在怀孕时受到肥胖症和糖尿病影响的母亲会让她们的孩子具有罹患这些疾病及其它代谢性问题的风险。但是母亲的减肥意味着孩子的健康能得到改善吗？据一项新的研究报告，并不一定如此。研究人员在大鼠中发现，母亲在接受减肥手术之后因体重减轻而有的裨益无法延续到其后代之中。这些发现对进一步理解母亲的健康会如何影响其孩子向前迈出了一步。与男子相比，妇女中有越来越多的人正在接受减肥手术，但人们就这一手术对母体健康的影响知之甚少。Bernadette Grayson及其同事让雌性大鼠吃高脂饮食以使其肥胖并接着在这些动物中做垂直袖状胃切除术；该手术涉及切除部分的胃而使其变得较小。果然，这些雌性大鼠在手术后减轻了体重。研究人员等到这些大鼠的新的体重得到稳定之后便接着让它们怀孕。
这些母体大鼠及它们的后代被喂以一种高脂饮食或一种正常饮食，而研究人员对它们的代谢的不同方面进行了检测。在其母亲手术之后无论是维持一种高脂饮食或是正常饮食，这些后代会表现出比那些没有做过手术的母体大鼠的后代情况更差的早期征兆。无论母亲的饮食如何，那些母亲做过垂直袖状胃切除术的幼年大鼠会在成年时出现更多的身体脂肪及更严重的葡萄糖不耐症。研究人员不知道究竟是何原因，但他们怀疑由减肥手术所诱导的激素或代谢改变可能给其后代制造了长期的问题。这些结果强化了对那些做过减肥手术的母亲的建议，即她们应该着眼于改善其饮食并经常运动以减少其宝宝的患病风险。此外，大多数的外科医生建议其病人在手术后再等至少18个月之后才尝试怀孕。（这些数据支持该建议。）文章的作者指出，值得注意的是，啮齿类动物与人之间有着重要的发育方面的差异，因此需要在非人类的灵长类动物及人中做进一步的研究来检验这个问题。
Sci Transl Med. doi: 10.1126/scitranslmed.3006505
B.E. Grayson; K.M. Schneider; S.C. Woods; R.J. Seeley
Obesity has profound negative consequences on female reproduction as well as on the metabolic health of offspring. Bariatric surgery is the most effective method for sustained weight loss. A critical question is whether bariatric surgery can reverse the deleterious effects of obesity on both female reproduction and subsequent offspring. Vertical sleeve gastrectomy (VSG) is a bariatric procedure rapidly growing in popularity because it provides weight loss and other metabolic benefits that are comparable to those offered by the more complicated Roux-en-Y gastric bypass (RYGB). Female rats rendered obese on a high-fat diet (HFD) underwent either VSG or sham surgery. Like their male counterparts, females had significant metabolic improvements including reduced adiposity and improved glucose tolerance. After VSG, female rats showed a more normal reproductive cycle. Despite these maternal benefits, the offspring of dams receiving VSG were born smaller and lighter than offspring of control dams that underwent sham surgery. When maintained on an HFD after puberty, these adult offspring had a greater propensity to develop glucose intolerance and increased adiposity than the offspring of lean mothers or obese mothers who underwent sham surgery. These data suggest that weight loss alone by obese mothers is not sufficient to reverse the deleterious effects of an HFD and obesity on their offspring.
