Early Growth, Cardiovascular and Renal Development: The Generation R Study
Vroege groei, de ontwikkeling van het hart, de bloedvaten en de nieren: Het Generation R Onderzoek
Cardiovascular disease is a major health problem in the adult general population. Epidemiological studies strongly suggest that early life events have an important role for the susceptibility to develop cardiovascular disease in later life. In the 1980’s, Barker and Osmond showed that areas of Britain with the highest neonatal mortality rates early in the 20th century also had the highest incidence of cardiovascular disease in adults, many decades later1. Birth weight is an important predictor of neonatal mortality. After these observations, many epidemiological studies consistently showed that low birth weight is associated with adult health outcomes such as cardiovascular disease, type 2 diabetes and kidney disease. It was also noted that the risk of cardiovascular disease was highest in subjects who show a postnatal catch-up growth after being born with a low birth weight6. These observations resulted in the “fetal origins of adult disease” hypothesis, also currently known as the “Developmental Origins of Health and Disease “ Hypothesis (DOHaD-hypothesis). This hypothesis states that a suboptimal fetal environment leads to developmental adaptations that permanently alter growth, physiology and metabolism, with long-term consequences for adult health. More recently, this hypothesis has been adapted to a more general “developmental plasticity hypothesis”, which proposes that an organism may develop in different ways, depending on the environment it is exposed to. Investigating specific adverse fetal exposures and early growth may provide new insights in mechanisms underlying the associations of low birth weight with adult disease. Different aspects of early development might be important in determining future risk of adult cardiovascular and renal diseases.
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|The Generation R Study has been made possible by financial support from the Erasmus Medical Center, Rotterdam; Erasmus University Rotterdam; and The Netherlands Organization for Health Research and Development (ZonMw), the Netherlands Organization for Scientific Research (NWO), the Ministry of Health, Welfare and Sport, and the Ministry of Youth and Families. Additional support for the studies performed in this thesis was provided by a grant from the Dutch Kidney Foundation (C08.2251). Publication of this thesis was supported by the Generation R Study Group and the Department of Epidemiology of the Erasmus Medical Center, Rotterdam, the Erasmus University Rotterdam and the Dutch Kidney Foundation. Financial support by the Dutch Heart Foundation for the publication of this thesis is gratefully acknowledged. Further support was kindly provided by Chipsoft B.V.|
|A.J. van der Heijden (Bert) , A. Hofman (Albert)|
|Erasmus University Rotterdam|
|Organisation||Erasmus MC: University Medical Center Rotterdam|