Annals of the Russian academy of medical sciencesAnnals of the Russian academy of medical sciencesВестник Российской академии медицинских наук0869-60472414-3545"Paediatrician" Publishers LLC98810.15690/vramn988PEDIATRICS: CURRENT ISSUESАКТУАЛЬНЫЕ ВОПРОСЫ ПЕДИАТРИИMATERNAL NUTRITION AND THE PROBLEM OF INTRAUTERINE DISEASE PROGRAMMING IN CHILDRENПИТАНИЕ МАТЕРИ И ПРОБЛЕМА ВНУТРИУТРОБНОГО ПРОГРАММИРОВАНИЯ ЗАБОЛЕВАНИЙ РЕБЕНКАhttps://orcid.org/0000-0002-4462-4179KovtunO. P.КовтунОльга Петровна
Russian Federation

Olga P. Kovtun - MD, PhD, professor.

Yekaterinburg

Доктор медицинских наук, профессор, член-корреспондент РАН, ректор.

620028, Екатеринбург, ул. Репина, д. 3, тел.: +7 (343) 214-86-52, SPIN-код: 9919-9048

kovtun@usma.ruhttps://orcid.org/0000-0002-8186-6329TsyvianP. B.ЦывьянПавел Борисович
Russian Federation

Pavel B. Tsyvian - MD, PhD, professor.

Yekaterinburg

Доктор медицинских наук, профессор, заведующий кафедрой нормальной физиологии УГМУ МР; ведущий научный сотрудник УНИИОММ МР.

620028, Екатеринбург, ул. Репина, д. 3, тел.: +7 (343) 214-86-79, SPIN-код: 1750-0200

pavel.tsyvian@gmail.comUral State Medical University Russian Ministry of Public HealthУральский государственный медицинский университетMother and Child Care Research Institute Russian Ministry of Public HealthУральский научно-исследовательский институт охраны материнства и младенчества200720187331901940305201819062018Copyright ©; 2018, "Paediatrician" Publishers LLCCopyright ©; 2018, Издательство "Педиатръ"2018"Paediatrician" Publishers LLCИздательство "Педиатръ"https://vestnikramn.spr-journal.ru/jour/about/submissionshttps://vestnikramn.spr-journal.ru/jour/article/view/988

Environmental conditions during perinatal development such as maternal undernutrition or overnutrition can program changes in the integration among physiological systems leading to cardio-metabolic diseases. This phenomenon can be understood in the context of the phenotypic plasticity and refers to the adjustment of a phenotype in response to environmental input without genetic change. Experimental studies indicate that fetal exposure to an adverse maternal environment may alter the morphology and physiology that contribute to the development of cardio-metabolic diseases. The significance and role of genetic polymorphism, markers of chronic inflammation, oxidative stress, endothelial dysfunction, leptin synthesis disruption, rennin-angiotensin system in intrauterine cardio-metabolic disease programming are discussed. The study demonstrated that both maternal protein restriction and overnutrition alter the central and peripheral control of arterial pressure and metabolism. Breastfeeding may have beneficial effect on obesity risk later in life in genetically predisposed groups. Understanding the mechanisms which affect health outcomes in the offspring influenced by the macronutrient composition of the maternal diet during pregnancy or lactation may lead to new maternal nutrition recommendations, disease prevention strategies, and therapies that reduce the increasing incidence of cardio-metabolic diseases in children and adults.

Условия развития в перинатальный период, такие как повышение или понижение питания матери, могут программировать определенные изменения интеграции основных физиологических систем плода и ребенка, в частности артериальную гипертензию, дислипидемию и диабет 2-го типа, часто объединяемые в мировой литературе названием «кардиометаболические заболевания». Такое программирование может быть понято в контексте феномена фенотипической пластичности, представляющего собой изменение фенотипа в ответ на эпигенетические воздействия без изменения генотипа. Экспериментальные исследования на животных (крысы, овцы, приматы) подтверждают возможность развития кардиометаболических заболеваний в ответ на неблагоприятные условия внутриутробной среды. Обсуждается значение генетического полиморфизма, маркеров хронического воспаления, окислительного стресса, эндотелиальной дисфункции, нарушения синтеза лептина, активности ренин-ангиотензиновой ситемы в программировании этих заболеваний. Показано, как повышение питания или ограничение содержания белка в рационе матери меняют периферический и центральный контроль артериального давления и метаболизма. Полноценное грудное кормление в постнатальном периоде способно нивелировать предрасположенность к кардиометаболическим заболеваниям, связанную с генетическими полиморфизмами. Понимание механизмов, посредством которых количество и качество питания матери во время беременности и лактации влияют на состояние здоровья потомства на протяжении всей последующей жизни, может привести к формированию новых рекомендаций по питанию матерей, новорожденных детей с программируемой патологией, а также развитию технологий, направленных на предупреждение кардиометаболических заболеваний у детей и взрослых.

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