Obesity and Endocrine Dysfunction Programmed by Maternal Smoking in Pregnancy and Lactation

Patricia Cristina Lisboa,Egberto Gaspar De Moura,Elaine De Oliveira

doi:10.3389/fphys.2012.00437

Abstract

Obesity is a global epidemic, and maternal smoking has been shown to be associated with the development of childhood obesity. Overall, approximately 40% of children worldwide are exposed to tobacco smoke at home. It is well known that environmental changes within a critical window of development, such as gestation or lactation, can initiate permanent alterations in metabolism that lead to diseases in adulthood, a phenomenon called programming. It is known that programming is based on epigenetic alterations (changes in DNA methylation, histone acetylation, or small interfering RNA expression) that change the expression pattern of several genes. However, little is known concerning the mechanisms by which smoke exposure in neonatal life programs the adipose tissue and endocrine function. Here, we review several epidemiological and experimental studies that confirm the association between maternal nicotine or tobacco exposure during gestation or lactation and the development of obesity and endocrine dysfunction. For example, a positive correlation was demonstrated in rodents between increased serum leptin in the neonatal period and exposure of the mothers to nicotine during lactation, and the further development of leptin and insulin resistance, and thyroid and adrenal dysfunction, in adulthood in the same offspring. Thus, a smoke-free environment during the lactation period is essential to improving health outcomes in adulthood and reducing the risk for future diseases. An understanding of the pathophysiological mechanisms underlying the effects of smoking on programming can provide new insights into therapeutic strategies for obesity.

Highlights

Obesity is a global epidemic, and maternal smoking has been shown to be associated with the development of childhood obesity
A strong association has been shown between changes caused by epigenetic insults that occur in utero or early childhood that impact the regulation of metabolic pathways related to adipogenesis and complications, including diabetes, hypertension, and dyslipidemia (Monteiro et al, 2004; Doak et al, 2005; Ozanne et al, 2011)
Hormonal changes associated with nicotine/tobacco exposure during lactation Our group has shown that maternal nicotine exposure (6 mg/kg/day) from day 2 to 16 of lactation causes neonatal hyperleptinemia and primary hypothyroidism and programs for overweight, higher visceral adiposity, adipocyte hypertrophy, hyperleptinemia, leptin and insulin resistance, and secondary hypothyroidism in adult rat offspring (Oliveira et al, 2009; de Oliveira et al, 2010)

Summary

Introduction

Obesity is a global epidemic, and maternal smoking has been shown to be associated with the development of childhood obesity. In a Chinese population, some parameters of metabolic syndrome, such as hypertriglyceridemia, central obesity, a decreased HDL-c and an increased level of fasting serum insulin in the adult offspring, have been associated with maternal cigarette smoke exposure (Xie et al, 2010).

Results

Conclusion