Delivery by Caesarean section, rather than vaginal delivery, promotes hepatic steatosis in piglets
Résumé
There has been a marked increase in the number of babies born by elective caesarean section (CS). Following CS, the lack of normal stimuli that occur at birth alters the thermogeneic response but any effects on hepatic metabolism had not been identified. We compared the effect of delivery on hepatic metabolism in piglets, born either by CS or vaginal delivery (VD) and fed by total parenteral nutrition, by measuring lipid metabolism and enzyme activity coupled with metabolomic and genomic approaches. Hepatic lipid in the CS piglets 7 days post-partum was in excess of 5mg/g of liver consistent with hepatic steatosis whereas in the VD piglets the amount of lipid was markedly lower (3mg/g) and below the threshold for a diagnosis of steatosis. Metabolomic analysis indicated that CS resulted in higher hepatic glycerol and lower glycerol phosphate-dehydrogenase activity suggesting that CS causes an decrease in hepatic gluconeogenesis from glycerol. CS also resulted in altered cholesterol handling and gene expression despite the same dietary intake 7 days post-partum. Furthermore the CS piglets had lower expression of interferon responsive genes, but higher expression of markers of immature hepatocytes. The data suggest that VD promotes normal liver maturation and hepatic metabolism, thereby reducing the accumulation of hepatic lipid.
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