FETAL ENVIRONMENT AND CARDIO-ISCHEMIC RIS K - LITERATURE-REVIEW WITH SPECIFIC REFERENCE TO THE SYNDROME-X

The paper reviews epidemiological studies published since 1989, not in cluding ecological studies and addressing the relationship between the fetal environment and component elements of the chronic insulin resis tance syndrome (syndrome X). Thirty papers have been recorded. Birth w eight associated or not with other perinatal characteristics are studi ed in 24 articles. A relationship with further occurrence of hypertens ion (17 papers), dyslipemia (3), non insulin-dependent diabetes or alt ered glucose tolerance (8), or of a combination of these disorders (2) , has been sought for. A negative relationship between birth weight an d these disorders is found in adults, inconstantly in children. Some f indings support a mechanism implying nutritional condition during preg nancy. Methodology inaccuracies jeopardize the validity of the conclus ions drawn. The interpretation of a causal relationship between fetal environment and insulin resistance is compared to alternative assumpti ons relating to genetic mechanisms or selection biases.