Parikh Nisha I, Hwang Shih-Jen, Ingelsson Erik, Benjamin Emelia J, Fox Caroline S, Vasan Ramachandran S, Murabito Joanne M
The National Heart, Lung, and Blood Institute's Framingham Heart Study, Framingham, Mass, USA.
Am J Med. 2009 Jul;122(7):656-63.e1. doi: 10.1016/j.amjmed.2008.11.034.
Public health recommendations advocate breastfeeding in infancy as a means to reduce obesity in later life. Several prior studies relating breastfeeding to cardiovascular risk factors have been limited by lack of adjustment for maternal and participant confounding factors.
We ascertained breastfeeding history via questionnaire from mothers enrolled in the Framingham Offspring Study. In their young to middle-aged adult children enrolled in the Framingham Third Generation, we examined the relations between maternal breastfeeding history (yes, no) and cardiovascular risk factors, including body mass index (BMI), high-density lipoprotein (HDL) cholesterol, total cholesterol, triglycerides, fasting blood glucose, and systolic and diastolic blood pressure levels. We applied generalized estimating equations to account for sibling correlations and adjusted for maternal and participant lifestyle, education, and cardiovascular risk factors.
In Third Generation participants (n = 962, mean age = 41 years, 54% were women), 26% of their mothers reported breastfeeding. Compared with non-breastfed individuals, breastfed adult participants had lower multivariable-adjusted BMI (26.1 kg/m2 vs 26.9 kg/m2, P = .04) and higher HDL cholesterol levels (HDL 56.6 mg/dL vs 53.7 mg/dL, P = .01). On additional adjustment for BMI, the association between breastfeeding and HDL cholesterol was attenuated (P = .09). Breastfeeding was not associated with total cholesterol, triglycerides, fasting blood glucose, systolic blood pressure, or diastolic blood pressure.
Breastfeeding in infancy is inversely associated with adult BMI and positively associated with HDL cholesterol. Associations between breastfeeding and BMI may mediate the association between breastfeeding and HDL cholesterol.
公共卫生建议提倡婴儿期进行母乳喂养,以此作为降低日后肥胖风险的一种方式。此前一些将母乳喂养与心血管危险因素相关联的研究,因未对母亲及参与者的混杂因素进行调整而受到限制。
我们通过问卷调查确定了参与弗雷明汉后代研究的母亲的母乳喂养史。在参与弗雷明汉第三代研究的中青年成年子女中,我们研究了母亲的母乳喂养史(是、否)与心血管危险因素之间的关系,这些危险因素包括体重指数(BMI)、高密度脂蛋白(HDL)胆固醇、总胆固醇、甘油三酯、空腹血糖以及收缩压和舒张压水平。我们应用广义估计方程来考虑兄弟姐妹之间的相关性,并对母亲及参与者的生活方式、教育程度和心血管危险因素进行了调整。
在第三代参与者中(n = 962,平均年龄 = 41岁,54%为女性),其母亲中有26%报告进行过母乳喂养。与未母乳喂养的个体相比,母乳喂养的成年参与者经多变量调整后的BMI较低(26.1kg/m² 对 26.9kg/m²,P = 0.04),HDL胆固醇水平较高(HDL 56.6mg/dL 对 53.7mg/dL,P = 0.01)。在对BMI进行额外调整后,母乳喂养与HDL胆固醇之间的关联减弱(P = 0.09)。母乳喂养与总胆固醇、甘油三酯、空腹血糖、收缩压或舒张压无关。
婴儿期母乳喂养与成年后的BMI呈负相关,与HDL胆固醇呈正相关。母乳喂养与BMI之间的关联可能介导了母乳喂养与HDL胆固醇之间的关联。