在懷孕時(shí)受到肥胖癥和糖尿病影響的母親會(huì)讓她們的孩子具有罹患這些疾病及其它代謝性問題的風(fēng)險(xiǎn),。但是母親的減肥意味著孩子的健康能得到改善嗎？據(jù)一項(xiàng)新的研究報(bào)告，并不一定如此,。研究人員在大鼠中發(fā)現(xiàn)，母親在接受減肥手術(shù)之后因體重減輕而有的裨益無法延續(xù)到其后代之中,。這些發(fā)現(xiàn)對(duì)進(jìn)一步理解母親的健康會(huì)如何影響其孩子向前邁出了一步,。與男子相比，婦女中有越來越多的人正在接受減肥手術(shù),，但人們就這一手術(shù)對(duì)母體健康的影響知之甚少,。Bernadette Grayson及其同事讓雌性大鼠吃高脂飲食以使其肥胖并接著在這些動(dòng)物中做垂直袖狀胃切除術(shù)；該手術(shù)涉及切除部分的胃而使其變得較小,。果然,，這些雌性大鼠在手術(shù)后減輕了體重,。研究人員等到這些大鼠的新的體重得到穩(wěn)定之后便接著讓它們懷孕。
這些母體大鼠及它們的后代被喂以一種高脂飲食或一種正常飲食,，而研究人員對(duì)它們的代謝的不同方面進(jìn)行了檢測(cè),。在其母親手術(shù)之后無論是維持一種高脂飲食或是正常飲食，這些后代會(huì)表現(xiàn)出比那些沒有做過手術(shù)的母體大鼠的后代情況更差的早期征兆,。無論母親的飲食如何,，那些母親做過垂直袖狀胃切除術(shù)的幼年大鼠會(huì)在成年時(shí)出現(xiàn)更多的身體脂肪及更嚴(yán)重的葡萄糖不耐癥。研究人員不知道究竟是何原因,，但他們懷疑由減肥手術(shù)所誘導(dǎo)的激素或代謝改變可能給其后代制造了長期的問題,。這些結(jié)果強(qiáng)化了對(duì)那些做過減肥手術(shù)的母親的建議，即她們應(yīng)該著眼于改善其飲食并經(jīng)常運(yùn)動(dòng)以減少其寶寶的患病風(fēng)險(xiǎn),。此外,，大多數(shù)的外科醫(yī)生建議其病人在手術(shù)后再等至少18個(gè)月之后才嘗試懷孕。（這些數(shù)據(jù)支持該建議,。）文章的作者指出,，值得注意的是，嚙齒類動(dòng)物與人之間有著重要的發(fā)育方面的差異,，因此需要在非人類的靈長類動(dòng)物及人中做進(jìn)一步的研究來檢驗(yàn)這個(gè)問題,。
Sci Transl Med. doi: 10.1126/scitranslmed.3006505
B.E. Grayson; K.M. Schneider; S.C. Woods; R.J. Seeley
Obesity has profound negative consequences on female reproduction as well as on the metabolic health of offspring. Bariatric surgery is the most effective method for sustained weight loss. A critical question is whether bariatric surgery can reverse the deleterious effects of obesity on both female reproduction and subsequent offspring. Vertical sleeve gastrectomy (VSG) is a bariatric procedure rapidly growing in popularity because it provides weight loss and other metabolic benefits that are comparable to those offered by the more complicated Roux-en-Y gastric bypass (RYGB). Female rats rendered obese on a high-fat diet (HFD) underwent either VSG or sham surgery. Like their male counterparts, females had significant metabolic improvements including reduced adiposity and improved glucose tolerance. After VSG, female rats showed a more normal reproductive cycle. Despite these maternal benefits, the offspring of dams receiving VSG were born smaller and lighter than offspring of control dams that underwent sham surgery. When maintained on an HFD after puberty, these adult offspring had a greater propensity to develop glucose intolerance and increased adiposity than the offspring of lean mothers or obese mothers who underwent sham surgery. These data suggest that weight loss alone by obese mothers is not sufficient to reverse the deleterious effects of an HFD and obesity on their offspring.
