Wu Yue, Yu Jiaxiao, Liu Xiyao, Wang Wenling, Chen Zhi, Qiao Juan, Liu Xiaohui, Jin Huili, Li Xin, Wen Li, Tian Jing, Saffery Richard, Kilby Mark D, Qi Hongbo, Tong Chao, Baker Philip N
Department of Obstetrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China; State Key Laboratory of Maternal and Fetal Medicine of Chongqing Municipality, Chongqing Medical University, Chongqing, 400016, China; International Collaborative Laboratory of Reproduction and Development of Chinese Ministry of Education, Chongqing Medical University, Chongqing, 400016, China.
Department of Obstetrics, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, Gansu, 730050, China.
Clin Nutr. 2021 Jun;40(6):4043-4054. doi: 10.1016/j.clnu.2021.02.014. Epub 2021 Feb 16.
Gestational diabetes mellitus (GDM) is the most common metabolic disturbance during pregnancy and leads to an altered metabolic profile of human breast milk (HBM). The association between HBM metabolites and neonatal growth in GDM pregnancies has not been thoroughly investigated.
The primary aim was to quantify differences in the HBM metabolome between normal and GDM pregnancies. The secondary aim was to identify metabolites associated with neonatal growth during the first year postpartum.
In the present study, mothers intending to exclusively breastfeed (BF) and their newborns (mother-infant pairs) were recruited at delivery (n = 129 normal pregnancies and n = 98 GDM pregnancies). HBM samples (colostrum, transition milk, and mature milk) from mothers with normal pregnancies (n = 50) and GDM pregnancies (n = 50) were subjected to metabolomic profiling via liquid chromatography tandem mass spectrometry (LC-MS/MS). Receiver operating characteristic (ROC) analysis revealed the metabolomic fingerprints of GDM-associated mature HBM. Correlations between metabolites and neonatal body weight gain (BWG) were evaluated by Spearman correlation analysis.
In total, 620 metabolites were identified in each HBM sample; 253 compounds had the same variation patterns, whereas 38 compounds had significantly different pattern transitions between the GDM and normal groups. Moreover, 12, 49 and 28 metabolites exhibited significant differences in the 3 milk types between the 2 groups. Twenty-two metabolites were confirmed by ROC analysis as metabolomic fingerprints in the mature BM of GDM patients. Ten compounds were significantly negatively correlated with neonatal growth, and only 2 unsaturated lipids (eicosatrienoic acid (FA 20:3) and lysophosphatidylcholine (LysoPC) (22:6)) were positively correlated with neonatal BWG.
GDM is associated with alterations in the HBM metabolome. Only a small subset of compounds are associated with neonatal body weight (BW).
ChiCTR-ROC-17011508. Prospectively registered on 26 May 2017 (http://www.chictr.org.cn/listbycreater.aspx).
妊娠期糖尿病（GDM）是孕期最常见的代谢紊乱疾病，会导致人乳（HBM）的代谢特征发生改变。GDM 妊娠中 HBM 代谢物与新生儿生长之间的关联尚未得到充分研究。
主要目的是量化正常妊娠和 GDM 妊娠之间 HBM 代谢组的差异。次要目的是确定产后第一年与新生儿生长相关的代谢物。
在本研究中，招募了打算纯母乳喂养（BF）的母亲及其新生儿（母婴对）（正常妊娠 129 对，GDM 妊娠 98 对）。对正常妊娠母亲（50 例）和 GDM 妊娠母亲（50 例）的 HBM 样本（初乳、过渡乳和成熟乳）通过液相色谱串联质谱（LC-MS/MS）进行代谢组学分析。受试者工作特征（ROC）分析揭示了 GDM 相关成熟 HBM 的代谢组学指纹。通过 Spearman 相关分析评估代谢物与新生儿体重增加（BWG）之间的相关性。
每个 HBM 样本共鉴定出 620 种代谢物；253 种化合物具有相同的变化模式，而 38 种化合物在 GDM 组和正常组之间具有明显不同的模式转变。此外，两组间 3 种乳类中的 12、49 和 28 种代谢物存在显著差异。22 种代谢物经 ROC 分析确认为 GDM 患者成熟母乳中的代谢组学指纹。10 种化合物与新生儿生长显著负相关，只有 2 种不饱和脂质（二十碳三烯酸（FA 20:3）和溶血磷脂酰胆碱（LysoPC）（22:6））与新生儿 BWG 正相关。
GDM 与 HBM 代谢组的改变有关。只有一小部分化合物与新生儿体重（BW）有关。
ChiCTR-ROC-17011508。于 2017 年 5 月 26 日前瞻性注册（http://www.chictr.org.cn/listbycreater.aspx）。
