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„Programming“ diabetes before birth

  November, 19 2006 18:45
your information resource in human molecular genetics
Berlin, 8th of November 2006. Insulin resistance, a risk factor for cardiovascular disease, is already present in the newborn child and thus not necessarily acquired in later life. This is the key result of a study by Professor Berthold Hocher, Center for Cardiovascular Research at the Charité, Campus Mitte, that has been published in the October issue of the journal Circulation* . Insulin resistance is an early stage of non-insulin dependent diabetes and is associated with cardiovascular diseases like hypertension and heart failure.

The background of the study is the so called Barker-hypothesis which completely overthrew medical science about 15 years ago by linking adult cardiovascular risk to a low birth weight. In other words: The lower your birth weight, the higher your risk for stroke, myocardial infarction or non-insulin dependent diabetes. This astonishing association has been explained by a mechanism termed “fetal programming”: During fetal development there are short vulnerable periods in which basic metabolic functions are set. For instance, in case of insufficient fetal nutrition during such a period the fetal organism irrevocably “programs” its metabolism on maximum efficiency. This adaptation lasts for lifetime and thus predisposes to obesity in case of sufficient nutrition in later life due to a more efficient food metabolism.

Insulin resistance so far has mainly been attributed to unhealthy nutrition and lifestyle during lifetime. In contrast, the present study demonstrates that insulin resistance is already present during fetal development thus leading to a fundamentally new concept of diabetes. Further research is now aimed at elucidating the mechanisms of fetal programming including the question if a “re-programming” is a possible therapeutic option. But as Professor Hocher puts it: "At present this is purely hypothetical."

In general, increased awareness to nutritional issues during pregnancy is recommendable, because results of another study** by Professor Hocher`s working group indicate that not only insufficient but also a mal-composed nutrition during pregnancy has an impact on the offspring: In an animal experiment dealing with offspring subjected to a high-protein diet during pregnancy and lactation an increased blood pressure and an altered food metabolism has been demonstrated.

* Circulation. 2006; 114: 1687-1692
** Am J Physiol Regul Integr Comp Physiol. 2006Oct;291(4):R1025-30.

Kontakt: Prof. Berthold Hocher, Charité - Universitätsmedizin Berlin, Tel. +49 172 9208098, berthold.hocher@charite.de

Message posted by: Frank S. Zollmann

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