Larsson Melanie W, Lind Mads V, Laursen Rikke Pilmann, Yonemitsu Chloe, Larnkjær Anni, Mølgaard Christian, Michaelsen Kim F, Bode Lars
Department of Nutrition, Exercise, and Sports, University of Copenhagen, København, Denmark.
Department of Nursing and Nutrition, University College Copenhagen, København, Denmark.
Front Pediatr. 2019 Jul 18;7:297. doi: 10.3389/fped.2019.00297. eCollection 2019.
Some infants experience excessive weight gain during exclusive breastfeeding. The cause is unknown, but variation in human milk composition might play a role. Several human milk koligosaccharides (HMOs) have been associated with growth velocity in breastfed infants, and it has been suggested that the mechanism could be through an effect on infant gut microbiota composition. The purpose of this exploratory study was to evaluate if HMO composition was different in milk fed to infants with excessive weight gain compared to infants with normal weight gain. Furthermore, we aimed to examine if HMO composition was associated with growth velocity and change in body composition and if there were maternal determinants of HMO composition. We recruited 13 high weight-gain (HW) and 17 normal weight-gain (NW) breastfed infants, collected human milk and anthropometry data at 5 and 9 months, and analyzed HMO composition by high performance liquid chromatography. In the HW group eight out of 11 infants received milk from secretor mothers and in the NW group 15 out of 17. Comparing milk from Secretor mothers only, four HMO's were significantly different between the HW and NW group at 5 months and two remained significant at 9 months. Total HMO concentrations as well as total HMO-bound fucose at 5 months were positively associated with both fat mass index (FMI) and weight velocity from 0 to 5 months (all < 0.025). 2'-fucosyllactose (2'-FL) was positively associated with weight velocity from 0 to 5 months and FMI at 5 months. In contrast, lacto-N-neotetraose was lower in the HW group ( = 0.012) and negatively associated with height-for-age Z-scores ( = 0.008), weight velocity from 0 to 5 months ( = 0.009) and FMI ( = 0.033). Maternal BMI at 5 months was negatively associated with 6'-sialyllactose and sialyl-lacto-N-tetraose (LSTb) and positively with 2'-FL, total HMO and total HMO-bound fucose (all ≤ 0.03). In a small cohort, we found significantly different HMO concentrations in milk to exclusively breastfed infants with excessive weight gain, suggesting that some HMOs, including 2'-FL, which is the most abundant HMO and currently added to some infant formula, could be part of the cause for the excessive weight gain.
一些婴儿在纯母乳喂养期间体重过度增加。原因尚不清楚，但母乳成分的差异可能起了作用。几种母乳低聚糖（HMOs）已被证明与母乳喂养婴儿的生长速度有关，有人认为其机制可能是通过影响婴儿肠道微生物群的组成。本探索性研究的目的是评估与体重正常增加的婴儿相比，体重过度增加的婴儿所食用的母乳中HMO成分是否不同。此外，我们旨在研究HMO成分是否与生长速度和身体成分变化相关，以及HMO成分是否存在母体决定因素。我们招募了13名高体重增加（HW）和17名正常体重增加（NW）的母乳喂养婴儿，在5个月和9个月时收集母乳和人体测量数据，并通过高效液相色谱法分析HMO成分。在HW组中，11名婴儿中有8名接受了分泌型母亲的母乳，在NW组中，17名婴儿中有15名接受了分泌型母亲的母乳。仅比较分泌型母亲的母乳，HW组和NW组在5个月时四种HMOs存在显著差异，在9个月时两种仍有显著差异。5个月时总HMO浓度以及总HMO结合岩藻糖与脂肪量指数（FMI）和0至5个月的体重增长速度均呈正相关（均<0.025）。2'-岩藻糖基乳糖（2'-FL）与0至5个月的体重增长速度以及5个月时的FMI呈正相关。相比之下，HW组中乳糖-N-新四糖含量较低（P = 0.012），且与年龄别身高Z评分呈负相关（P = 0.008），与0至5个月的体重增长速度呈负相关（P = 0.009），与FMI呈负相关（P = 0.033）。5个月时母体BMI与6'-唾液酸乳糖和唾液酸乳糖-N-四糖（LSTb）呈负相关，与2'-FL、总HMO和总HMO结合岩藻糖呈正相关（均≤0.03）。在一个小队列中，我们发现纯母乳喂养的体重过度增加婴儿所食用的母乳中HMO浓度存在显著差异，这表明一些HMOs，包括最丰富的HMO且目前已添加到一些婴儿配方奶粉中的2'-FL，可能是体重过度增加的部分原因。
