Metabolic Bone Diseases Research Group (GIEMO), University of Extremadura, School of Nursing and Occupational Therapy, Cáceres, Spain.
Arch Med Sci. 2013 Aug 30;9(4):703-8. doi: 10.5114/aoms.2013.36903. Epub 2013 Aug 8.
During lactation abundant calcium is lost from the mother as a result of the amount of breast milk produced. Lactation leads to transient fragility, with some women experiencing even fragility fractures, but nearly all of these women subsequently undergo a large increase in bone mineral density (BMD), confirming that the BMD must have declined during lactation but it increases after weaning. We have retrospectively examined the relationship between the duration of breastfeeding and bone properties in Spanish premenopausal healthy women, to identify the site-specific changes in BMD.
Four hundred and thirty-three premenopausal healthy women, 295 with a mean of 7.82 ±6.68 months of exclusive breastfeeding and 138 control women, were studied. We examined total, trabecular and cortical volumetric BMD (mg/mm(3)) at the distal radius using peripheral quantitative computed tomography. Areal BMD (g/cm(2)) was measured using dual energy X-ray absorptiometry at the femoral neck, lumbar spine, trochanter and Ward's triangle. Phalangeal bone ultrasound was measured by amplitude-dependent speed of sound.
Areal BMD analysis at L2-L4 revealed significant intergroup differences (p < 0.05). There were significant intergroup differences in the volumetric BMD in both total and cortical bone (p < 0.05). The observed BMD of breast-feeders was higher than the BMD in non-breast-feeding women. Additionally, the lactation subgroup analysis revealed significant differences in the areal BMD at trochanter and L2-L4 (p < 0.05) and in the cortical volumetric BMD (p < 0.05).
This study adds to the growing evidence that breastfeeding has no deleterious effects and may confer an additional advantage for BMD in premenopausal women.
哺乳期母亲由于产奶量的关系会大量流失钙。哺乳期会导致骨质暂时脆弱,一些女性甚至会出现脆性骨折,但几乎所有这些女性随后都会经历骨密度(BMD)的大幅增加,这证实哺乳期的 BMD 肯定会下降,但在断奶后会增加。我们回顾性地研究了西班牙绝经前健康女性母乳喂养时间与骨特性之间的关系,以确定 BMD 的特定部位变化。
研究了 433 名绝经前健康女性,其中 295 名平均有 7.82±6.68 个月的纯母乳喂养,138 名对照组女性。我们使用外周定量计算机断层扫描(pQCT)检测远端桡骨的总、小梁和皮质体积 BMD(mg/mm(3))。使用双能 X 射线吸收法(DXA)在股骨颈、腰椎、转子和 Ward 三角处测量面积 BMD(g/cm(2))。通过声速依赖幅度测量指骨骨超声。
L2-L4 的面积 BMD 分析显示组间存在显著差异(p<0.05)。总骨和皮质骨的体积 BMD 也存在显著的组间差异(p<0.05)。母乳喂养者的 BMD 高于非母乳喂养者。此外,哺乳亚组分析显示在转子和 L2-L4 处的面积 BMD(p<0.05)和皮质体积 BMD(p<0.05)存在显著差异。
本研究进一步证明母乳喂养没有不良影响,并且可能为绝经前妇女的 BMD 提供额外的优势。