title: Exercise as an intervention to improve metabolic outcomes after intrauterine growth restriction.
abstract: Individuals born after intrauterine growth restriction (IUGR) are at an increased risk of developing diabetes in their adult life. IUGR impairs β-cell function and reduces β-cell mass, thereby diminishing insulin secretion. IUGR also induces insulin resistance, with impaired insulin signaling in muscle in adult humans who were small for gestational age (SGA) and in rodent models of IUGR. There is epidemiological evidence in humans that exercise in adults can reduce the risk of metabolic disease following IUGR. However, it is not clear whether adult IUGR individuals benefit to the same extent from exercise as do normal-birth-weight individuals, as our rat studies suggest less of a benefit in those born IUGR. Importantly, however, there is some evidence from studies in rats that exercise in early life might be able to reverse or reprogram the long-term metabolic effects of IUGR. Studies are needed to address gaps in current knowledge, including determining the mechanisms involved in the reprogramming effects of early exercise in rats, whether exercise early in life or in adulthood has similar beneficial metabolic effects in larger animal models in which insulin resistance develops after IUGR. Human studies are also needed to determine whether exercise training improves insulin secretion and insulin sensitivity to the same extent in IUGR adults as in control populations. Such investigations will have implications for customizing the recommended level and timing of exercise to improve metabolic health after IUGR.
authors.affiliation: Robinson Institute and School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia;
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Gatford
authors.forename: Gunveen
authors.initials: G
authors.lastname: Kaur
authors.forename: Filippe
authors.initials: F
authors.lastname: Falcão-Tebas
authors.forename: Glenn D
authors.initials: GD
authors.lastname: Wadley
authors.forename: Mary E
authors.initials: ME
authors.lastname: Wlodek
authors.forename: Rhianna C
authors.initials: RC
authors.lastname: Laker
authors.forename: Peter R
authors.initials: PR
authors.lastname: Ebeling
authors.forename: Glenn K
authors.initials: GK
authors.lastname: McConell
mesh_terms: D000328:Adult; D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D005081:Exercise Therapy; D005260:Female; D005317:Fetal Growth Retardation / Q000378:metabolism* / Q000628:therapy*; D006801:Humans; D050417:Insulin-Secreting Cells / Q000378:metabolism*; D010805:Physical Conditioning, Animal; D011247:Pregnancy; D051381:Rats; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose
keywords: IUGR; glucose tolerance; insulin secretion; insulin sensitivity; physical activity; training; β-cells