Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA.
Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
Obesity (Silver Spring). 2019 Apr;27(4):621-628. doi: 10.1002/oby.22409.
The aim of this study was to test associations of prepregnancy BMI, gestational weight gain, oral glucose challenge test results, and postpartum weight loss as predictors of breast milk leptin, insulin, and adiponectin concentrations and whether these relationships vary over time.
Milk was collected at 1 and 3 months from 135 exclusively breastfeeding women from the longitudinal Mothers and Infants Linked for Healthy Growth (MILk) study. Hormones were assayed in skimmed samples using ELISA. Mixed-effects linear regression models were employed to assess main effects and effect-by-time interactions on hormone concentrations.
In adjusted models, BMI was positively associated with milk leptin (P < 0.001) and insulin (P = 0.03) and negatively associated with milk adiponectin (P = 0.02); however, the association was stronger with insulin and weaker with adiponectin at 3 months than at 1 month (time interaction P = 0.017 for insulin and P = 0.045 for adiponectin). Gestational weight gain was positively associated and postpartum weight loss was negatively associated with milk leptin (both P < 0.001), independent of BMI. Oral glucose challenge test results were not associated with these milk hormone concentrations.
Maternal weight status before, during, and after pregnancy contributes to interindividual variation in human milk composition. Continuing work will assess the role of these and other milk bioactive factors in altering infant metabolic outcomes.
本研究旨在检验孕前 BMI、妊娠期体重增加、口服葡萄糖耐量试验结果和产后体重减轻作为预测母乳瘦素、胰岛素和脂联素浓度的指标的相关性，以及这些相关性是否随时间变化而变化。
从纵向母亲和婴儿健康生长（MILk）研究的 135 名纯母乳喂养妇女中，在 1 个月和 3 个月时收集母乳。使用 ELISA 法测定脱脂样本中的激素。采用混合效应线性回归模型评估对激素浓度的主要影响和影响-时间交互作用。
在调整后的模型中，BMI 与母乳瘦素（P<0.001）和胰岛素（P=0.03）呈正相关，与母乳脂联素（P=0.02）呈负相关；然而，在 3 个月时，与胰岛素的相关性更强，与脂联素的相关性更弱，与 1 个月时相比（胰岛素的时间交互作用 P=0.017，脂联素的时间交互作用 P=0.045）。妊娠期体重增加与母乳瘦素呈正相关，产后体重减轻与母乳瘦素呈负相关（均 P<0.001），与 BMI 无关。口服葡萄糖耐量试验结果与这些母乳激素浓度无关。
妊娠前、妊娠期间和妊娠后母体体重状况导致人乳成分的个体间差异。继续研究将评估这些和其他母乳生物活性因素在改变婴儿代谢结果中的作用。
