Fetal Liver Blood Flow Distribution Role in Human Developmental Strategy to Prioritize Fat Deposition versus Brain Development 英文参考文献.docVIP

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Fetal Liver Blood Flow Distribution Role in Human Developmental Strategy to Prioritize Fat Deposition versus Brain Development 英文参考文献.doc

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Fetal Liver Blood Flow Distribution Role in Human Developmental Strategy to Prioritize Fat Deposition versus Brain Development 英文参考文献

FetalLiverBloodFlowDistribution:RoleinHuman DevelopmentalStrategytoPrioritizeFatDeposition versusBrainDevelopment Keith M. Godfrey1,2,3, Guttorm Haugen1,4*, Torvid Kiserud5,6, Hazel M. Inskip2, Cyrus Cooper2,3, Nicholas C. W. Harvey2, Sarah R. Crozier2, Sian M. Robinson2, Lucy Davies2, the Southampton Women’s Survey Study Group 2 , Mark A. Hanson 1,3 1InstituteofDevelopmentalSciences,UniversityofSouthampton,UniversityHospitalSouthamptonNHSFoundationTrust,Southampton,UnitedKingdom, 2Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom, 3Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, United Kingdom, 4Department of Obstetrics, Oslo University Hospital - Rikshospitalet and University of Oslo, Oslo, Norway, 5Department of Obstetrics and Gynecology, HaukelandUniversityHospital,Bergen,Norway, 6DepartmentofClinicalMedicine,UniversityofBergen,Bergen,Norway Abstract Amongprimates,humanneonateshavethelargestbrainsbutalsothehighestproportionofbodyfat.Ifplacentalnutrient supplyislimited,thefetusfacesadilemma:shouldresourcesbeallocatedtobraingrowth,ortofatdepositionforuseasa potentialpostnatalenergyreserve?Wehypothesisedthatresolvingthisdilemmaoperatesatthelevelofumbilicalblood distributionenteringthefetalliver.In381uncomplicatedpregnanciesinthirdtrimester,wemeasuredbloodflowperfusing thefetalliver,orbypassingitviatheductusvenosustosupplythebrainandheartusingultrasoundtechniques.Acrossthe rangeoffetalgrowthandindependentofthemother’sadiposityandparity,greaterliverbloodflowwasassociatedwith greateroffspringfatmassmeasuredbydual-energyX-rayabsorptiometry,bothintheinfantatbirth(r=0.43,P,0.001)and atage4years(r=0.16,P=0.02).Incontrast,smallerplacentaslessabletomeetfetaldemandforessentialnutrientswere associatedwithabrain-s