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Prenatal Stress, Glucocorticoids, and the Metabolic Syndrome

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Obesity Before Birth

Part of the book series: Endocrine Updates ((ENDO,volume 30))

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Abstract

Compelling epidemiological evidence linking exposure to an adverse intrauterine environment with a markedly elevated risk of cardiometabolic disorders in adulthood has led to the concept of “developmental programming”. One major hypothesis for early life physiological programming implicates fetal overexposure to glucocorticoids. In animal studies, prenatal glucocorticoid excess as a consequence of maternal stress, exogenous administration, or dysfunction of the placental enzyme 11β-hydroxysteroid dehydrogenase type 2 (the placental glucocorticoid “barrier”) reduces birthweight and is associated with programming effects in the offspring. Prenatal glucocorticoid overexposure is associated with persistent elevations in blood pressure, potentially secondary to effects on nephron number, renal glucocorticoid sensitivity, the renin–angiotensin system, and vascular responsiveness. Additionally, offspring exposed to excess glucocorticoid in utero have altered glucose and insulin homeostasis in adulthood, with insulin resistance and hyperglycemia, which may result from programming effects on specific genes in liver and pancreas. The long-term effects of prenatal glucocorticoid overexposure in humans have been poorly investigated thus far, although some studies have shown prenatal glucocorticoid administration to be associated with increased blood pressure, altered renal function, and insulin resistance in early adulthood. In this chapter we review the evidence for early life glucocorticoid effects on the programming of cardiometabolic risk and discuss the potential mechanisms, including alterations in organ size or cell number, changes in gene expression, altered target organ responsiveness, and epigenetic modifications.

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    Amanda J. Drake & Jonathan R. Seckl

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    Robert H Lustig

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Drake, A.J., Seckl, J.R. (2011). Prenatal Stress, Glucocorticoids, and the Metabolic Syndrome. In: Lustig, R. (eds) Obesity Before Birth. Endocrine Updates, vol 30. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-7034-3_14

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