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Developmental origins of health and disease theory in cardiology
Yuichiro Arima1, Hideoki Fukuoka2
1Department of Cardiovascular Medicine, Kumamoto University, Kumamoto City, Japan; International Research Center for Medical Science, Kumamoto University, Kumamoto City, Japan.
Insights
Low birth weight, often due to poor prenatal conditions, increases adult risk for lifestyle diseases like heart disease and diabetes. The Developmental Origin of Health and Disease theory explains this link through early-life environmental influences on later health outcomes.
Area of Science:
- Developmental Biology
- Epidemiology
- Public Health
- Genetics and Epigenetics
Background:
- Epidemiological and animal studies link lower birth weight to increased incidence of adult lifestyle-related disorders, including cardiovascular disease, diabetes, and chronic kidney disease.
- Undesired intrauterine environments such as malnutrition, smoking, alcohol consumption, or stress are associated with lower birth weight.
- The Developmental Origin of Health and Disease (DOHaD) theory, building on the Barker Hypothesis, posits that early-life exposures shape lifelong health trajectories.
Purpose of the Study:
- To review the concept of the Developmental Origin of Health and Disease (DOHaD).
- To introduce related clinical and basic research on the DOHaD theory.
- To explore the mechanisms linking early-life development to adult-onset chronic diseases.
Main Methods:
- Review of epidemiological studies, including prospective cohort and observational analyses.
- Examination of animal studies investigating the effects of intrauterine environments.
- Inclusion of recent epigenetic studies exploring molecular mechanisms.
- Overview of hormonal regulation and its role in organ development and physiological functions.
Main Results:
- Consistent association found between lower birth weight and higher cardiovascular risks in adults.
- Evidence suggests that early-life environmental insults permanently alter an individual's physiology and endocrine status.
- Epigenetic modifications are proposed as a key molecular mechanism underlying disease predisposition.
- Dysregulation of epigenetic modifications is linked to the acquisition of disease-susceptible traits.
Conclusions:
- The DOHaD theory provides a framework for understanding how early-life factors influence adult health outcomes.
- Epigenetic modifications play a crucial role in mediating the long-term effects of early-life environments on disease susceptibility.
- Further research into the molecular mechanisms of DOHaD is essential for developing preventative strategies against lifestyle-related diseases.
Abstract:
Numerous epidemiological and animal studies disclosed that birth weight is inversely associated with the incidence of the lifestyle-related disorders in adult life, such as cardiovascular disease, diabetes, and /or chronic kidney disease. Lower birth weight occurs in numerous undesired intrauterine environments including malnutrition, smoking, alcohol consumption, or stress. The Developmental Origin of Health and Disease (DOHaD) theory is based on the concept that the origins of lifestyle-related disease is formed at the time of fertilization, embryonic, fetal, and neonatal stages by the interrelation between genes and the environments (nutrition, stress, or environmental chemicals). Adult disease develops after delivery facing to abnormal environments such as over-nutrition, much stress, or lack of exercise. Disease develops through these two insults. This concept was first proposed as the "Barker Hypothesis." David Barker had discovered the relation between the lower birth weight and the higher prevalence of ischemic heart disease mortality. Previous epidemiologic studies have found the people exposed to famine during early life had higher risks of cardiovascular diseases in adulthood. Yet, the exact mechanisms that permanently change the structure, physiology, and endocrine status of an individual across their lifespan following altered growth during fetal life are not entirely clear. Epidemiological studies including prospective cohort and observational analysis of the people exposed to malnutrition during fetal or infancy have disclosed the strong relation between the lower birth weight and the higher cardiovascular risks in adults. Recent progress of epigenetic studies unveiled strong genetic association. Hormonal regulation and epigenetic modifications have an important role for proper organ development and physiological functions. The molecular mechanism of predisposition is supposed to be the epigenetics modifications. Their dysregulation is related to the acquisition of the disease-susceptible trait. In this review, we overview the concept of DOHaD and introduce related clinical and basic research.
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