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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:ali="http://www.niso.org/schemas/ali/1.0/" article-type="review-article" dtd-version="1.2" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">Obstetrics and Gynecology</journal-id><journal-title-group><journal-title xml:lang="en">Obstetrics and Gynecology</journal-title><trans-title-group xml:lang="ru"><trans-title>Акушерство и гинекология</trans-title></trans-title-group></journal-title-group><issn publication-format="print">0300-9092</issn><issn publication-format="electronic">2412-5679</issn><publisher><publisher-name xml:lang="en">Bionika Media</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">632069</article-id><article-id pub-id-type="doi">10.18565/aig.2024.60</article-id><article-categories><subj-group subj-group-type="toc-heading" xml:lang="en"><subject>Reviews</subject></subj-group><subj-group subj-group-type="toc-heading" xml:lang="ru"><subject>Обзоры</subject></subj-group><subj-group subj-group-type="article-type"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title xml:lang="en">The concept of epigenetic modifications in fetal metabolic programming</article-title><trans-title-group xml:lang="ru"><trans-title>Концепция эпигенетических модификаций в метаболическом программировании плода</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8946-501X</contrib-id><contrib-id contrib-id-type="researcherid">С-6187-2018</contrib-id><contrib-id contrib-id-type="spin">2896-6986</contrib-id><name-alternatives><name xml:lang="en"><surname>Tezikov</surname><given-names>Yurii V.</given-names></name><name xml:lang="ru"><surname>Тезиков</surname><given-names>Юрий Владимирович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Professor, Dr. Med. Sci., Head of the Department of Obstetrics and Gynecology of the Institute of Clinical Medicine</p></bio><bio xml:lang="ru"><p>профессор, д.м.н., заведующий кафедрой акушерства и гинекологии Института клинической медицины</p></bio><email>yra.75@inbox.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7277-7431</contrib-id><contrib-id contrib-id-type="researcherid">С-5060-2018</contrib-id><contrib-id contrib-id-type="spin">9625-2947</contrib-id><name-alternatives><name xml:lang="en"><surname>Lipatov</surname><given-names>Igor S.</given-names></name><name xml:lang="ru"><surname>Липатов</surname><given-names>Игорь Станиславович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Professor, Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology of the Institute of Clinical Medicine</p></bio><bio xml:lang="ru"><p>профессор, д.м.н., профессор кафедры акушерства и гинекологии Института клинической медицины</p></bio><email>i.lipatoff2012@yandex.ru</email><xref ref-type="aff" rid="aff1"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5830-5099</contrib-id><contrib-id contrib-id-type="scopus">56190621500</contrib-id><contrib-id contrib-id-type="researcherid">B-2364-2015</contrib-id><contrib-id contrib-id-type="spin">1963-1359</contrib-id><name-alternatives><name xml:lang="en"><surname>Tyutyunnik</surname><given-names>Victor L.</given-names></name><name xml:lang="ru"><surname>Тютюнник</surname><given-names>Виктор Леонидович</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Professor, Dr. Med. Sci., Leading Researcher of the Center for Scientific and Clinical Research</p></bio><bio xml:lang="ru"><p>профессор, д.м.н., в.н.с. центра научных и клинических исследований</p></bio><email>tioutiounnik@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-5087-5946</contrib-id><contrib-id contrib-id-type="scopus">57008835600</contrib-id><contrib-id contrib-id-type="researcherid">B-2370-2015</contrib-id><contrib-id contrib-id-type="spin">5378-8437</contrib-id><name-alternatives><name xml:lang="en"><surname>Kan</surname><given-names>Natalia E.</given-names></name><name xml:lang="ru"><surname>Кан</surname><given-names>Наталья Енкыновна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Professor, Dr. Med. Sci., Deputy Director of Science</p></bio><bio xml:lang="ru"><p>профессор, д.м.н., заместитель директора по научной работе</p></bio><email>kan-med@mail.ru</email><xref ref-type="aff" rid="aff2"/></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5277-0379</contrib-id><contrib-id contrib-id-type="researcherid">KEJ-3777-2024</contrib-id><contrib-id contrib-id-type="spin">6299-0501</contrib-id><name-alternatives><name xml:lang="en"><surname>Kurbanova</surname><given-names>Aminat M.</given-names></name><name xml:lang="ru"><surname>Курбанова</surname><given-names>Аминат Мурадовна</given-names></name></name-alternatives><address><country country="RU">Russian Federation</country></address><bio xml:lang="en"><p>Assistant at the Department of Obstetrics and Gynecology of the Institute of Clinical Medicine</p></bio><bio xml:lang="ru"><p>ассистент кафедры акушерства и гинекологии Института клинической медицины</p></bio><email>aminca.kurbanova@mail.ru</email><xref ref-type="aff" rid="aff1"/></contrib></contrib-group><aff-alternatives id="aff1"><aff><institution xml:lang="en">Samara State Medical University, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБОУ ВО «Самарский государственный медицинский университет» Минздрава России</institution></aff></aff-alternatives><aff-alternatives id="aff2"><aff><institution xml:lang="en">Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia</institution></aff><aff><institution xml:lang="ru">ФГБУ «Национальный медицинский исследовательский центр акушерства, гинекологии и перинатологии имени академика В.И. Кулакова» Минздрава России</institution></aff></aff-alternatives><pub-date date-type="pub" iso-8601-date="2024-04-17" publication-format="electronic"><day>17</day><month>04</month><year>2024</year></pub-date><issue>4</issue><issue-title xml:lang="en"/><issue-title xml:lang="ru"/><fpage>5</fpage><lpage>14</lpage><history><date date-type="received" iso-8601-date="2024-05-16"><day>16</day><month>05</month><year>2024</year></date><date date-type="accepted" iso-8601-date="2024-05-16"><day>16</day><month>05</month><year>2024</year></date></history><permissions><copyright-statement xml:lang="en">Copyright ©; 2024, Bionika Media</copyright-statement><copyright-statement xml:lang="ru">Copyright ©; 2024, ООО «Бионика Медиа»</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="en">Bionika Media</copyright-holder><copyright-holder xml:lang="ru">ООО «Бионика Медиа»</copyright-holder></permissions><self-uri xlink:href="https://journals.eco-vector.com/0300-9092/article/view/632069">https://journals.eco-vector.com/0300-9092/article/view/632069</self-uri><abstract xml:lang="en"><p>This review presents the issue of fetal metabolic programming within the concept of epigenetic regulation of the genome. The paper discusses the main mechanisms of metabolic programming of the fetus in case of placental insufficiency, impaired energy supply, changes in the formation of the microbiome, somatic pathology and the influence of other factors in terms of epigenetics. The review provides a systematization of the existing knowledge about the role of epigenetic modifications of the genome in the metabolic programming of the fetus and the analysis of their significance in increasing the risk of cardiovascular diseases in the postnatal period. The analysis of the literature revealed that epigenetic mechanisms, such as DNA methylation/demethylation, histone modifications, microRNAs are able to program fetal metabolism due the changes in chromatin organization and DNA availability; fetal metabolism can be programmed under unfavorable intrauterine conditions under the influence of external and internal stimuli. The review shows the possibilities of epigenetic therapy and preventive measures aimed at reducing the burden of non-communicable diseases which are the leading causes of mortality.</p> <p><bold>Conclusion:</bold> When the number of diseases associated with metabolic syndrome steadily increases, epigenetics should be considered as a key factor reflecting the indicators of individual health. It is the fetal period that is fundamental in terms of the possibilities of epigenetic prevention and therapy, making this area promising for further study.</p></abstract><trans-abstract xml:lang="ru"><p>В представленном обзоре проблема метаболического программирования плода рассматривается в рамках концепции эпигенетической регуляции генома. Обсуждаются основные механизмы метаболического программирования плода при плацентарной недостаточности, нарушенном энергопластическом обеспечении, изменениях становления микробиома, соматической патологии и влиянии других факторов с позиции эпигенетики. Проведены систематизация существующих знаний о роли эпигенетических модификаций генома в метаболическом программировании плода и анализ их значимости в реализации высокого риска сердечно-сосудистых заболеваний в постнатальном периоде. По результатам анализа литературы выявлено, что эпигенетические механизмы, такие как метилирование/деметилирование ДНК, модификации гистонов, микроРНК путем изменения организации хроматина и доступности ДНК, способны программировать метаболизм плода в неблагоприятных внутриутробных условиях под воздействием внешних и внутренних стимулов. Показаны возможности эпигенетической терапии и реализации превентивных мер, направленных на снижение бремени неинфекционных заболеваний, являющихся ведущими причинами смертности.</p> <p><bold>Заключение: </bold>Эпигенетика должна рассматриваться как ключевой фактор, отражающий показатели индивидуального здоровья в условиях неуклонного роста числа заболеваний, ассоциированных с метаболическим синдромом, и именно фетальный период является основополагающим с позиции возможностей эпигенетической профилактики и терапии, делая данное направление перспективным для дальнейшего изучения.</p></trans-abstract><kwd-group xml:lang="en"><kwd>epigenome</kwd><kwd>fetal programming</kwd><kwd>insulin resistance</kwd><kwd>metabolic syndrome</kwd><kwd>placental insufficiency</kwd><kwd>epigenetic modifications</kwd><kwd>epigenetic therapy</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>эпигеном</kwd><kwd>фетальное программирование</kwd><kwd>инсулинорезистентность</kwd><kwd>метаболический синдром</kwd><kwd>плацентарная недостаточность</kwd><kwd>эпигенетические модификации</kwd><kwd>эпигенетическая терапия</kwd></kwd-group><funding-group/></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Silveira Rossi J.L., Barbalho S.M., Reverete de Araujo R., Bechara M.D., Sloan K.P., Sloan L.A. 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