Abstract

Intrauterine growth restriction (IUGR) of the fetus, resulting from placental insufficiency (PI), is characterized by low fetal oxygen and nutrient concentrations that stunt growth rates of metabolic organs. Numerous animal models of IUGR recapitulate pathophysiological conditions found in human fetuses with IUGR. These models provide insight into metabolic dysfunction in skeletal muscle and liver. For example, cellular energy production and metabolic rate are decreased in the skeletal muscle and liver of IUGR fetuses. These metabolic adaptations demonstrate that fundamental processes in mitochondria, such as substrate utilization and oxidative phosphorylation, are tempered in response to low oxygen and nutrient availability. As a central metabolic organelle, mitochondria coordinate cellular metabolism by coupling oxygen consumption to substrate utilization in concert with tissue energy demand and accretion. In IUGR fetuses, reducing mitochondrial metabolic capacity in response to nutrient restriction is advantageous to ensure fetal survival. If permanent, however, these adaptations may predispose IUGR fetuses toward metabolic diseases throughout life. Furthermore, these mitochondrial defects may underscore developmental programming that results in the sequela of metabolic pathologies. In this review, we examine how reduced nutrient availability in IUGR fetuses impacts skeletal muscle and liver substrate catabolism, and discuss how enzymatic processes governing mitochondrial function, such as the tricarboxylic acid cycle and electron transport chain, are regulated. Understanding how deficiencies in oxygen and substrate metabolism in response to placental restriction regulate skeletal muscle and liver metabolism is essential given the importance of these tissues in the development of later lifer metabolic dysfunction.

Highlights

  • Many cases of intrauterine growth restriction (IUGR) of the fetus are caused by reductions in placental mass and function resulting in lower fetal nutrient and oxygen availability

  • IUGR fetuses have an early activation of hepatic glucose production, an adenosine triphosphate (ATP) and substrate demanding process that is absent in the normal fetus but activated to counteract hypoglycemia [7, 74, 120]

  • Skeletal muscle and liver serve as major metabolic tissues but exhibit distinct metabolic responses to fetal conditions causing IUGR (Figure 5)

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Summary

INTRODUCTION

Many cases of intrauterine growth restriction (IUGR) of the fetus are caused by reductions in placental mass and function resulting in lower fetal nutrient and oxygen availability. The skeletal muscle and liver each comprise a small amount of the total fetal weight near term (~10% for skeletal mass and 3–4% for liver mass) [19,20,21,22] Combined, these tissues are responsible for 40–50% of the total fetal oxygen consumption, underscoring their importance as two of the largest metabolic organs in the fetus [19, 23]. Individuals born IUGR are at risk of increased morbidities due to impaired substrate metabolism combined with lower lean mass and greater adiposity These observations highlight that placental restriction negatively impacts prenatal metabolism, alters lean-to-fat mass ratios, which, through developmental programming mechanisms, negatively affects postnatal energy balance. We will discuss our current understanding of mitochondrial metabolism in the skeletal muscle and liver of IUGR fetuses and present gaps in the field

MAINTENANCE OF OXIDATIVE PHOSPHORYLATION IN MITOCHONDRIA
ANIMAL MODELS OF IUGR WITH METABOLIC DYSFUNCTION
MITOCHONDRIAL METABOLISM AND DYSFUNCTION IN ANIMAL MODELS OF IUGR
Skeletal Muscle
CONCLUSION
Findings
AUTHOR CONTRIBUTIONS
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