Buffered or impaired: Maternal anemia, inflammation and breast milk macronutrients in northern Kenya
Buffered or impaired: Maternal anemia, inflammation and breast milk macronutrients in northern Kenya
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DOI：
10.1002/ajpa.23752
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发表时间：
2019-02-01
影响因子：
2.8
通讯作者：
Brindle, Eleanor
中科院分区：
文献类型：
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作者：
Fujita, Masako;Ruvalcaba, Nerli Paredes;Brindle, Eleanor
背景母亲贫血对母婴二分体有不良后果。为了评估牛奶营养成分是否以及如何改变，以“缓冲”婴儿对母体贫血的潜在条件，本研究评估了牛奶常量营养素与母体缺铁性贫血（IDA），非缺铁性贫血（NIDA）和炎症之间的关联。方法对来自肯尼亚北方的横断面数据和牛奶进行二次分析（n = 204）。血红蛋白和转铁蛋白受体的结合定义IDA/NIDA。血清C反应蛋白升高定义为急性炎症。在回归模型中评估IDA、NIDA和炎症对牛奶常量营养素的影响。结果IDA（β = 0.077，p = 0.022）和NIDA（β = 0.083，p = 0.100）预测较高的总蛋白（ln）。Ida（β =-0.293，p = .002），NIDA（β =-0.313，p = 0.047）和炎症（beta =-0.269，p = .007）均预测低脂肪（ln）;然而，贫血伴随炎症预示着较高的脂肪（IDA的β = 0.655，p = 0.007，NIDA的β = 0.468，p = 0.092）。NIDA预测较高的乳糖（β = 1.020，p = .003）。结论母乳常量营养素含量在母亲贫血和炎症的存在下增加和减少，这表明在母亲应激期间比简单的营养输送受损更复杂和动态的变化。贫血时母体脂肪向乳汁的输送可能受损。母亲可以通过增加乳蛋白（患有IDA/NIDA的母亲）、乳糖（患有NIDA的母亲）或脂肪（患有贫血和炎症的母亲）来缓冲婴儿营养，以应对不利条件或母亲健康状况不佳。这项研究证明了母体微量营养素健康和炎症或感染对于促进母乳营养变化的生态理解的重要性。
Background Maternal anemia has adverse consequences for the mother-infant dyad. To evaluate whether and how milk nutrient content may change in ways that could "buffer" infants against the conditions underlying maternal anemia, this study assessed associations between milk macronutrients and maternal iron-deficiency anemia (IDA), non-iron-deficiency anemia (NIDA), and inflammation. Methods A secondary analysis of cross-sectional data and milk from northern Kenya was conducted (n = 204). The combination of hemoglobin and transferrin receptor defined IDA/NIDA. Elevated serum C-reactive protein defined acute inflammation. The effects of IDA, NIDA, and inflammation on milk macronutrients were evaluated in regression models. Results IDA (beta = 0.077, p = .022) and NIDA (beta = 0.083, p = .100) predicted higher total protein (ln). IDA (beta = -0.293, p = .002), NIDA (beta = -0.313, p = .047), and inflammation (beta = -0.269, p = .007) each predicted lower fat (ln); however, anemia accompanying inflammation predicted higher fat (beta = 0.655, p = .007 for IDA and beta = 0.468, p = .092 for NIDA). NIDA predicted higher lactose (beta = 1.020, p = .003). Conclusions Milk macronutrient content both increases and decreases in the presence of maternal anemia and inflammation, suggesting a more complicated and dynamic change than simple impairment of nutrient delivery during maternal stress. Maternal fat delivery to milk may be impaired under anemia. Mothers may buffer infant nutrition against adverse conditions or poor maternal health by elevating milk protein (mothers with IDA/NIDA), lactose (mothers with NIDA), or fat (mothers with anemia and inflammation). This study demonstrates the foundational importance of maternal micronutrient health and inflammation or infection for advancing the ecological understanding of human milk nutrient variation.