1375/twin.4.5.321] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractTwin studies have a contribution to make to the debate concerning the foetal origins of adult disease. Twins are growth retarded compared to singletons and experience post-natal catch-up growth. However, there is no evidence that twins are at increased risk of cardiovascular disease. Studying whether discordance in size at birth within monozygotic twin pairs is predictive of discordance in later life disease should help resolve whether the association between size at birth and later disease is due to common genetic factors. Results from studies of blood pressure in childhood and adult life looking at these within twin effects are far from conclusive. There are, however, methodological problems in the interpretation of these results, not least of which is the relatively small numbers of twin pairs studied. Studies exploring the effect of zygosity and chorion type on later disease provide may provide a useful extension of the research agenda. In summary, twin studies to date have raised more questions about the foetal origins hypothesis than they have resolved.
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Poulsen P, Vaag A. Glucose and Insulin Metabolism in Twins: Influence of Zygosity and Birth Weight. ACTA ACUST UNITED AC 2012. [DOI: 10.1375/twin.4.5.350] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractSeveral epidemiological and metabolic studies have demonstrated an impact of the intrauterine environment on the development of disease in adult life, including Type 2 diabetes and glucose intolerance. Our finding of lower birth weights among monozygotic diabetic twins compared to their non-diabetic genetically identical co-twins confirms this association and, furthermore, eliminates the possibility that the association could be explained solely by common genes leading to both impaired intrauterine growth and increased risk of Type 2 diabetes. Due to an often shared placenta monozygotic twins may experience a more adverse intrauterine environment compared to dizygotic twins and may therefore be more prone to develop various metabolic abnormalities. Our findings of a higher glucose and insulin profile after oral glucose ingestion, and recently lower insulin-stimulated glucose uptake — indicating glucose intolerance and insulin resistance — among monozygotic compared to dizygotic twins may to some extent question the validity of classical twin studies in diabetes research where equal environmental influences in monozygotic and dizygotic twins is assumed. The potential role of an adverse intrauterine environment in causing Type 2 diabetes in humans, may to some degree alter our conception of the twin model in diabetes research including the interpretation of aetiological conclusions reached in previous classical twin studies of diabetes. However, our present knowledge is far too insufficient to discard the results from classical twin studies concerning the relative role of genes versus environment for the development of diabetes and its metabolic effects.
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Lyssenko V, Eliasson L, Kotova O, Pilgaard K, Wierup N, Salehi A, Wendt A, Jonsson A, De Marinis YZ, Berglund LM, Taneera J, Balhuizen A, Hansson O, Osmark P, Dunér P, Brøns C, Stancáková A, Kuusisto J, Bugliani M, Saxena R, Ahlqvist E, Kieffer TJ, Tuomi T, Isomaa B, Melander O, Sonestedt E, Orho-Melander M, Nilsson P, Bonetti S, Bonadonna R, Miccoli R, Delprato S, Marchetti P, Madsbad S, Poulsen P, Vaag A, Laakso M, Gomez MF, Groop L. Pleiotropic effects of GIP on islet function involve osteopontin. Diabetes 2011; 60:2424-33. [PMID: 21810601 PMCID: PMC3161325 DOI: 10.2337/db10-1532] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The incretin hormone GIP (glucose-dependent insulinotropic polypeptide) promotes pancreatic β-cell function by potentiating insulin secretion and β-cell proliferation. Recently, a combined analysis of several genome-wide association studies (Meta-analysis of Glucose and Insulin-Related Traits Consortium [MAGIC]) showed association to postprandial insulin at the GIP receptor (GIPR) locus. Here we explored mechanisms that could explain the protective effects of GIP on islet function. RESEARCH DESIGN AND METHODS Associations of GIPR rs10423928 with metabolic and anthropometric phenotypes in both nondiabetic (N = 53,730) and type 2 diabetic individuals (N = 2,731) were explored by combining data from 11 studies. Insulin secretion was measured both in vivo in nondiabetic subjects and in vitro in islets from cadaver donors. Insulin secretion was also measured in response to exogenous GIP. The in vitro measurements included protein and gene expression as well as measurements of β-cell viability and proliferation. RESULTS The A allele of GIPR rs10423928 was associated with impaired glucose- and GIP-stimulated insulin secretion and a decrease in BMI, lean body mass, and waist circumference. The decrease in BMI almost completely neutralized the effect of impaired insulin secretion on risk of type 2 diabetes. Expression of GIPR mRNA was decreased in human islets from carriers of the A allele or patients with type 2 diabetes. GIP stimulated osteopontin (OPN) mRNA and protein expression. OPN expression was lower in carriers of the A allele. Both GIP and OPN prevented cytokine-induced reduction in cell viability (apoptosis). In addition, OPN stimulated cell proliferation in insulin-secreting cells. CONCLUSIONS These findings support β-cell proliferative and antiapoptotic roles for GIP in addition to its action as an incretin hormone. Identification of a link between GIP and OPN may shed new light on the role of GIP in preservation of functional β-cell mass in humans.
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Affiliation(s)
- Valeriya Lyssenko
- Diabetes and Endocrinology, Department of Clinical Sciences, University Hospital Malmö, Lund University, Malmö, Sweden.
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Petersen I, Nielsen MMF, Beck-Nielsen H, Christensen K. No evidence of a higher 10 year period prevalence of diabetes among 77,885 twins compared with 215,264 singletons from the Danish birth cohorts 1910-1989. Diabetologia 2011; 54:2016-24. [PMID: 21487729 DOI: 10.1007/s00125-011-2128-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Accepted: 03/07/2011] [Indexed: 12/29/2022]
Abstract
AIMS/HYPOTHESIS Previous Danish twin studies have found a highly increased risk of precursors of type 2 diabetes as well as a higher prevalence of type 2 diabetes among twins compared with singletons. Likewise, small-scale studies of Danish twins have shown that monozygotic twins have a higher risk of developing precursors of type 2 diabetes compared with dizygotic twins. In the present register-based study, the 10 year period diabetes prevalence in Danish twins is compared with that in a random sample of Danish citizens. Furthermore, the 10 year period prevalence of diabetes in monozygotic twins is compared with that in dizygotic twins. METHODS The study population consisted of twins (n = 77,885) identified in the Danish Twin Registry, and a 5% random sample (n = 215,264) from the birth cohorts 1910-1989. We identified diabetes patients by means of three nationwide Danish health registers. RESULTS The number of identified diabetes cases among males was 6,677 (6.24%) for singletons vs 2,271 (5.68%) for twins (difference = 0.56% [0.29-0.83%]). The number among females was 6,143 (5.67%) for singletons and 1,722 (4.54%) for twins (difference = 1.13% [0.88-0.38%]). Restriction to various birth cohorts, known zygosity and known type 2 diabetes did not alter the overall conclusions. The difference between monozygotic twins (males, 5.29%; females, 4.40%) and dizygotic twins (males, 5.77%; females, 4.63%) was non-significant. CONCLUSIONS/INTERPRETATION Danish twins do not have an increased risk of developing diabetes compared with singletons, and the risk of diabetes among monozygotic twins does not differ from that of dizygotic twins.
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Affiliation(s)
- I Petersen
- The Danish Twin Registry, Danish Aging Research Center, University of Southern Denmark, J. B. Winsløws Vej 9B st.tv., 5000 Odense C, Denmark.
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Abstract
Dr. David Barker first popularized the concept of fetal origins of adult disease (FOAD). Since its inception, FOAD has received considerable attention. The FOAD hypothesis holds that events during early development have a profound impact on one's risk for development of future adult disease. Low birth weight, a surrogate marker of poor fetal growth and nutrition, is linked to coronary artery disease, hypertension, obesity, and insulin resistance. Clues originally arose from large 20th century, European birth registries. Today, large, diverse human cohorts and various animal models have extensively replicated these original observations. This review focuses on the pathogenesis related to FOAD and examines Dr. David Barker's landmark studies, along with additional human and animal model data. Implications of the FOAD extend beyond the low birth weight population and include babies exposed to stress, both nutritional and nonnutritional, during different critical periods of development, which ultimately result in a disease state. By understanding FOAD, health care professionals and policy makers will make this issue a high health care priority and implement preventive measures and treatment for those at higher risk for chronic diseases.
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Abstract
There are many instances in life when the environment plays a critical role in the health outcomes of an individual, yet none more so than those experienced in fetal and neonatal life. One of the most detrimental environmental problems encountered during this critical growth period are changes in nutrition to the growing fetus and newborn. Disturbances in the supply of nutrients and oxygen to the fetus can not only lead to adverse fetal growth patterns, but they have also been associated with the development of features of metabolic syndrome in adult life. This fetal response has been termed developmental programming or the developmental origins of health and disease. The present review focuses on the epidemiological studies that identified this association and the importance that animal models have played in studying this concept. We also address the potential mechanisms that may underpin the developmental programming of future disease. It also highlights (i) how developmental plasticity, although beneficial for short-term survival, can subsequently programme glucose intolerance and insulin resistance in adult life by eliciting changes in key organ structures and the epigenome, and (ii) how aberrant mitochondrial function can potentially lead to the development of Type 2 diabetes and other features of metabolic syndrome.
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Affiliation(s)
- Matthew J Warner
- Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge, UK
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Alibegovic AC, Højbjerre L, Sonne MP, van Hall G, Alsted TJ, Kiens B, Stallknecht B, Dela F, Vaag A. Increased rate of whole body lipolysis before and after 9 days of bed rest in healthy young men born with low birth weight. Am J Physiol Endocrinol Metab 2010; 298:E555-64. [PMID: 19996383 DOI: 10.1152/ajpendo.00223.2009] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Individuals born with low birth weight (LBW) are at risk of developing type 2 diabetes mellitus (T2D), which may be precipitated by physical inactivity. Twenty-two LBW subjects and twenty-three controls were studied before and after bed rest by the hyperinsulinemic euglycemic clamp combined with indirect calorimetry and infusion of stable isotope tracers and preceded by an intravenous glucose tolerance test. LBW subjects had a similar body mass index but elevated abdominal obesity compared with controls. The basal rate of whole body lipolysis (WBL) was elevated in LBW subjects with and without correction for abdominal obesity before and after bed rest (all P = 0.01). Skeletal muscle hormone-sensitive lipase (HSL) protein expression and phosphorylation at Ser565 were similar in the two groups. Bed rest resulted in a decrease in WBL and an increased skeletal muscle HSL Ser565 phosphorylation indicating a decreased HSL activity in both groups. All subjects developed peripheral insulin resistance in response to bed rest (all P < 0.0001) with no differences between groups. LBW subjects developed hepatic insulin resistance in response to bed rest. In conclusion, increased WBL may contribute to the development of hepatic insulin resistance when exposed to bed rest in LBW subjects. Nine days of bed rest causes severe peripheral insulin resistance and reduced WBL and skeletal muscle HSL activity, as well as a compensatory increased insulin secretion, with no differences in LBW subjects and controls.
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Beardsall K, Ong KK, Murphy N, Ahmed ML, Zhao JH, Peeters MW, Dunger DB. Heritability of childhood weight gain from birth and risk markers for adult metabolic disease in prepubertal twins. J Clin Endocrinol Metab 2009; 94:3708-13. [PMID: 19723754 DOI: 10.1210/jc.2009-0757] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Associations between size at birth, postnatal weight gain, and potential risk for adult disease have been variably explained by in utero exposures or genetic risk that could affect both outcomes. We utilized a twin model to explore these hypotheses. METHODS One hundred pairs of healthy twins aged 8.9 yr (range, 7.2-10.9 yr) had fasting blood samples collected, blood pressure (BP) measured, and anthropometry assessed. All measurements were converted to sd scores (SDS) to adjust for age and sex. RESULTS Mean birth weights in both monozygotic and dizygotic twins were -0.90 SDS lower than the UK reference. In postnatal life, 58% of monozygotic twins and 59% of dizygotic twins showed rapid weight gain (a change of more than +0.67 in weight SDS) from birth. Postnatal weight gain was positively associated with sum of skinfolds (r = 0.51; P < 0.0005), fasting insulin levels (r = 0.35; P < 0.0005), systolic BP (r = 0.30; P < 0.0005), and diastolic BP (r = 0.15; P < 0.05) at follow-up. Heritability estimates (additive genetic components) were calculated using variance components models for: birth weight, 44%; postnatal weight gain, 80%; childhood height, 89%; body mass index, 72%; sum of skinfolds, 89%; waist circumference, 74%; fasting insulin, 65%; systolic BP, 33%; and diastolic BP, 29%. CONCLUSIONS Postnatal weight gain from birth, rather than birth weight, was associated with childhood risk markers for adult metabolic disease. Childhood weight gain was highly heritable, and genetic factors associated with postnatal weight gain are likely to also contribute to risks for adult disease.
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Affiliation(s)
- Kathryn Beardsall
- Department of Paediatrics, University of Cambridge, Addenbrooke's Hospital, Box 116, Cambridge CB2 0QQ, United Kingdom
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Grunnet LG, Nilsson E, Ling C, Hansen T, Pedersen O, Groop L, Vaag A, Poulsen P. Regulation and function of FTO mRNA expression in human skeletal muscle and subcutaneous adipose tissue. Diabetes 2009; 58:2402-8. [PMID: 19587359 PMCID: PMC2750213 DOI: 10.2337/db09-0205] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Common variants in FTO (the fat mass- and obesity-associated gene) associate with obesity and type 2 diabetes. The regulation and biological function of FTO mRNA expression in target tissue is unknown. We investigated the genetic and nongenetic regulation of FTO mRNA in skeletal muscle and adipose tissue and their influence on in vivo glucose and fat metabolism. RESEARCH DESIGN AND METHODS The FTO rs9939609 polymorphism was genotyped in two twin cohorts: 1) 298 elderly twins aged 62-83 years with glucose tolerance ranging from normal to type 2 diabetes and 2) 196 young (25-32 years) and elderly (58-66 years) nondiabetic twins examined by a hyperinsulinemic-euglycemic clamp including indirect calorimetry. FTO mRNA expression was determined in subcutaneous adipose tissue (n = 226) and skeletal muscle biopsies (n = 158). RESULTS Heritability of FTO expression in both tissues was low, and FTO expression was not influenced by FTO rs9939609 genotype. FTO mRNA expression in skeletal muscle was regulated by age and sex, whereas age and BMI were predictors of adipose tissue FTO mRNA expression. FTO mRNA expression in adipose tissue was associated with an atherogenic lipid profile. In skeletal muscle, FTO mRNA expression was negatively associated to fat and positively to glucose oxidation rates as well as positively correlated with expression of genes involved in oxidative phosphorylation including PGC1alpha. CONCLUSIONS The heritability of FTO expression in adipose tissue and skeletal muscle is low and not influenced by obesity-associated FTO genotype. The age-dependent decline in FTO expression is associated with peripheral defects of glucose and fat metabolism.
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Affiliation(s)
- Louise G. Grunnet
- Steno Diabetes Center, Gentofte, Denmark
- Department of International Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Charlotte Ling
- Department of Clinical Sciences, Diabetes and Endocrinology, Malmø University Hospital, Malmø, Sweden
| | | | | | - Leif Groop
- Department of Clinical Sciences, Diabetes and Endocrinology, Malmø University Hospital, Malmø, Sweden
| | - Allan Vaag
- Steno Diabetes Center, Gentofte, Denmark
| | - Pernille Poulsen
- Steno Diabetes Center, Gentofte, Denmark
- Corresponding author: Pernille Poulsen,
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Zhang S, Liu X, Yu Y, Hong X, Christoffel KK, Wang B, Tsai HJ, Li Z, Liu X, Tang G, Xing H, Brickman WJ, Zimmerman D, Xu X, Wang X. Genetic and environmental contributions to phenotypic components of metabolic syndrome: a population-based twin study. Obesity (Silver Spring) 2009; 17:1581-7. [PMID: 19407809 PMCID: PMC3766632 DOI: 10.1038/oby.2009.125] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The increasing prevalence of metabolic syndrome (MS) poses a serious public-health problem worldwide. Effective prevention and intervention require improved understanding of the factors that contribute to MS. We analyzed data on a large twin cohort to estimate genetic and environmental contributions to MS and to major MS components and their intercorrelations: waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), fasting plasma glucose (FPG), triglycerides (TGs), and high-density lipoprotein-cholesterol (HDL-C). We applied structural equation modeling to determine genetic and environmental structure of MS and its major components, using 1,617 adult female twin pairs recruited from rural China. The heritability estimate for MS was 0.42 (95% confidence interval (CI): 0.00-0.83) in this sample with low MS prevalence (4.4%). For MS components, heritability estimates were statistically significant and ranged from 0.13 to 0.64 highest for WC, followed by TG, SBP, DBP, HDL-C, and FPG. HDL-C was mainly influenced by common environmental factors (0.62, 95% CI: 0.58-0.62), whereas the other five MS components were largely influenced by unique environmental factors (0.32-0.44). Bivariate Cholesky decomposition analysis indicated that the clinical clustering of MS components may be explained by shared genetic and/or environmental factors. Our study underscores the importance of examining MS components as intercorrelated traits, and to carefully consider environmental and genetic factors in studying MS etiology.
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Affiliation(s)
- Shanchun Zhang
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
| | - Xin Liu
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
| | - Yunxian Yu
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
| | - Xiumei Hong
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
| | - Katherine Kaufer Christoffel
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
| | - Binyan Wang
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
| | - Hui-Ju Tsai
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
| | - Zhiping Li
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Xue Liu
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Genfu Tang
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Houxun Xing
- Institute for Biomedicine, Anhui Medical University, Hefei, China
| | - Wendy J. Brickman
- Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital, IL, USA
| | - Donald Zimmerman
- Division of Endocrinology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital, IL, USA
| | - Xiping Xu
- Center for Population Genetics, University of Illinois at Chicago School of Public Health, Chicago, IL
| | - Xiaobin Wang
- Mary Ann and J. Milburn Smith Child Health Research Program, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Children's Memorial Hospital and Children's Memorial Research Center, Chicago, IL, USA
- Correspondence and reprint requests should be addressed to: Xiaobin Wang, MD, ScD, Mary Ann and J. Milburn Smith Child Health Research Program, Children’s Memorial Hospital and Children’s Memorial Research Center; Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; telephone:312-573-7738, fax:312-573-7825,
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16
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Poulsen P, Grunnet LG, Pilgaard K, Storgaard H, Alibegovic A, Sonne MP, Carstensen B, Beck-Nielsen H, Vaag A. Increased risk of type 2 diabetes in elderly twins. Diabetes 2009; 58:1350-5. [PMID: 19336677 PMCID: PMC2682675 DOI: 10.2337/db08-1714] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Genetic susceptibility, low birth weight (LBW), and aging are key etiological factors in the development of type 2 diabetes. LBW is common among twins. It is unknown whether twin status per se is associated with risk of type 2 diabetes, and valid concordance rates of type 2 diabetes in twins on a lifetime perspective are lacking. RESEARCH DESIGN AND METHODS A clinical study was done on a population-based cohort of same-sex elderly monozygotic (MZ) and dizygotic (DZ) twins (n = 297) and singleton control subjects (C) (n = 71) including measures of anthropometry and glucose tolerance. In addition, type 2 diabetes incidence cases in twins (n = 626) and singletons (n = 553) were identified through the National Diabetes Register. RESULTS Twins were more abdominally obese, insulin resistant, and glucose intolerant, as evidenced by a higher A1C (%) (means +/- SD) (MZ: 6.0 +/- 1.0, DZ: 5.8 +/- 0.7, C: 5.6 +/- 0.3, P = 0.004) and 120-min post-oral glucose tolerance test plasma glucose levels (in mmol/l) (MZ: 8.6 +/- 4.6, DZ: 8.4 +/- 3.9, C: 6.8 +/- 2.4, P = 0.003) compared with singletons. Importantly, twins had a higher prevalence of type 2 diabetes (MZ: 17.5% [95% CI 14.4-20.6], DZ: 15.7% [13.1-18.3], C: 5.6% [3.0-8.2], P = 0.03) together with a 60% higher incidence rate of type 2 diabetes compared with singletons. Cumulative concordance rates of type 2 diabetes to the age of 84 years were similar among elderly MZ (0.76 [0.68-0.84]) and DZ (0.71 [0.63-0.78]) twins. CONCLUSIONS Twin status per se is associated with abdominal obesity, insulin resistance, and increased prevalence of type 2 diabetes in elderly twins. The data support a quantitatively significant impact of the fetal environment as opposed to genetics on risk of type 2 diabetes.
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Wegner L, Hussain MS, Pilgaard K, Hansen T, Pedersen O, Vaag A, Poulsen P. Impact of TCF7L2 rs7903146 on insulin secretion and action in young and elderly Danish twins. J Clin Endocrinol Metab 2008; 93:4013-9. [PMID: 18611970 DOI: 10.1210/jc.2008-0855] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE We investigated the regulation and metabolic effects of TCF7L2 gene expression in human sc fat and skeletal muscle and the impact of the TCF7L2, rs7903146, T-allele on gene expression and measures of glucose metabolism including insulin secretion and peripheral and hepatic insulin action. RESEARCH DESIGN AND METHODS The rs7903146 was genotyped in 1) a population-based sample of 587 twins (55-64 yr) with glucose tolerance ranging from normal to type 2 diabetes and 2) a population of 196 nondiabetic young (22-31 yr) and elderly (57-66 yr) twins. All subjects underwent oral glucose tolerance tests, and population 2 was additionally examined with iv glucose tolerance tests and hyperinsulinemic, euglycemic clamps. RESULTS Elderly T-allele carriers had decreased plasma insulin responses and lower disposition index, whereas insulinogenic index was similar between genotype groups. Elderly nondiabetic T-allele carriers had increased peripheral insulin sensitivity (P = 0.03). Young T-allele carriers had impaired hepatic insulin sensitivity (P = 0.04) independent of plasma insulin levels. TCF7L2 gene expression in skeletal muscle and adipose tissue was not explained by genotype, sex, aerobic capacity, birth, or adult anthropometry and was not associated with in vivo glucose metabolism. CONCLUSIONS The rs7903146 T-allele associates with hepatic insulin resistance and diminished glucose-stimulated plasma insulin secretion. Our study does not provide evidence of a role of TCF7L2 gene expression in sc fat tissue and muscle tissue in the regulation of glucose homeostasis. This suggests that the primary defect of rs7903146 T-allele carriers is impairment of insulin secretion rather than a defect in insulin action in peripheral tissues.
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Affiliation(s)
- Lise Wegner
- Steno Diabetes Center, DK-2820 Gentofte, Denmark.
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Abstract
PURPOSE OF REVIEW The purpose of this review is to provide a critical update of the impact of the 'thrifty phenotype hypothesis' on metabolism, and its implications for heritability estimates as obtained in so-called classical twin studies. RECENT FINDINGS Our recent studies demonstrated a complex age or time-dependent relationship between different and independent markers of an adverse intrauterine environment, including birth weight, twin and zygosity status on one side, and distinct defects of insulin secretion and glucose metabolism on the other side. SUMMARY These novel findings may, to some unknown extent, influence and perhaps bias the heritability estimates of type 2 diabetes-related traits obtained using classical twin analyses. The studies add to the increasing evidence of the intrauterine environment as a - or the - key player in the cause and pathophysiology of type 2 diabetes and the metabolic syndrome. We and others have shown that monozygotic twins represent a powerful tool to demonstrate nongenetic associations between low birth weight and different phenotypes of the metabolic syndrome, including type 2 diabetes, insulin resistance and, recently, hypertension. Future studies of discordant monozygotic twins may provide novel and crucial mechanistic explanations of the link between low birth weight and the metabolic syndrome.
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Affiliation(s)
- Allan Vaag
- Steno Diabetes Center, Gentofte, Denmark.
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Bloomfield FH, Oliver MH, Harding JE. Effects of twinning, birth size, and postnatal growth on glucose tolerance and hypothalamic-pituitary-adrenal function in postpubertal sheep. Am J Physiol Endocrinol Metab 2007; 292:E231-7. [PMID: 16940472 DOI: 10.1152/ajpendo.00210.2006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Low birth weight is associated with postnatal physiological changes, including impaired glucose tolerance and increased cortisol secretion, that may predispose to disease in adulthood. Twins are born lighter than singletons, but there are conflicting data regarding the association between birth weight and postnatal physiology in twins. We studied glucose tolerance and ACTH and cortisol responses to a combined corticotropin-releasing hormone and arginine vasopressin (CRH + AVP) challenge in postpubertal female twin (n = 7 twin pairs) and singleton (n = 13) sheep from the same flock. There were no differences in glucose tolerance between twins and singletons and no association with birth weight. Twins had a greater ACTH (P < 0.05), but not cortisol, response to CRH + AVP than singletons. ACTH area under the curve was inversely related to birth weight in both singletons [R(2) = 0.31, P = 0.05; -8,311 (SD 3,736) pg.min.ml(-1).kg(-1)] and twins (R(2) = 0.49); in twins, this was due to the within-twin pair rather than the between-twin pair coefficient in the regression analysis [P = 0.02, -26,856 (9,806) vs. P = 0.1, 8,619 (4,950) pg.min.ml(-1).kg(-1)]. We conclude that the reduced fetal growth in twins has postnatal consequences for hypothalamic-pituitary-adrenal function and that this is determined by factors specific to the fetus (within-twin pair) rather than by shared maternal factors (between-twin pair). Studies investigating the associations between fetal growth and postnatal outcomes in twins benefit from an appropriate singleton control group and from analyses evaluating the contribution from both between- and within-pair coefficients in twins.
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Affiliation(s)
- Frank H Bloomfield
- Liggins Institute, Univ. of Auckland, Private Bag 92019, Auckland, New Zealand.
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Abstract
The immediate prenatal and postnatal consequences of reduced fetal growth have long been known. The longer term associations between reduced birth weight and adult disease risk are also now well established. Reduced fetal growth is usually detected late in gestation, and the assumption has been that this is the time when factors regulating fetal growth have their greatest effect. However, recent evidence suggests that both the growth trajectory of the fetus and its adaptive responses to the prenatal and postnatal environment may be determined in the period around the time of conception.
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Affiliation(s)
- F H Bloomfield
- Liggins Institute, University of Auckland, Private Bag 92019, Auckland, New Zealand.
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21
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Poulsen P, Vaag A. The intrauterine environment as reflected by birth size and twin and zygosity status influences insulin action and intracellular glucose metabolism in an age- or time-dependent manner. Diabetes 2006; 55:1819-25. [PMID: 16731848 DOI: 10.2337/db05-1462] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
According to the "fetal origins hypothesis," monozygotic (MZ) twins may be more prone to develop various metabolic abnormalities compared with dizygotic (DZ) twins, and twins all together may be more predisposed to metabolic defects compared with singletons. To determine the impact of twin and zygosity status as well as birth size on in vivo measures of glucose metabolism, we examined 123 young (aged 22-31 years) and 103 elderly (aged 57-66 years) MZ and DZ twins and age-matched singleton control subjects. All participants were born at term with available birth records. Peripheral and hepatic insulin action and intracellular glucose partitioning was determined by a euglycemic-hyperinsulinemic clamp using tritiated glucose combined with indirect calorimetry. In elderly subjects, zygosity status influenced nonoxidative glucose metabolism, while twin status per se was associated with elevated hepatic glucose production during both steady-state periods. Birth weight was associated with nonoxidative glucose metabolism in a nongenetic manner within twins and with a high glucose and low lipid oxidation in singletons. In younger subjects, twin status influenced glucose and lipid oxidation rates. We demonstrate a complex age- or time-dependent relationship between independent markers of fetal environment and glucose homeostasis in twins. The documented differential programming effects associated with either low birth weight and twin or zygosity status all represent known defects of glucose homeostasis in type 2 diabetes.
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Affiliation(s)
- Pernille Poulsen
- Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark.
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22
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Vaag A, Jensen CB, Poulsen P, Brøns C, Pilgaard K, Grunnet L, Vielwerth S, Alibegovic A. Metabolic aspects of insulin resistance in individuals born small for gestational age. HORMONE RESEARCH 2006; 65 Suppl 3:137-43. [PMID: 16612127 DOI: 10.1159/000091519] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Numerous studies have shown an association between low weight at birth and being born small for gestational age (SGA) on the one hand and risk of developing insulin resistance and type 2 diabetes on the other. Our studies in twins have indicated a non-genetic age-dependent origin of insulin resistance and type 2 diabetes associated with being born SGA. In order to gain insight into the molecular metabolic defects and mechanisms linking SGA with insulin resistance and type 2 diabetes, we performed a series of experiments in young and elderly twins, and, in particular, in young men (aged 19-23 years) with a weight at birth at term in the lowest 10th percentile with no family history of diabetes. The control group included age-matched men with birth weights at term in the upper normal range. While body mass index and waist-to-hip ratios were similar in the individuals born SGA and controls, dual-energy X-ray absorptiometry studies documented a higher degree of abdominal obesity in the men who had a low weight at birth. Using the gold standard hyperinsulinaemic-euglycaemic clamp technique combined with glucose tracers and studies of forearm glucose uptake, we found an impairment of insulin-stimulated glycolytic flux and reduced forearm (muscle) glucose uptake in the face of normal whole-body glucose uptake. In addition, we found a significantly decreased insulin secretion rate during oral glucose ingestion after correction for insulin action (disposition index), a paradoxical enhanced insulin suppression of hepatic glucose production and lower fasting plasma glycerol levels, suggesting impaired lipolysis. Finally, analysis of skeletal muscle biopsies showed reduced muscle expression of several key proteins involved in insulin signalling and glucose transport, including protein kinase C-zeta, the two subunits of phosphoinositol 3-kinase (i.e., p85alpha and p110beta) and the insulin-sensitive glucose transporter, Glut-4, in individuals of low birth weight. In conclusion, being born SGA and of low birth weight is associated with type 2 diabetes in a non-genetic manner, and programming of muscle insulin action and signalling represents an early mechanism responsible for this association.
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Affiliation(s)
- A Vaag
- Steno Diabetes Centre, Gentofte, Denmark
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23
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Abstract
The term 'fetal origins of adult disease' was coined on the basis of the inverse association between low birth weight and blood pressure, adult-onset diabetes, coronary heart disease, and stroke seen in numerous epidemiological studies. However, it seems unlikely that birth weight is involved in causal pathways underlying these observations, and if it were then the significance to public health of these findings is very limited because of our inability to modify birth weight to a relevant extent in humans. There has been a major focus on maternal nutrition. Despite evidence that experimental manipulation of maternal nutrition in animals influences offspring birth weight and programme measures related to cardiovascular disease, human studies in general provide limited and unconvincing evidence that differences in maternal macronutrient intake are important. Nevertheless there is a need to understand the underlying causal pathways, and the utility of studies of twins and possible mechanisms are discussed.
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Affiliation(s)
- Ruth Morley
- Department of Paediatrics and Murdoch Children's Research Institute, University of Melbourne, Flemington Road, Parkville, Victoria 3070, Australia.
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24
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Grunnet L, Poulsen P, Klarlund Pedersen B, Mandrup-Poulsen T, Vaag A. Plasma cytokine levels in young and elderly twins: genes versus environment and relation to in vivo insulin action. Diabetologia 2006; 49:343-50. [PMID: 16374628 DOI: 10.1007/s00125-005-0080-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2005] [Accepted: 09/05/2005] [Indexed: 10/25/2022]
Abstract
AIMS/HYPOTHESIS We studied the impact of genetic versus pre- and postnatal environmental factors on the plasma levels of IL6, TNF and the soluble TNF receptor superfamily, member 1A (TNFRSF1A, previously known as TNF receptor type1 [TNFR1]). MATERIALS AND METHODS Using the hyperinsulinaemic-euglycaemic clamp, we assessed the association between cytokine levels and both peripheral insulin sensitivity and hepatic glucose production. Fasting plasma IL6, TNF and soluble TNFRSF1A levels were measured using ELISA in 55 young and 43 elderly twin pairs. RESULTS Plasma IL6 and TNF were influenced by genetic factors in young and elderly twins respectively, while no significant impact of genetics was found for soluble TNFRSF1A. Significant intra-twin pair correlations between birthweight and both IL6 and soluble TNFRSF1A levels were found. In addition to the effect of birthweight on IL6, age and fat % also significantly influenced IL6 levels, whereas soluble TNFRSF1A levels were significantly influenced by zygosity, age, fat % and sex. Plasma soluble TNFRSF1A was associated with higher plasma NEFA and to some extent with reduced insulin sensitivity. Plasma IL6 was associated positively with basal NEFA. TNF level was not associated with in vivo glucose or fat metabolism after correction for known confounders. CONCLUSIONS/INTERPRETATION Plasma IL6 and soluble TNFRSF1A are influenced by the intrauterine environment. We found some evidence of a genetic component for TNF and IL6 in young and elderly twins respectively. Plasma IL6 may influence basal lipolysis, but neither plasma TNF nor IL6 levels are independently associated with hepatic or peripheral insulin action. Nevertheless, plasma soluble TNFRSF1A may play some role in the control of insulin action.
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Affiliation(s)
- L Grunnet
- Steno Diabetes Centre, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark.
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25
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Davies MJ. Fetal programming: the perspective of single and twin pregnancies. Reprod Fertil Dev 2005; 17:379-86. [PMID: 15745646 DOI: 10.1071/rd04101] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2004] [Accepted: 01/09/2005] [Indexed: 11/23/2022] Open
Abstract
Multiple pregnancy is associated with increased risk of adverse consequences for both mother and fetus(es), including increased rates of maternal hypertension and pre-eclampsia, spontaneous abortion, Caesarean delivery, low birthweight, birth prematurity, perinatal mortality, admission to neonatal intensive care and extended length of care, respiratory distress, cerebral palsy, developmental delay, contact with disability services and mortality to age 5 years. Premature birth, which affects 97% of triplets and 53.3% of twins in Australia, is not the sole factor involved. The rate of multiple pregnancy in Australia is 1.7%. This compares to 22.1% for pregnancies resulting from assisted reproduction technology (ART). As a result, 21.8% of babies born from ART are from a multiple pregnancy, in comparison to the USA where the majority of babies born from ART are from a multiple pregnancy. Additionally, the population rate of multiple births is rising due to the more frequent use of ART and continued multi-embryo transfers, which is operating against a background of rising implantation rates within ART clinics. Twins have been of interest from a programming perspective. However, analysis of associations between crude birthweight and subsequent metabolic risk factors or mortality in adulthood from chronic disease indicate that adaptations in pregnancy to support multi-fetal growth are not identical to fetal growth restriction in singleton pregnancies. Indeed, the process of ‘maternal constraint’ is incompletely understood and confounds such comparisons. From a programming perspective, it is a challenge to identify in twin pregnancies the transition from physiological adaptation to pathological growth restriction. Growth disparity between twins has been more illuminating of subtle adverse effects for the smaller of twin pairs in both blood pressure and insulin resistance in adulthood. Interestingly, these effects can be observed in both dizygotic and to a lesser degree in monozygotic twins, which indicates a role for both genetic and environmental factors in these measures. This suggests that, consistent with experimental studies in other species, the relationship between impaired growth in utero and chronic disease in later life is not simply mediated by a common genetic pathway.
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Affiliation(s)
- Michael J Davies
- Research Centre for Reproductive Health, Department of Obstetrics and Gynaecology, University of Adelaide, Australia.
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Poulsen P, Levin K, Petersen I, Christensen K, Beck-Nielsen H, Vaag A. Heritability of insulin secretion, peripheral and hepatic insulin action, and intracellular glucose partitioning in young and old Danish twins. Diabetes 2005; 54:275-83. [PMID: 15616039 DOI: 10.2337/diabetes.54.1.275] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The etiology of type 2 diabetes is multifactorial, including genetic as well as pre- and postnatal factors that influence several different defects of glucose homeostasis, primarily in muscle, beta-cells, and liver. In the present twin study, we report heritability estimates (h(2)) for measures of insulin secretion, insulin resistance, hepatic glucose production (HGP), and intracellular glucose partitioning using gold standard methods (euglycemic-hyperinsulinemic clamp technique, tritiated glucose infusion, indirect calorimetry, and intravenous glucose tolerance testing) among 110 younger (22-31 years of age) and 86 older (57-66 years of age) twins. To obtain a valid estimate of beta-cell function, insulin secretion was adjusted for the individual degree of insulin action (disposition index). In both age-groups there was a major genetic component in the etiology of insulin secretion that was statistically significantly higher among older twins (young h(2) = 0.75 [0.55-0.86] and old h(2) = 0.84 [0.69-0.92], P < 0.05). The heritability estimates for peripheral insulin sensitivity (young h(2) = 0.53 [0.28-0.71] and old h(2) = 0.55 [0.20-0.76]) and nonoxidative glucose metabolism (young h(2) = 0.50 [0.32-0.64] and old h(2) = 0.48 [0.04-0.72]) were similar in younger and older twins, supporting the notion of both genetic and environmental etiological factors in the control of insulin action and nonoxidative glucose metabolism. The results suggested that HGP was predominantly controlled by nongenetic factors in both young and old twins. In conclusion, we provide further evidence for a role of genes in controlling insulin secretion, insulin action, and nonoxidative glucose metabolism. The relative contribution of genes versus environment on in vivo insulin secretion exhibited an age dependency with a slightly greater relative impact of genes among older as compared with younger twins.
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Affiliation(s)
- Pernille Poulsen
- Steno Diabetes Center, Niels Steensens Vej 2, DK-2820 Gentofte, Denmark.
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27
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Abstract
A number of recent studies have used data from twins to shed light on the causal pathways underlying the observed association between birthweight and cardiovascular risk factors or coronary heart disease. The issue of whether findings from twin studies are generally informative, or whether factors associated with twinning preclude generalisation, is considered here. It is concluded that the association between birthweight and later health may differ quantitatively between twins and singletons, but evidence regarding blood pressure suggests it may not differ qualitatively. However, more information is needed on a number of gestational and maternal factors, and on measures of health other than blood pressure. Placentation and issues relating to infertility and its treatment need to be recorded and, together with gestation length, may need to be taken into account in analyses.
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Affiliation(s)
- Ruth Morley
- Clinical Epidemiology and Biostatistics Unit, University of Melbourne Department of Paediatrics, and Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Australia.
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28
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Jefferies CA, Hofman PL, Knoblauch H, Luft FC, Robinson EM, Cutfield WS. Insulin resistance in healthy prepubertal twins. J Pediatr 2004; 144:608-13. [PMID: 15126994 DOI: 10.1016/j.jpeds.2004.01.059] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate insulin sensitivity (S(I)) in prepubertal twins and to examine the relation to reduced birth weight, prematurity, and peroxisome proliferator-activated receptor-gamma (PPAR gamma) polymorphism. STUDY DESIGN Fifty twins (birth weight SDS, -0.7 +/- 0.2; gestation, 33.5 +/- 0.5 weeks; and body mass index SDS, -0.04 +/- 0.2) were studied at 8.2 +/- 0.3 years. S(I) was measured by Bergman's minimal model from a 90 minutes frequently sampled intravenous glucose test. Twenty control children (height SDS, -1.7 +/- 0.3; birth weight SDS, -0.3 +/- 0.2; and gestation of 39.2 +/- 0.7 weeks) were also evaluated at 7.0 +/- 0.4 years. The PPAR gamma T-variant polymorphism was evaluated in 41 twins. Values are expressed as mean +/- SEM, or 95% confidence intervals. RESULTS S(I) was reduced in twins compared with control subjects, (12.7 [11-15] versus 23.0 [16.8-31.4] 10(-4) min(-1) microU/mL, respectively, P=.005). The reduction in S(I) was independent of prematurity and birth weight and zygosity (P<.0001). There was no difference in S(I), even in twin pairs with >20% difference in birth weight (P=.9). The PPAR gamma heterozygote T-variant polymorphism was present in 7 of 41, with a further reduction in S(I) (P=.03) and a later gestation (P=.03). These twins also had increased fat mass (P=.02) but with similar fat free mass (P=.14). CONCLUSIONS Twin children, independent of prematurity or birth weight, had a marked reduction in S(I). To use twins as a model to study the fetal origins of adult diseases for glucose homeostasis is not valid.
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Affiliation(s)
- Craig A Jefferies
- Liggins Institute, Health Research Council Biostatistics Unit, Department of Community Health, University of Auckland, Auckland, New Zealand
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Beck-Nielsen H, Vaag A, Poulsen P, Gaster M. Metabolic and genetic influence on glucose metabolism in type 2 diabetic subjects--experiences from relatives and twin studies. Best Pract Res Clin Endocrinol Metab 2003; 17:445-67. [PMID: 12962696 DOI: 10.1016/s1521-690x(03)00041-1] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Based on our investigations in first-degree relatives, in twins in general, and in monozygotic twins discordant for type 2 diabetes, we have studied the inheritance of glucose intolerance, insulin resistance and insulin secretion in order to evaluate the role of genes versus environment in the development of type 2 diabetes. Insulin resistance in type 2 diabetes is mainly linked to glucose disposal in skeletal muscle, i.e. reduced glycogen synthesis. In order to investigate the genetic component responsible for the reduced glycogen synthase activity and reduced glucose transport, we also investigated cultured myotubes based on in vivo skeletal muscle biopsies. The results obtained in our own studies are discussed in comparison with the international literature. We conclude that both genetic and environmental factors play a role in the development of type 2 diabetes (hyperglycaemia), and that only subjects who are genetically disposed to insulin resistance and who possess beta-cells which are unable to compensate for the degree of insulin resistance seem to develop type 2 diabetes. Variables of two gene alleles disposing to insulin resistance have been identified, and their role is discussed. The most important environmental factor seems to be obesity, but intrauterine malnutrition also plays a role. The cellular mechanism responsible for obesity/lipid-induced diabetes mellitus is discussed with specific emphasis on the role of accumulation of long-chain AcylCoA and triglycerides in liver, muscle and beta-cells.
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Poulsen P, Andersen G, Fenger M, Hansen T, Echwald SM, Vølund A, Beck-Nielsen H, Pedersen O, Vaag A. Impact of two common polymorphisms in the PPARgamma gene on glucose tolerance and plasma insulin profiles in monozygotic and dizygotic twins: thrifty genotype, thrifty phenotype, or both? Diabetes 2003; 52:194-8. [PMID: 12502512 DOI: 10.2337/diabetes.52.1.194] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Pro12Ala polymorphism in the PPARgamma2 gene has been associated with reduced risk of type 2 diabetes and insulin resistance. Recently, an association between dizygotic twinning and PPARgamma gene polymorphisms has been proposed. We investigated the phenotypic appearance of the two polymorphisms (Pro12Ala and exon 6 C-->T) in PPARgamma among elderly twins (207 monozygotic [MZ] and 342 dizygotic [DZ]) and evaluated whether they could explain previously reported differences in plasma glucose and insulin profiles among MZ and DZ twins. We demonstrated a significant impact of the Pro12Ala polymorphism on glucose tolerance, diabetic status, homeostasis model assessment for insulin resistance, and plasma insulin profiles in twins. No impact of the silent exon 6 polymorphism on glucose homeostasis or plasma insulin profiles was found. Independent of the polymorphisms, we observed a significant impact of zygosity status per se on the plasma insulin profile after oral glucose ingestion, with the MZ twins being more hyperinsulinemic, indicating insulin resistance, than the DZ twins. Nonsignificantly higher glucose concentrations were observed among MZ compared with DZ twins. We demonstrated an association between the Ala allele and reduced risk of diabetes and insulin resistance in twins. However, the differences in metabolic profiles among MZ and DZ twins were not explained by differences in frequencies of the genetic variants and may be due to intrauterine environmental factors operating in twins independent of genotype. Accordingly, our study simultaneously supports a role for both the intrauterine environment (thrifty phenotype) and for genetics (thrifty genotype) in the etiology of insulin resistance and perhaps glucose intolerance in twins.
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Affiliation(s)
- Pernille Poulsen
- Department of Endocrinology, Odense University Hospital, Odense C, Denmark.
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Poulsen P, Vaag A, Beck-Nielsen H. The influence of zygosity status on blood pressure and on lipid profiles in male and female twins. J Hypertens 2002; 20:645-9. [PMID: 11910299 DOI: 10.1097/00004872-200204000-00021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To study the influence of zygosity on blood pressure and serum lipid concentrations among male and female twins. SETTING Department of Endocrinology, Odense University Hospital, Denmark. PARTICIPANTS A total of 125 monozygotic and 178 dizygotic twin pairs aged 55-74 years of age, ascertained from The Danish Twin Register. DESIGN Population-based cross-sectional study. MAIN OUTCOME MEASURES Blood pressure and serum lipid concentrations. RESULTS The prevalence of hypertriglyceridemia and hypercholesterolemia were higher among monozygotic compared with dizygotic twins, whereas the prevalence of hypertension was similar. The level of triglycerides [0.28 (0.44) versus 0.18 (0.41), P = 0.01] and total cholesterol [1.82 (0.17) versus 1.78 (0.19), P = 0.03] were significantly higher in monozygotic compared with dizygotic twins. Systolic blood pressure was non-significantly higher among monozygotic twins (136.8 (21.3) versus 134.1 (19.6), P = 0.10). When comparing monozygotic and dizygotic twins within each sex group, the difference in triglyceride level was only apparent among male twins and the differences in systolic blood pressure and total cholesterol were only seen among female twins. Birth weight as determined in a subgroup of the population was similar in monozygotic and dizygotic twins. CONCLUSIONS Zygosity status per se influences fasting serum triglycerides and total-cholesterol and to some extent systolic blood pressure in twins, supporting an influence of an intrauterine component on lipid profiles. The influence is independent of birth weight and seems to be sex-specific.
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Affiliation(s)
- Pernille Poulsen
- Department of Endocrinology, Odense University Hospital, DK-5000 Odense C, Denmark.
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Jaquet D, Leger J, Czernichow P, Levy-Marchal C. The effect of in-utero undernutrition on the insulin resistance syndrome. Curr Diab Rep 2002; 2:77-82. [PMID: 12643126 DOI: 10.1007/s11892-002-0062-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The metabolic and cardiovascular complications associated with in-utero undernutrition have been identified during the past 10 years. Reduced fetal growth is independently associated with an increased risk for the development of cardiovascular diseases, the insulin resistance syndrome and its components: hypertension, dyslipidemia, impaired glucose tolerance, and type 2 diabetes. All appear to result from the initial development of insulin resistance that seems to be a key component underlying this association. Several hypotheses have been proposed over the past 10 years to understand this unexpected association. Each of them points to either a detrimental fetal environment or genetic susceptibilities or interactions between these two components as playing a critical role in this context. The hypothesis that this association could be the consequence of genetic/environmental interactions remains at the moment the most attractive. Although the mechanism remains unclear, there is also some evidence that adipose tissue plays a role in the emergence of insulin resistance associated with in-utero undernutrition.
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Affiliation(s)
- Delphine Jaquet
- INSERM Unité 457, Hôpital Robert Debré, Paris 75019, France.
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Affiliation(s)
- J C Wyatt
- School of Public Policy, University College London, UK.
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