Intrauterine growth, the vascular system, and the metabolic syndrome

Richard I G Holt1, Christopher D Byrne

  • 1Endocrinology and Metabolism Sub-Division, Fetal Origins of Adult Disease Division, School of Medicine, Southampton University, Southampton General Hospital, Southampton, England. righ@soton.ac.uk

Insights

Low birth weight is linked to adult cardiovascular disease risk due to fetal adaptations to undernutrition. Preventing growth imbalances may reduce disease risk.

Area of Science:

  • Developmental biology
  • Epidemiology
  • Cardiovascular medicine

Background:

  • Substantial evidence links birth size to adult cardiovascular disease (CVD) and its risk factors.
  • The fetal origins hypothesis suggests CVD originates from fetal adaptations to undernutrition.
  • These adaptations can be cardiovascular, metabolic, or endocrine, permanently altering body structure and function.

Purpose of the Study:

  • To examine recent epidemiological associations between low birth weight and adult atherosclerotic vascular disease.
  • To discuss potential mechanisms underlying these associations.

Main Methods:

  • Epidemiological studies examining birth weight and adult cardiovascular disease risk factors.
  • Review of proposed biological mechanisms linking fetal development to adult disease.

Main Results:

  • Low birth weight is associated with increased risk of adult atherosclerotic vascular disease.
  • Fetal adaptations to undernutrition, including cardiovascular, metabolic, and endocrine changes, are implicated.
  • Imbalances in fetal growth or nutrient supply may contribute to disease development.

Conclusions:

  • Birth size is a significant determinant of adult cardiovascular health.
  • Preventing prenatal and postnatal growth imbalances is crucial for CVD prevention.
  • Understanding fetal adaptations is key to mitigating lifelong disease risk.

Related Concept Videos

Development of Blood Vessels01:07

Development of Blood Vessels

The development of the vascular system in a fetus is a complex and intricate process that begins as early as 15 to 16 days post-conception. This process starts outside the embryo, specifically in the mesoderm of the yolk sac, chorion, and connecting stalk. Approximately two days later, the formation of blood vessels occurs within the embryo itself.
The initial formation of this system is facilitated by the small amount of yolk present in the ovum and yolk sac. Blood vessels originate from...
Overview of the Vascular System01:20

Overview of the Vascular System

The vascular system comprises an extensive network of arteries, capillaries, and veins. The vascular system can be broadly divided into the blood and lymphatic systems. Typically, blood vessels can be categorized into three histological regions: tunica intima, tunica media, and tunica adventitia. The tunica intima consists of a single layer of endothelial cells attached to the basal lamina. Underlying the basal lamina is a connective tissue layer and an elastic lamina that gives stability and...
Fetal Circulation01:14

Fetal Circulation

Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
Regulation of Angiogenesis and Blood Supply01:24

Regulation of Angiogenesis and Blood Supply

Rapidly dividing tumors, embryos, and wounded tissues require more oxygen than usual, lowering the oxygen concentration in the blood. At low oxygen or hypoxic conditions, an oxygen-sensitive transcription factor called the hypoxia-inducible factor 1 or HIF1 is activated. HIF1 is a dimeric protein of alpha (ɑ) and beta (β) subunits.  Under optimal oxygen conditions, HIF1β is present in the nucleus while HIF1ɑ remains in the cytosol. HIF1ɑ is hydroxylated by prolyl hydroxylase and factor...
Diabetes Mellitus: Type 2 and Gestational01:22

Diabetes Mellitus: Type 2 and Gestational

Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...