Quifer-Rada Paola, Aguilar-Camprubí Laia, Samino Sara, Amigó Nuria, Soler Oria, Padró-Arocas Alba
LactApp Women Health, 08014 Barcelona, Spain.
Department of Endocrinology & Nutrition, Biomedical Research Institute Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.
Metabolites. 2024 Oct 21;14(10):566. doi: 10.3390/metabo14100566.
: Mastitis is one of the main complications during breastfeeding and contributes to the cessation of breastfeeding. However, the etiopathogenesis and diagnosis of mastitis are complex and not yet well defined. We aimed to identify metabolic and lipidic changes in human milk during acute and subacute mastitis in order to detect potential biomarkers of mastitis. We conducted a pilot case-control study including 14 breastfeeding women with acute mastitis, 32 with subacute mastitis symptoms, and 19 without any mastitis symptoms (control). Milk samples were collected and analyzed by proton nuclear magnetic resonance (H-NMR) for metabolomics analysis. To assess the association between the significant metabolites and lipids and the development of acute and subacute mastitis, multi-adjusted logistic regression models were developed. The NMR-based metabolomics approach was able to identify and quantify a total of 40 metabolites in breast milk samples. After adjusting for confounding variables, acute mastitis was significantly associated with acetate (OR 3.9 IC 1.4-10.8), total cholesterol (OR 14 CI 3.2-62), esterified cholesterol (OR 3.3 CI 1.9-5.8), and sphingomyelin (OR 2.6 CI 1.2-5.8). The other metabolites presented weak association (OR < 2.5). Subacute mastitis was significantly associated with glutamine, lysophosphatidylcholine, phosphatidylcholine, plasmalogen, and total polyunsaturated fatty acids, but only cholesterol showed a strong association (OR > 2.5) with an OR of 2.6 (IC 1.1-6.6). : Metabolic alteration in breast milk occurs during a process of both acute and subacute mastitis. Acetate, esterified cholesterol, lysophostidylcholine, and polyunsaturated fatty acids increased in both acute and subacute mastitis. However, according to the multi-adjusted regression logistic models, the candidate biomarkers for acute and subacute mastitis are cholesterol, lysophosphatidylcoholine, phosphatidylcholine, plasmalogen, and polyunsaturated fatty acids.
乳腺炎是母乳喂养期间的主要并发症之一，会导致母乳喂养停止。然而，乳腺炎的病因发病机制和诊断较为复杂，尚未完全明确。我们旨在确定急性和亚急性乳腺炎期间人乳中的代谢和脂质变化，以检测乳腺炎的潜在生物标志物。我们进行了一项试点病例对照研究，纳入了14名患有急性乳腺炎的哺乳期妇女、32名有亚急性乳腺炎症状的妇女以及19名无任何乳腺炎症状的妇女（对照组）。收集乳汁样本并通过质子核磁共振（H-NMR）进行代谢组学分析。为了评估显著代谢物和脂质与急性和亚急性乳腺炎发展之间的关联，建立了多因素调整逻辑回归模型。基于核磁共振的代谢组学方法能够识别和定量母乳样本中的总共40种代谢物。在调整混杂变量后，急性乳腺炎与乙酸盐（比值比3.9，可信区间1.4 - 10.8）、总胆固醇（比值比14，可信区间3.2 - 62）、酯化胆固醇（比值比3.3，可信区间1.9 - 5.8）和鞘磷脂（比值比2.6，可信区间1.2 - 5.8）显著相关。其他代谢物呈现弱关联（比值比<2.5）。亚急性乳腺炎与谷氨酰胺、溶血磷脂酰胆碱、磷脂酰胆碱、缩醛磷脂和总多不饱和脂肪酸显著相关，但只有胆固醇显示出强关联（比值比>2.5），比值比为2.6（可信区间1.1 - 6.6）。：母乳中的代谢改变发生在急性和亚急性乳腺炎过程中。乙酸盐、酯化胆固醇、溶血磷脂酰胆碱和多不饱和脂肪酸在急性和亚急性乳腺炎中均增加。然而，根据多因素调整回归逻辑模型，急性和亚急性乳腺炎的候选生物标志物是胆固醇、溶血磷脂酰胆碱、磷脂酰胆碱、缩醛磷脂和多不饱和脂肪酸。
