Multiple Indicators of Undernutrition, Infection, and Inflammation in Lactating Women Are Associated with Maternal Iron Status and Infant Anthropometry in Panama: The MINDI Cohort.
Multiple Indicators of Undernutrition, Infection, and Inflammation in Lactating Women Are Associated with Maternal Iron Status and Infant Anthropometry in Panama: The MINDI Cohort.
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DOI：
10.3390/nu14173497
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发表时间：
2022-08-25
期刊：
影响因子：
5.9
通讯作者：
Koski, Kristine G.
中科院分区：
文献类型：
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作者：
Gonzalez-Fernandez, Doris;Nemeth, Elizabeta;Pons, Emerita Del Carmen;Sinisterra, Odalis Teresa;Rueda, Delfina;Starr, Lisa;Sangkhae, Veena;Murillo, Enrique;Scott, Marilyn E.;Koski, Kristine G.
关键词：
在巴拿马的哺乳土著妇女中，母体感染、营养缺乏和炎症(Mindi)共存，但它们对母体铁状况和婴儿生长的影响尚不清楚。为了对我们Mindi队列中哺乳母亲的横断面数据进行二次分析，我们调查了99对母婴中Mindi变量与母亲贫血、血清转铁蛋白受体(STfR)升高、低血清铁、庚西丁、铁蛋白以及婴儿年龄体重(WAZ)、年龄长度(LAZ)和头围(HCAZ)Z分数的关系。一种自举重采样程序，预先选择协变量以包括在慢性孕产妇感染和营养状况[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]指标的多变量回归模型中。贫血很普遍(53.5%)，但由于普遍的低血浆量(<；2.2 L，79.9%)而被低估，并与营养不良指标[较低的胰岛素样生长因子-1、体重指数、维生素D和进食绿色/绿叶蔬菜]有关，但与炎症无关。高C反应蛋白与较低的血清铁、较高的海普西丁和铁蛋白相关，而母血小板与较低的HCAZ值(β=−0.22)、WAZ值(β=−0.17)和LAZ值(β=−0.17)相关。更高的LAZ与母亲血清维生素D有关(β=0.23)，而母亲补充铁降低了LAZ(β=−=0.22)。在这个Mindi队列中，对铁状况的评估是复杂的，补充策略必须考虑对母亲和婴儿的影响。
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.
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