Perinatale Programmierung

Zusammenfassung

Weltweit werden derzeit intensiv epidemiologische und tierexperimentelle Befunde diskutiert, die darauf hinweisen, dass Einflüsse während der Präund Perinatalperiode das lebenslange Risiko für die Entwicklung von Adipositas und konsekutiven Stoffwechsel-und Herz-Kreislauferkrankungen„prägen” können. Entscheidend hierfür waren v. a. Langzeitbeobachtungen an Kindern von Müttern mit Diabetes mellitus während der Schwangerschaft sowie an Kindern mit einem verminderten Geburtsgewicht. Der Beitrag illustriert unter Fokussierung auf die Folgen eines mütterlichen Diabetes während der Schwangerschaft sowie einer perinatalen Über- und Unterernährung anhand ausgewählter epidemiologisch-klinischer und tierexperimenteller Daten den derzeitigen Kenntnisstand zum Phänomen einer perinatalen Programmierung von Adipositas und diskutiert zugrunde liegende ätiopathogenetische Mechanismen. Vor diesem Hintergrund werden einerseits die hieraus erwachsenden weitreichenden Konsequenzen für die Primärprävention von Adipositas sowie andererseits der Modellcharakter dieser Hypothesen und Beobachtungen für das grundlegende Verständnis der Entwicklung von Gesundheit und Krankheit hervorgehoben.

Summary

Currently, epidemiological and experimental data are intensively discussed which indicate that exposures during prenatal and perinatal life have lifelong consequences for the risk of developing obesity and consecutive metabolic and cardiovascular diseases. In this context, observations in offspring of mothers with diabetes during pregnancy as well as studies in children with low birth weight were most influencial. This paper illustrates the current knowledge on perinatal programming of obesity and discusses possible etiopathogenetic mechanisms, focussing on epidemiological and animal studies on the consequences of exposure to maternal diabetes and perinatal over- or undernutrition. Against this background, the resultant far-reaching potential for primary prevention of obesity as well as the paradigmatic character of these hypotheses and observations for the general understanding of health and disease are highlighted.

Schlüsselwörter

Perinatale Programmierung - Funktionelle Teratologie - perinatale Überernährung - Diabetes während der Schwangerschaft

Keywords

Perinatal programming - functional teratology - perinatal overnutrition - diabetes during pregnancy

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