NAFLD at the interface of the mother-infant dyad.

This review aims to focus the links existing between several aspects of the mother-child dyad in the intricate playground of obesity and Metabolic Syndrome (MetS) including its hepatic component, the Non-Alcoholic Fatty Liver Disease (NAFLD). In recent years human and animal model studies could show that dietary interventions in mothers and offspring can be successful in reducing the risk of NAFLD development. Evidences concern also the new concept of a real intergenerational transmission of the predisposition to metabolic disorders. Certain genes, such as SIRT1 and PNPLA3, and some epigenetic modifications, including micro RNAs function, seem to be responsible for fetal reprogramming in the setting of maternal obesity. These modifiers appear to be potential therapeutic targets to reduce the risk of future metabolic dysfunctions. Controlling antepartum hyperglycemia, preventing gestational diabetes, avoiding excessive weight gain during pregnancy can help to reduce the relentless epidemic of childhood obesity and NAFLD. Also the composition of the intestinal microbiota seems to be related to the development of metabolic disorders in the offspring. Several studies show that breastfed infants have a microbial signature different from formula-fed infants. Much interestingly, prolonged breastfeeding is beneficial not only for the newborn and his health in adult life, but also for the mother health. Maternal benefits include reducing risk of developing chronic diseases, such as diabetes mellitus, myocardial infarction and NAFLD as well. In conclusion, all above mechanisms appear to intervene synergistically and may act as modifiable risk factors for infant and mother NAFLD.