School of Human Nutrition, McGill University, (Macdonald Campus), Ste-Anne de Bellevue, QC H9X 3V9, Canada.
Center for Iron Disorders, David Geffen School of Medicine, University of California, Los Angeles, CA 90089, USA.
Nutrients. 2022 Aug 25;14(17):3497. doi: 10.3390/nu14173497.
Maternal infections, nutrient deficiencies, and inflammation (MINDI) co-exist in lactating indigenous women in Panama, but their impact on maternal iron status and infant growth is unknown. For this secondary analysis of cross-sectional data of lactating mothers from our MINDI cohort, we investigated associations of MINDI variables with maternal anemia, elevated serum transferrin receptor (sTfR), low serum iron, hepcidin, ferritin, and infant weight-for-age (WAZ), length-for-age (LAZ), and head-circumference-for-age (HCAZ) Z-scores in 99 mother-infant dyads. A bootstrapping resampling procedure preselected covariates for inclusion in multivariable regressions models from chronic maternal infections and nutritional status [folate, vitamins A, D, retinol-binding protein (RBP), insulin-growth factor-1 (IGF-1)] and inflammation [C-reactive protein (CRP), cytokines, platelet indices] indicators. Anemia was prevalent (53.5%) but underestimated due to widespread low plasma volume (<2.2 L, 79.9%) and was associated with indicators of malnutrition [lower IGF-1, body mass index (BMI), vitamin D, and intake of green/leafy vegetables], but not inflammation. Higher CRP was associated with lower serum iron, and higher hepcidin and ferritin, whereas maternal platelets were associated with lower HCAZ (β = −0.22), WAZ (β = −0.17), and LAZ (β = −0.17). Higher LAZ was also associated with maternal serum vitamin D (β = 0.23), whereas maternal iron supplementation lowered LAZ (β = −0.22). Assessment of iron status in this MINDI cohort is complex and supplementation strategies must consider consequences for both the mother and the infant.
在巴拿马的哺乳期土着妇女中，母体感染、营养缺乏和炎症（MINDI）同时存在，但它们对产妇铁状况和婴儿生长的影响尚不清楚。本研究对我们的 MINDI 队列中哺乳期母亲的横断面数据进行了二次分析，调查了 MINDI 变量与母亲贫血、血清转铁蛋白受体（sTfR）升高、血清铁、铁调素、铁蛋白以及婴儿体重年龄（WAZ）、身长年龄（LAZ）和头围年龄（HCAZ）Z 评分之间的关系。采用 bootstrap 重采样程序，从慢性母体感染和营养状况[叶酸、维生素 A、D、视黄醇结合蛋白（RBP）、胰岛素样生长因子-1（IGF-1）]和炎症[C 反应蛋白（CRP）、细胞因子、血小板指数]指标中预选出纳入多变量回归模型的协变量。贫血患病率较高（53.5%），但由于广泛存在低血浆量（<2.2 L，79.9%）而被低估，与营养不良指标[较低的 IGF-1、体重指数（BMI）、维生素 D 和绿叶蔬菜摄入量]有关，但与炎症无关。较高的 CRP 与较低的血清铁以及较高的铁调素和铁蛋白有关，而母亲的血小板与较低的 HCAZ（β=−0.22）、WAZ（β=−0.17）和 LAZ（β=−0.17）有关。较高的 LAZ 也与母亲血清维生素 D 有关（β=0.23），而母亲补铁则降低了 LAZ（β=−0.22）。在这个 MINDI 队列中评估铁状况较为复杂，补充策略必须考虑到对母亲和婴儿的双重影响。
