research-article

Evidence for fetal programming of obesity with a focus on putative mechanisms

Sarah H. Wild^a1 and Christopher D. Byrne^a2 c1

^a1 Public Health Sciences, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK

^a2 University of Southampton School of Medicine, Developmental Origins of Health and Disease Division, Level F, Centre Block, MP113, Southampton General Hospital, Southampton SO16 6YD, UK

Abstract

Obesity is associated with insulin resistance, the metabolic syndrome (a clustering of three or more of increased waist circumference, blood pressure, fasting glucose and fasting plasma triacylglycerol levels and reduced HDL levels), and a marked increase in the risk of type 2 diabetes and CHD. The impact of obesity differs between individuals, particularly between men and women and between ethnic groups. For example, in South Asians, although overall obesity is less prevalent, central obesity and the metabolic syndrome are more prevalent than in Europeans and this pattern is associated with the development of type 2 diabetes and CHD at an earlier age. It is important to examine individual risk factors contributing to obesity because they may have a different impact in population subgroups. Many factors contribute to the aetiology of obesity and there is increasing evidence to suggest that altered early development is one such factor and is associated with abnormal fat accumulation, the metabolic syndrome and type 2 diabetes in later life. The present review presents this evidence and discusses some of the mechanisms that may be involved in the pathogenesis of the programming of obesity.

Key Words:

• Fetal programming;
• Diabetes mellitus;
• Obesity;
• Metabolic syndrome;
• Coronary heart disease

Correspondence:

^c1 *Corresponding author: Professor Christopher D. Byrne, fax +44 2380 794945, email C.D.Byrne@soton.ac.uk