Lactation intensity and postpartum maternal glucose tolerance and insulin resistance in women with recent GDM: the SWIFT cohort.
Lactation intensity and postpartum maternal glucose tolerance and insulin resistance in women with recent GDM: the SWIFT cohort.
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DOI：
10.2337/dc11-1409
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发表时间：
2012-01
期刊：
影响因子：
16.2
通讯作者：
Selby JV
中科院分区：
文献类型：
--
作者：
Gunderson EP;Hedderson MM;Chiang V;Crites Y;Walton D;Azevedo RA;Fox G;Elmasian C;Young S;Salvador N;Lum M;Quesenberry CP;Lo JC;Sternfeld B;Ferrara A;Selby JV
根据妊娠期糖尿病（GDM）患者产后6-9周的2小时75 g口服葡萄糖耐量试验（OGTT）结果，研究母乳喂养强度与母体血糖和胰岛素以及葡萄糖不耐受之间的关系。我们选择了522名参加妇女、婴儿喂养和2型糖尿病研究（SWIFT）的受试者，这是一项前瞻性观察性队列研究，研究对象是根据Carpenter和Coustan标准采用3小时100 g OGTT诊断为GDM的Kaiser Permanente北方加州成员。根据产后2小时75克OGTT结果，根据美国糖尿病协会标准，将妇女分为正常、糖尿病前期或糖尿病。与完全或大部分配方喂养相比（每24小时>17盎司配方奶粉），纯母乳喂养和大部分母乳喂养（≤6盎司配方奶粉/24小时）组的空腹血糖（mg/dL）校正均值（95% CI）组间差异较低，为-4.3（−7.4至−1.3）和−5.0（−8.5至−1.4），空腹胰岛素（μU/mL）为−6.3（−10.1至−2.4）和−7.5（−11.9至−3.0），2小时胰岛素为−21.4（−41.0至−1.7）和−36.5（−59.3至−13.7）（均P < 0.05）。纯母乳喂养组或母乳喂养组的糖尿病或糖尿病前期患病率较低（P = 0.02）。较高的泌乳强度与产后6-9周空腹血糖的改善和胰岛素水平的降低有关。哺乳可能对糖代谢和胰岛素敏感性有有利影响，可能降低GDM妊娠后糖尿病的风险。
To examine the association between breastfeeding intensity in relation to maternal blood glucose and insulin and glucose intolerance based on the postpartum 2-h 75-g oral glucose tolerance test (OGTT) results at 6–9 weeks after a pregnancy with gestational diabetes mellitus (GDM). We selected 522 participants enrolled into the Study of Women, Infant Feeding, and Type 2 Diabetes (SWIFT), a prospective observational cohort study of Kaiser Permanente Northern California members diagnosed with GDM using the 3-h 100-g OGTT by the Carpenter and Coustan criteria. Women were classified as normal, prediabetes, or diabetes according to American Diabetes Association criteria based on the postpartum 2-h 75-g OGTT results. Compared with exclusive or mostly formula feeding (>17 oz formula per 24 h), exclusive breastfeeding and mostly breastfeeding (≤6 oz formula per 24 h) groups, respectively, had lower adjusted mean (95% CI) group differences in fasting plasma glucose (mg/dL) of −4.3 (−7.4 to −1.3) and −5.0 (−8.5 to −1.4), in fasting insulin (μU/mL) of −6.3 (−10.1 to −2.4) and −7.5 (−11.9 to −3.0), and in 2-h insulin of −21.4 (−41.0 to −1.7) and −36.5 (−59.3 to −13.7) (all P < 0.05). Exclusive or mostly breastfeeding groups had lower prevalence of diabetes or prediabetes (P = 0.02). Higher intensity of lactation was associated with improved fasting glucose and lower insulin levels at 6–9 weeks’ postpartum. Lactation may have favorable effects on glucose metabolism and insulin sensitivity that may reduce diabetes risk after GDM pregnancy.
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影响因子：
7.7
作者：
Gunderson EP;Jacobs DR Jr;Chiang V;Lewis CE;Feng J;Quesenberry CP Jr;Sidney S
通讯作者：
Sidney S
影响因子：
9.8
作者：
Ram, Kavitha T.;Bobby, Paul;Santoro, Nanette
通讯作者：
Santoro, Nanette
影响因子：
7.7
作者：
Hanley, AJG;Williams, K;Haffner, SM
通讯作者：
Haffner, SM
影响因子：
105.7
作者：
LUCAS, A;EWING, G;COWARD, WA
通讯作者：
COWARD, WA
影响因子：
7.7
作者：
Gunderson, Erica P.;Lewis, Cora E.;Sidney, Stephen
通讯作者：
Sidney, Stephen