摘要：Ba c k g r o u n d: In utero exposure of the fetus to a stressor can lead to disease in later life. Epigenetic mechanisms are likely mediators of later-life expression of early-life events.oB j e c t i v e s: We examined the current state of understanding of later-life diseases resulting from early-life exposures in order to identify in utero and post natal indicators of later-life diseases, develop an agenda for future research, and consider the risk a ssessment implications of this emerging knowledge. Me t h o d s: This review was developed based on our participation in a National Research Council workshop titled "Use of in Utero and Postnatal Indicators to Predict Health Outcomes Later in Life: State of the Science and Research Recommendations." We used a case study approach to high-light the later-life consequences of early-life malnutrition and arsenic exposure. di sc u ss i o n: The environmental sensitivity of the epigenome is viewed as an adaptive mechanism by which the developing organism adjusts its metabolic and homeostatic systems to suit the antici-pated extra uterine environment. Inappropriate adaptation may produce a mismatch resulting in subsequent increased susceptibility to disease. A nutritional mismatch between the prenatal and post natal environments, or early-life obesogen exposure, may explain at least some of the recent rapid increases in the rates of obesity, type 2 diabetes, and cardio vascular diseases. Early-life arsenic exposure is also associated with later-life diseases, including cardio vascular disease and cancer.co n c l u s i o n s: With mounting evidence connecting early-life exposures and later-life disease, new strategies are needed to incorporate this emerging knowledge into health protective practices
