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墨西哥儿童3个月大时的母乳喂养状况与4岁时的肥胖及心脏代谢指标相关。

Breastfeeding status at age 3 months is associated with adiposity and cardiometabolic markers at age 4 years in Mexican children.

作者信息

Ramirez-Silva Ivonne, Rivera Juan A, Trejo-Valdivia Belem, Martorell Reynaldo, Stein Aryeh D, Romieu Isabelle, Barraza-Villarreal Albino, Ramakrishnan Usha

机构信息

Center for Nutrition and Health Research, and.

Center for Nutrition and Health Research, and

出版信息

J Nutr. 2015 Jun;145(6):1295-302. doi: 10.3945/jn.114.198366. Epub 2015 Apr 29.

Abstract

BACKGROUND

The effect of breastfeeding (BF) on cardiometabolic risk factors is not well characterized.

OBJECTIVE

The objective was to assess the association of BF status at 3 mo and duration with adiposity and cardiometabolic markers at 4 y.

METHODS

We studied 727 children with prospectively collected BF information and anthropometric measurements at 4 y, of whom 524 provided a nonfasting blood sample. BF status at 3 mo was classified as exclusive or predominant (EBF-PreBF), partial (PaBF), or nonbreastfeeding (NBF). Total duration of any BF was classified as <3 mo, 3- 6 mo, >6 to 12 mo, and >12 mo. We modeled associations of BF with body mass index (BMI; in kg/m(2)), serum total cholesterol and low-density lipoprotein (LDL) cholesterol, triglycerides (TGs), and insulin at 4 y.

RESULTS

Children who were NBF or PaBF at 3 mo had higher BMI [0.46 (95% CI: 0.16, 0.76) and 0.31 (95% CI: 0.07, 0.54), respectively] than the EBF-PreBF group (P < 0.01). NBF children had higher total cholesterol (8.02 mg/dL; 95% CI: 1.39, 14.64; P = 0.02) than children who were EBF-PreBF. LDL cholesterol (5.04 mg/dL; 95% CI: -0.72, 10.81) and TGs (12% change; 95% CI: -0.01, 0.24) showed similar patterns. An inverse association between EBF-PreBF and insulin, mediated through abdominal circumference, was documented (P < 0.05). Children breastfed <3 mo had higher BMI (0.44; 95% CI: 0.11, 0.77) at 4 y than children breastfed for >12 mo.

CONCLUSION

EBF and PreBF at 3 mo were associated with lower adiposity and serum total cholesterol in children at 4 y. In addition, BF >12 mo was associated with lower adiposity. These data confirm the importance of exclusive BF and prolonged BF for later cardiometabolic health.

摘要

背景

母乳喂养(BF)对心血管代谢危险因素的影响尚未得到充分描述。

目的

评估3个月时的母乳喂养状况及持续时间与4岁时肥胖及心血管代谢指标之间的关联。

方法

我们研究了727名前瞻性收集了母乳喂养信息及4岁时人体测量数据的儿童,其中524名提供了非空腹血样。3个月时的母乳喂养状况分为纯母乳喂养或主要母乳喂养(EBF-PreBF)、部分母乳喂养(PaBF)或非母乳喂养(NBF)。任何母乳喂养的总持续时间分为<3个月、3 - 6个月、>6至12个月和>12个月。我们建立了母乳喂养与4岁时体重指数(BMI,单位:kg/m²)、血清总胆固醇、低密度脂蛋白(LDL)胆固醇、甘油三酯(TGs)和胰岛素之间的关联模型。

结果

3个月时为NBF或PaBF的儿童的BMI分别比EBF-PreBF组高[0.46(95%CI:0.16,0.76)和0.31(95%CI:0.07,0.54)](P < 0.01)。NBF儿童的总胆固醇比EBF-PreBF儿童高(8.02mg/dL;95%CI:1.39,14.64;P = 0.02)。LDL胆固醇(5.04mg/dL;95%CI:-0.72,10.81)和TGs(变化12%;95%CI:-0.01,0.24)呈现相似模式。记录到EBF-PreBF与胰岛素之间通过腹围介导的负相关(P < 0.05)。4岁时,母乳喂养<3个月的儿童比母乳喂养>12个月的儿童BMI更高(0.44;95%CI:0.11,0.77)。

结论

3个月时的纯母乳喂养和主要母乳喂养与4岁儿童较低的肥胖程度和血清总胆固醇相关。此外,母乳喂养>12个月与较低的肥胖程度相关。这些数据证实了纯母乳喂养和延长母乳喂养对后期心血管代谢健康的重要性。

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