生命第一年接受添加牛乳脂肪球膜配方奶粉的婴儿在 24 月龄时的微量营养素、代谢和炎症生物标志物：一项随机对照试验。

Micronutrient, Metabolic, and Inflammatory Biomarkers through 24 Months of Age in Infants Receiving Formula with Added Bovine Milk Fat Globule Membrane through the First Year of Life: A Randomized Controlled Trial.

机构信息

Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.

Medical Sciences, Reckitt|Mead Johnson Nutrition Institute, Evansville, IN, USA; School of Medicine, Indiana University, Evansville, IN, USA.

出版信息

J Nutr. 2023 Feb;153(2):511-522. doi: 10.1016/j.tjnut.2022.12.006. Epub 2022 Dec 24.

DOI:10.1016/j.tjnut.2022.12.006

PMID:36894243

Abstract

BACKGROUND

Bovine milk fat globule membrane (MFGM) added in infant formula supports typical growth and safety through 24 mo of age in term infants.

OBJECTIVES

To assess micronutrient (zinc, iron, ferritin, transferrin receptor), metabolic [glucose, insulin, Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), insulin-like growth factor-1 (IGF-1), triglycerides (TGs), total cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C)], and inflammatory (leptin, adiponectin, high sensitivity C-reactive protein) secondary outcomes through 24 mo of age in infants who received standard cow's milk-based infant formula (SF), similar formula with added bovine MFGM (EF), or human milk (HM) through 1 y.

METHODS

Infants whose parents agreed to a blood draw at baseline (<120 d of age) (SF = 80; EF = 80; HM = 83) were included. Subsequent collections (2-4 h fasting) occurred at D180, D365, and D730. Biomarker concentrations were analyzed and group changes tested using generalized estimating equations models.

RESULTS

Only serum iron (+22.1 μg/dL) and HDL-C (+2.5 mg/dL) were significantly higher for EF compared with SF at D730. Prevalence of zinc deficiency for EF (-17.4%) and SF (-16.6%) at D180 and depleted iron stores for SF (+21.4%) at D180 and EF (-34.6%) and SF (-28.0%) at D365 were significantly different compared with HM. IGF-1 (ng/mL) for EF and SF was significantly higher at D180 (+8.9) and for EF (+8.8) at D365, and (+14.5) at D730 compared with HM. Insulin (μUI/mL) for EF (+2.5) and SF (+5.8) and HOMA-IR for EF (+0.5) and SF (+0.6) were significantly higher compared with HM at D180. TGs (mg/dL) for SF (+23.9) at D180, for EF (+19.0) and SF (+17.8) at D365, and EF (+17.3) and SF (+14.5) at D730 were significantly higher compared with HM. Zinc, ferritin, glucose, LDL-C and total cholesterol changes were higher in formula groups compared with HM between various time points.

CONCLUSIONS

Micronutrient, metabolic, and inflammatory biomarkers were generally similar through 2 y in infants who received infant formula with or without added bovine MFGM. Over the 2 y, differences were observed between infant formulas and HM reference group. This trial was registered at clinicaltrials.gov as NTC02626143.

摘要

背景

在足月婴儿中，配方奶粉中添加牛乳脂肪球膜（MFGM）可支持典型的生长和安全性，持续至 24 月龄。

目的

评估通过添加 MFGM 的配方奶（EF）或人乳（HM）与标准牛乳基配方奶（SF）进行比较，在 24 月龄内对微量营养素（锌、铁、铁蛋白、转铁蛋白受体）、代谢[葡萄糖、胰岛素、稳态模型评估的胰岛素抵抗（HOMA-IR）、胰岛素样生长因子-1（IGF-1）、甘油三酯（TGs）、总胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）]和炎症（瘦素、脂联素、高敏 C 反应蛋白）的次要结局进行评估。

方法

纳入父母同意在基线时（<120 日龄）进行血液采集的婴儿（SF=80；EF=80；HM=83）。随后在 D180、D365 和 D730 进行（2-4 h 禁食）采集。使用广义估计方程模型分析生物标志物浓度，并检测组间变化。

结果

仅 EF 组在 D730 时血清铁（+22.1μg/dL）和 HDL-C（+2.5mg/dL）显著高于 SF 组。EF（-17.4%）和 SF（-16.6%）在 D180 时缺锌的发生率和 SF（+21.4%）和 EF（-34.6%）和 SF（-28.0%）在 D365 时缺铁储存的发生率与 HM 相比差异显著。EF 和 SF 在 D180 时 IGF-1（ng/mL）显著升高（+8.9），EF 在 D365 时 IGF-1（+8.8）和 D730 时 IGF-1（+14.5）与 HM 相比显著升高。EF（+2.5）和 SF（+5.8）在 D180 时胰岛素（μUI/mL）和 EF（+0.5）和 SF（+0.6）在 D180 时 HOMA-IR 均显著高于 HM。SF（+23.9）在 D180、EF（+19.0）和 SF（+17.8）在 D365、EF（+17.3）和 SF（+14.5）在 D730 时 TGs（mg/dL）均显著高于 HM。在不同时间点，与 HM 相比，配方奶粉组的锌、铁蛋白、葡萄糖、LDL-C 和总胆固醇变化较高。