Breast-feeding vs Formula-feeding for Infants Born Small-for-Gestational-Age: Divergent Effects on Fat Mass and on Circulating IGF-I and High-Molecular-Weight Adiponectin in Late Infancy
Breast-feeding vs Formula-feeding for Infants Born Small-for-Gestational-Age: Divergent Effects on Fat Mass and on Circulating IGF-I and High-Molecular-Weight Adiponectin in Late Infancy
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DOI：
10.1210/jc.2012-3480
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发表时间：
2013-03-01
影响因子：
5.8
通讯作者：
Ibanez, Lourdes
中科院分区：
文献类型：
--
作者：
de Zegher, Francis;Sebastiani, Giorgia;Ibanez, Lourdes
背景：胎儿生长受限，如果随后体重迅速增加，会增加成人疾病的风险，包括糖尿病。母乳喂养是如何降低这种风险的，人们知之甚少。目的，研究参与者，干预，结果：在小胎龄（SGA）出生的婴儿中，我们研究了婴儿早期营养（母乳喂养vs配方奶喂养；BRF vs FOF）对婴儿后期体重分配和内分泌指标的影响。在出生时适合ga的BRF对照组（N = 31）和接受BRF （N = 48）或FOF （N = 51）的SGA婴儿中，在4个月和12个月时评估体成分（通过吸收测定法）、空腹血糖、胰岛素、IGF-I和高分子量（HMW）脂联素，后者被随机分配接受标准配方（FOF1）或富含蛋白质的配方（FOF2）。环境：本研究在一所大学医院进行。结果：SGA-BRF婴儿保持低脂肪量和正常水平的IGF-I和HMW脂联素。相反，SGA-FOF婴儿通过增加更多的脂肪来使他们的身体成分正常化；这种正常化伴随着HMW脂联素血症的显著下降，在FOF2婴儿中，IGF-I水平升高。在婴儿后期，SGA-BRF婴儿对胰岛素最敏感，甚至比ga - brf对照组更敏感。结论：由于SGA- brf婴儿的健康前景优于SGA-FOF婴儿，目前的研究结果表明，SGA婴儿的FOF应以维持正常的IGF-I和hw -脂联素水平为目标，而不是使身体成分正常化。因此，针对SGA婴儿的营养研究可能不得不重新定位。[J] .中华内分泌杂志，2013,31(5):442 - 447。
Context: Fetal growth restraint, if followed by rapid weight gain, confers risk for adult disease including diabetes. How breast-feeding may lower such risk is poorly understood.Objective, Study Participants, Intervention, Outcomes: In infants born small-for-gestational-age (SGA), we studied the effects of nutrition in early infancy (breast-feeding vs formula-feeding; BRF vs FOF) on weight partitioning and endocrine markers in late infancy. Body composition (by absorptiometry), fasting glycemia, insulin, IGF-I, and high-molecular-weight (HMW) adiponectin were assessed at 4 and 12 months in BRF controls born appropriate-for-GA (N = 31) and in SGA infants receiving BRF (N = 48) or FOF (N = 51), the latter being randomized to receive a standard formula (FOF1) or a protein-rich formula (FOF2).Setting: The study was conducted in a University Hospital.Results: SGA-BRF infants maintained a low fat mass and normal levels of IGF-I and HMW adiponectin. In contrast, SGA-FOF infants normalized their body composition by gaining more fat; this normalization was accompanied by a marked fall in HMW adiponectinemia and, in FOF2 infants, by elevated IGF-I levels. In late infancy, SGA-BRF infants were most sensitive to insulin, even more sensitive than appropriate-for-GA-BRF controls.Conclusions: Because the health perspectives are better for SGA-BRF than for SGA-FOF infants, the present results suggest that FOF for SGA infants should aim at maintaining normal IGF-I and HMW-adiponectin levels rather than at normalizing body composition. Nutriceutical research for SGA infants may thus have to be redirected. (J Clin Endocrinol Metab 98: 1242-1247, 2013)