Programmation fœtale et maladies de l'âge adulte : une analyse critique

Fetal malnutrition is an important risk factor for the occurrence of metabolic syndrome in adulthood (cardiovascular disease, high blood pressure, insulin resistance, hyperlipemia). This concept of metabolic programming is now well established in biology, whereby a stimulus or an insult during a critical or sensitive period of development can have long-term or life-time effects on the organism. The glucose-insulin-IGF system, main regulatory parameter of fetal growth, plays very likely an important role in metabolic programming. Nutritional epigenomics is another fascinating area of research. As opposed to mutations in the DNA sequence, epigenetic modifications are instable and reversible. They can be influenced by the nutritional status, as shown in animal models and more recently in humans. In infants presenting at birth with severe intrauterine growth retardation (IUGR) due to fetal malnutrition, rapid catch up growth can have an additional deleterious metabolic effect, which is difficult to differentiate from the specific metabolic effects of IUGR.