Fradet Alice, Berthiaume Line, Laroche Laurie-Anne, Dugas Camille, Perron Julie, Doyen Alain, Audet-Walsh Étienne, Robitaille Julie
Centre NUTRISS-Nutrition, Health, and Society, Institute of Nutrition and Functional Foods (INAF), Université Laval, Quebec City, QC G1V 0A6, Canada.
Endocrinology-Nephrology Research Axis, CHU de Québec Research Centre, Université Laval, Quebec City, QC G1V 4G2, Canada.
Nutrients. 2025 Apr 26;17(9):1466. doi: 10.3390/nu17091466.
BACKGROUND/OBJECTIVES: Gestational diabetes mellitus (GDM) is a condition characterized by hyperglycemia and is associated with increased risk of obesity and diabetes in exposed children. Differences in human milk composition between women with (GDM+) and without GDM (GDM-) suggest that GDM could impact milk production and composition, potentially influencing infant growth. However, this association remains poorly understood. The objective was to study the association between GDM and human milk composition and its influence on infant growth, focusing on metabolites and bioactive molecules involved in energy metabolism.
Using a cross-sectional design, 24 metabolites were measured by GC-MS in human milk obtained at 2 months postpartum from 20 GDM+ women and 29 GDM- women. Anthropometric measures, as well as lipid and glycemic profiles, were collected. Infant weight and length data were obtained from health records.
Human milk metabolites significantly differ between GDM+ and GDM- mothers, with higher levels of myristic acid, glycerol, uracil, arachidonic acid, and cholesterol in GDM+ milk ( < 0.05). Specific human milk metabolites showed distinct correlations with maternal glycemic as well as infant growth, depending on GDM status. While maternal glycemia was associated with succinate and malate in all groups, maternal glycemia was specifically correlated with valine and glutamate in GDM+ mothers. Additionally, in GDM+ women, α-ketoglutarate and glycine were negatively correlated with infant growth.
The results of this study suggest that GDM can influence the mother's health beyond delivery, impacting the mammary gland biology with effects on the human milk composition. Further, correlations with infant growth suggest that GDM-dependent variations in milk composition potentially influence infant growth and metabolism.
背景/目的：妊娠期糖尿病（GDM）是一种以高血糖为特征的疾病，与暴露儿童肥胖和糖尿病风险增加有关。患有GDM（GDM+）和未患GDM（GDM-）的女性母乳成分存在差异，这表明GDM可能会影响乳汁分泌和成分，进而潜在地影响婴儿生长。然而，这种关联仍未得到充分理解。本研究的目的是探讨GDM与母乳成分之间的关联及其对婴儿生长的影响，重点关注参与能量代谢的代谢物和生物活性分子。
采用横断面设计，通过气相色谱-质谱联用（GC-MS）对20名GDM+女性和29名GDM-女性产后2个月的母乳中的24种代谢物进行了测定。收集了人体测量指标以及血脂和血糖谱。婴儿体重和身长数据来自健康记录。
GDM+和GDM-母亲的母乳代谢物存在显著差异，GDM+母乳中肉豆蔻酸、甘油、尿嘧啶、花生四烯酸和胆固醇水平较高（<0.05）。特定的母乳代谢物与母亲血糖以及婴儿生长呈现出不同的相关性，具体取决于GDM状态。虽然在所有组中母亲血糖都与琥珀酸和苹果酸相关，但在GDM+母亲中，母亲血糖与缬氨酸和谷氨酸特异性相关。此外，在GDM+女性中，α-酮戊二酸和甘氨酸与婴儿生长呈负相关。
本研究结果表明，GDM对母亲健康的影响不仅限于分娩后，还会影响乳腺生物学，进而影响母乳成分。此外，与婴儿生长的相关性表明，GDM导致的母乳成分变化可能会影响婴儿的生长和代谢。
