心血管疾病與非酒精性脂肪肝疾病之健康編程：母體營養狀況之影響=Programming of Cardiovascular Disease and Nonalcoholic Fatty Liver Disease: The Role of Maternal Nutrition

很早人們就已經瞭解複雜性疾病例如糖尿病等的致病機轉屬於多種原因共同造成，包括遺傳變異、環境和生活習性等各種因素，彼此互相影響。近年來許多的流行病學研究證據更指出，不僅生物個體的後天環境因素影響他們自身的新陳代謝，子宮內和生命早期的營養因素也可能影響他們的代謝適應，進而增加罹患肥胖和非傳染性疾病（noncommunicable disease）的風險。這種生命早期環境因素透過母系和父系因素傳遞給下一代，並對下一代成年疾病的發生產生影響被稱為胎兒規劃（fetal programming）。其中，母體的營養狀況，包括從孕前、懷孕期及哺乳期等重要關鍵時期的營養狀況被認為是對發育中胎兒編程（programming）最具影響力。在這篇綜論，我們簡要回顧母體營養狀況，尤其是高膽固醇血症如何影響後代代謝表現型，特別是對心血管疾病與非酒精性脂肪肝疾病病程之影響，並且整理表觀遺傳學在胎兒規劃所扮演的角色。It has long been understood that most of complex diseases such as diabetes are caused by a combination of genetic, environmental and lifestyle components. More recently, emerging epidemiological evidence indicates that not only does an individual's environment influence their own metabolism, but their prenatal dietary experience and environment may also contribute to their risk of metabolic disease. This early life influence on non-communicable disease in later life has been termed fetal programming. Maternal nutritional status has been proposed to be the major programming influence on the developing fetus. Here, we review the evidence that maternal hyperlipidemia influences metabolic phenotype and the progression of cardiovascular disease and nonalcoholic fatty liver disease in offspring in mammals. We also summarize the evidence supporting a role for epigenetics in fetal programming.