Influence of breastfeeding during the postpartum oral glucose tolerance test on plasma glucose and insulin.
Influence of breastfeeding during the postpartum oral glucose tolerance test on plasma glucose and insulin.
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DOI：
10.1097/aog.0b013e31825b993d
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发表时间：
2012-07
影响因子：
7.2
通讯作者：
Sternfeld B
中科院分区：
文献类型：
--
作者：
Gunderson EP;Crites Y;Chiang V;Walton D;Azevedo RA;Fox G;Elmasian C;Young S;Salvador N;Lum M;Hedderson MM;Quesenberry CP;Lo JC;Ferrara A;Sternfeld B
目的：探讨产后口服葡萄糖耐量试验（OGTT）期间母乳喂养对近期妊娠期糖尿病（GDM）孕妇血糖和胰岛素的影响。参与者入组了妇女、婴儿喂养和2型糖尿病研究（SWIFT），这是一项前瞻性观察性队列研究，对象是2008年至2011年期间被诊断患有GDM并随后在产后6-9周接受2小时75 g OGTT的Kaiser Permanente北方加州成员。对于这项分析，我们选择了835名SWIFT参与者，他们报告了任何哺乳强度，并观察了在OGTT期间母乳喂养婴儿（即将婴儿放在乳房上）或不母乳喂养。在835名哺乳期妇女中，205名（25%）在产后6-9周的2小时75 g OGTT期间母乳喂养婴儿。OGTT期间母乳喂养的平均（SD）持续时间为15.3（8.1）分钟。与OGTT期间未进行母乳喂养相比，试验期间进行母乳喂养与校正后的2小时血糖均值（95%CI）降低-6.2相关（−11.5，−1.0），P=0.02，2小时胰岛素（μU/ml）乘以−15.1（-26.8，-3.5），P=0.01，2小时胰岛素的自然对数为-0.15（-0.25，-0.06），P<0.01，胰岛素敏感性指数0，120升高0.08（0.02，0.15），P=0.02，但空腹血糖或胰岛素浓度无差异。在近期GDM的产后妇女中，在2小时75 g OGTT期间母乳喂养婴儿可能会适度降低血浆2小时葡萄糖（平均降低5%），以及对葡萄糖摄入的胰岛素浓度。
To examine the effect of breastfeeding during the postpartum oral glucose tolerance test (OGTT) on maternal blood glucose and insulin among women with recent gestational diabetes mellitus (GDM). Participants were enrolled in the Study of Women, Infant Feeding, and Type 2 Diabetes (SWIFT), a prospective observational cohort study of Kaiser Permanente Northern California members who had been diagnosed with GDM and subsequently underwent a 2-hour 75 gram OGTT at 6–9 weeks postpartum for the SWIFT enrollment examinations from 2008 to 2011. For this analysis, we selected 835 SWIFT participants who reported any intensity of lactation and were observed either breastfeeding their infant (ie, putting the infant to the breast) or not breastfeeding during the OGTT. Of 835 lactating women, 205 (25%) breastfed their infant during the 2-hr 75 g OGTT at 6–9 weeks postpartum. Mean (SD) duration of breastfeeding during the OGTT was 15.3 (8.1) minutes. Compared with not having breastfed during the OGTT, having breastfed during the test was associated with lower adjusted mean (95%CI) 2-hr glucose (mg/dl) by −6.2 (−11.5, −1.0), P=0.02, 2-hr insulin (μU/ml) by −15.1 (−26.8, −3.5 ), P=0.01, and natural log 2-hr insulin by −0.15 (−0.25, −0.06), P<0.01, and with higher insulin sensitivity index0, 120 by 0.08 (0.02, 0.15), P=0.02, but no differences in plasma fasting glucose or insulin concentrations. Among postpartum women with recent GDM, breastfeeding an infant during the 2-hr 75 g OGTT may modestly lower plasma 2-hr glucose (5% lower on average), as well as insulin concentrations in response to ingestion of glucose.