USDA, ARS Western Human Nutrition Research Center, Davis, California, USA.
Department of Nutrition, University of California, Davis, California, USA.
Matern Child Nutr. 2018 Apr;14(2):e12503. doi: 10.1111/mcn.12503. Epub 2017 Aug 29.
We evaluated effects of antiretroviral (ARV) therapy and lipid-based nutrient supplements (LNSs) on iron, copper, and zinc in milk of exclusively breastfeeding HIV-infected Malawian mothers and their correlations with maternal and infant biomarkers. Human milk and blood at 2, 6, and 24 weeks post-partum and blood during pregnancy (≤30 weeks gestation) were collected from 535 mothers/infant-pairs in the Breastfeeding, Antiretrovirals, and Nutrition study. The participants received ARV, LNS, ARV and LNS, or no intervention from 0 to 28 weeks post-partum. ARVs negatively affected copper and zinc milk concentrations, but only at 2 weeks, whereas LNS had no effect. Among all treatment groups, approximately 80-90% of copper and zinc and <50% of iron concentrations met the current adequate intake for infants at 2 weeks and only 1-19% at 24 weeks. Pregnancy haemoglobin was negatively correlated with milk iron at 2 and 6 weeks (r = -.18, p < .02 for both). The associations of the milk minerals with each other were the strongest correlations observed (r = .11-.47, p < .05 for all); none were found with infant biomarkers. At 2 weeks, moderately anaemic women produced milk higher in iron when ferritin was higher or TfR lower. At 6 weeks, higher maternal α-1-acid glycoprotein and C-reactive protein were associated with higher milk minerals in mildly anaemic women. Infant TfR was lower when milk mineral concentrations were higher at 6 weeks and when mothers were moderately anaemic during pregnancy. ARV affects copper and zinc milk concentrations in early lactation, and maternal haemoglobin during pregnancy and lactation could influence the association between milk minerals and maternal and infant iron status and biomarkers of inflammation.
我们评估了抗逆转录病毒(ARV)治疗和基于脂质的营养补充剂(LNS)对纯母乳喂养的感染艾滋病毒的马拉维母亲的乳汁中铁、铜和锌的影响,以及它们与母婴生物标志物的相关性。在母乳喂养、抗逆转录病毒和营养研究中,从 535 对母婴中收集了产后 2、6 和 24 周以及妊娠期间(<30 周妊娠)的人乳和血液。参与者从产后 0 至 28 周接受 ARV、LNS、ARV 和 LNS 或无干预。ARV 对铜和锌的乳汁浓度有负面影响,但仅在 2 周时,而 LNS 则没有影响。在所有治疗组中,约 80-90%的铜和锌以及<50%的铁浓度在 2 周时符合婴儿目前的充足摄入量,只有 1-19%在 24 周时符合。妊娠血红蛋白与产后 2 和 6 周的乳汁铁呈负相关(r=-0.18,p<0.02)。乳汁矿物质之间的相关性最强(r=0.11-0.47,所有均<0.05);与婴儿生物标志物均无相关性。在 2 周时,铁蛋白较高或 TfR 较低时,中度贫血的妇女产生的乳汁中铁含量较高。在 6 周时,轻度贫血的妇女,较高的母体α-1-酸性糖蛋白和 C 反应蛋白与乳汁中较高的矿物质有关。当 6 周时乳汁矿物质浓度较高或母亲在妊娠和哺乳期中度贫血时,婴儿 TfR 较低。ARV 会影响哺乳期早期的乳汁铜和锌浓度,而妊娠和哺乳期的母体血红蛋白可能会影响乳汁矿物质与母婴铁状况和炎症生物标志物的关联。