早期饮食对长期肾脏健康的影响。

IF 2.4 Q1 PEDIATRICS
Eva Nüsken, Jenny Voggel, Gregor Fink, Jörg Dötsch, Kai-Dietrich Nüsken
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引用次数: 9

摘要

在过去的几年中,在了解营养影响如何影响长期肾脏健康方面取得了巨大进展。越来越多的证据表明,孕前和哺乳期的孕产妇营养以及产后早期的营养具有特殊的意义。本文综述了围产期能量限制、低蛋白饮食、高脂肪饮食、高果糖饮食、高盐饮食和低盐饮食以及微量营养素缺乏对肾脏影响的流行病学和实验数据。有趣的是,早期饮食的不同改变可能会给后代带来类似的后遗症。另一方面,在生命早期,不同的饮食干预可能会对分子途径产生相反的影响。重要的是,产后营养显著改变母体饮食诱导的表型。宏量或微量营养素摄入改变的后遗症包括肾单位计数改变、血压失调、钠处理改变、内皮功能障碍、炎症、线粒体功能障碍和氧化应激。此外,肾脏前列腺素代谢以及肾脏AMPK、mTOR和PPAR信号传导可能受到影响,肾素-血管紧张素-醛固酮系统可能失调。最近,早期饮食对肠道微生物群的影响导致短链脂肪酸谱的改变在动脉高血压的病因学中得到了讨论。在此背景下,围产期营养干预对肾脏疾病的预防和治疗潜力是一个新兴的研究领域。特别是有风险的个体(例如,在妊娠期间患有营养不良的母亲所生的新生儿)可以从针对性良好的饮食干预中获得不成比例的好处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Impact of early-life diet on long-term renal health.

Impact of early-life diet on long-term renal health.

In the last years, great advances have been made in the effort to understand how nutritional influences can affect long-term renal health. Evidence has accumulated that maternal nutrition before and during pregnancy and lactation as well as early postnatal nutrition is of special significance. In this review, we summarize epidemiologic and experimental data on the renal effects of perinatal exposure to energy restriction, low-protein diet, high-fat diet, high-fructose diet, and high- and low-salt diet as well as micronutrient deficiencies. Interestingly, different modifications during early-life diet may end up with similar sequelae for the offspring. On the other hand, molecular pathways can be influenced in opposite directions by different dietary interventions during early life. Importantly, postnatal nutrition significantly modifies the phenotype induced by maternal diet. Sequelae of altered macro- or micronutrient intakes include altered nephron count, blood pressure dysregulation, altered sodium handling, endothelial dysfunction, inflammation, mitochondrial dysfunction, and oxidative stress. In addition, renal prostaglandin metabolism as well as renal AMPK, mTOR, and PPAR signaling can be affected and the renin-angiotensin-aldosterone system may be dysregulated. Lately, the influence of early-life diet on gut microbiota leading to altered short chain fatty acid profiles has been discussed in the etiology of arterial hypertension. Against this background, the preventive and therapeutic potential of perinatal nutritional interventions regarding kidney disease is an emerging field of research. Especially individuals at risk (e.g., newborns from mothers who suffered from malnutrition during gestation) could disproportionately benefit from well-targeted dietary interventions.

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