“…The ending point of these two opposite situations is a paradoxical common prenatal metabolic programming of insulin sensitive tissues (i.e., pancreas, adipocytes, and skeletal muscle), which further explains the common later phenotype of metabolic syndrome in adulthood. In this context, diet-induced animal models have clarified that maternal obesity is associated with the following changes in the offspring: 1. adipose tissue modifications: increased sex-dependent adipogenesis (greater in males) with adipocyte hypertrophy, local inflammation enhanced PPAR- γ expression (obesogenic gene strictly related to lipid metabolism, cytokine production, and adipogenesis), reduced β 2- and β 3-adrenoreceptor expression and increased cytokine mRNA expression [ 79 , 83 , 93 ]; 2. central modifications: programmed hyperphagia (greater in male progeny), independent on postnatal nutrition, as a result of altered hypothalamic energy sensors and epigenetic responses, leading to altered development, neuronal abnormal differentiation, and appetite dysregulation [ 86 , 88 , 96 ]; 3. liver modifications: hepatic inflammation, steatosis, and fibrosis, leading to increased risk of nonalcoholic fatty liver disease, increased triglyceride accumulation and lipogenesis, enhanced proinflammatory cytokine and serum insulin expression, and premature gluconeogenic gene activation with impaired carbohydrate metabolism [ 80 , 82 , 89 ]; 4. skeletal muscle modifications: enhanced macrophage infiltration, increased inflammatory properties with upregulation of PPAR- γ , TLR2–4 , NF- κ B , and TNF α gene expression, intramuscular adipogenesis with adipocyte hypertrophy and hyperplasia, and reduced insulin receptor mRNA expression, together resulting in decreased muscular insulin sensitivity and functional impairment [ 77 , 81 , 87 , 90 , 97 ].…”