Differences in Breastmilk Composition and Infant Growth between Healthy and Overw

健康母乳成分和婴儿生长发育的差异

• 批准号: 8712817
• 负责人: Bridget Victoria Young
• 金额: $ 2.8万
• 依托单位: UNIVERSITY OF COLORADO DENVER
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2015-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8712817
• 关键词: 8-hydroxy-2' -deoxyguanosine; Address; Age-Months; Automobile Driving; Biological Assay; Birth; Body Composition; Body fat; Breast Feeding; Characteristics; Childhood; Clinical; Cohort Studies; Comorbidity; Complex; Data; Deposition; Development; Diabetes Mellitus; Disease; Exclusive Breastfeeding; F2-Isoprostanes; Fatty acid glycerol esters; Fetus; Functional disorder; Future; Glucose; Growth; High Risk Woman; Hormones; Human; Human Milk; IL8 gene; Individual; Infant; Inflammation; Inflammatory; Insulin; Insulin Resistance; Interleukin-6; Intervention; Knowledge; Lactation; Leptin; Life; Measures; Metabolic; Metabolic Diseases; Metabolism; Milk; Mothers; Nature; Non-Insulin-Dependent Diabetes Mellitus; Nutritional; Obesity; Overweight; Oxidative Stress; Parasites; Pattern; Perinatal Exposure; Phenotype; Postpartum Period; Predictive Value; Prevalence; Recommendation; Research; Research Design; Risk; Risk Factors; Sampling; Sum; TNF gene; Time; Weight; Weight Gain; Weight maintenance regimen; Woman; Work; adipokines; adiponectin; base; body system; critical period; density; feeding; ghrelin; glycemic control; improved; in utero; intergenerational; mother nutrition; novel; obesity in children; obesity risk; offspring; pregnant; prevent; programs; prospective; public health relevance; transmission process

DESCRIPTION (provided by applicant): Environmental and nutritional exposures in-utero and early postpartum exert profound influences on the developing metabolic profile of an infant, impacting future risk of obesity. Rapid and excessive weight gain in the first 4-6 months of life, regardless of feeding mode, places an infant at elevated risk of later obesity. Bioactive components of human milk (HM) that may influence weight and adiposity gain remain unknown to a large extent. Furthermore, how maternal metabolic disorders such as obesity and diabetes, may impact the bioactive composition of HM, and how, in turn, this may influence infant growth remains largely unknown. The rise in prevalence in Type 2 diabetes (T2D) among pregnant and breastfeeding women has outstripped current knowledge of the impact this disease has on HM composition. This study will address this gap in knowledge. Exclusive breastfeeding is universally recommended for the first 6 months of life. Considering this recommendation, and the alarming prevalence of pediatric obesity, understanding how maternal obesity, with or without insulin resistance, may impact HM composition, and secondarily infant adiposity gain is of critical importance to addressing early risk factors for obesity. The over-arching hypotheses driving this research is that maternal metabolic dysfunction that accompanies obesity and T2D will impact the bioactive components of HM, and that these components will correlate with the rate of weight gain and body fat accumulated by the infant over a critical window of growth. Study Design: To address these essential questions, we will undertake a longitudinal cohort study and follow 60 well-characterized mother/infant pairs over the first 4 months of life, collecting longitudinal measures of breast milk composition and infant growth and body composition. We will follow 20 mother/infant pairs in each of the following study groups: normal weight (NW), overweight/obese (OW/Ob), and T2D women. The normo-glycemic OW/Ob group will allow us to distinguish the effects of maternal obesity alone vs. the impact of the insulin resistance of T2D, on HM composition and secondarily on infant growth. Aims: We will use the samples obtained to determine if maternal characteristics impact bioactive components of HM: inflammatory and oxidative "load", adipokine, insulin, glucose, and caloric content of HM. We will also determine whether critical windows exist over these first 4 months of lactation when differences in HM between groups are more severe. Finally we will determine if these differences in HM composition are associated with the rate of infant weight and fat gain. Impact: Answers to these questions will have clinical implications for early post-natal feeding recommendations for high risk women and their infants. Identifying primary components of HM that associate with risky infant weight gain will provide an ideal avenue for intervention to optimize HM composition and minimize infant risk. Understanding the earliest post-natal risk factors that promote later obesity will identify opportunities to modify these influences, and thereby potentially interrupt the intergenerational transmission of obesity.

描述（由申请人提供）：环境和营养暴露于UTERO中和产后早期对婴儿的代谢形象产生深远影响，从而影响了未来的肥胖风险。在生命的头4-6个月，无论喂养模式如何，体重的快速和过度增长都会使婴儿处于肥胖后期的风险升高。可能影响体重和肥胖增长的人乳（HM）的生物活性成分在很大程度上尚不清楚。此外，肥胖和糖尿病等母体代谢疾病如何影响HM的生物活性组成，以及这可能影响婴儿生长仍然很大程度上是未知的。孕妇和母乳喂养妇女中2型糖尿病（T2D）的患病率上升超过了当前对这种疾病对HM组成的影响的了解。这项研究将解决这一知识的差距。普遍建议在生命的前6个月普遍推荐母乳喂养。考虑到这一建议，以及小儿肥胖症的令人震惊的患病率，了解孕产妇肥胖症（无论是否具有胰岛素抵抗）如何影响HM组成，其次是婴儿肥胖增长对解决肥胖症早期危险因素至关重要。推动这项研究的过度假设是，伴随肥胖和T2D伴随的母体代谢功能障碍会影响HM的生物活性成分，并且这些成分将与婴儿在关键窗口中累积的体重增加率和体重增加的速度和体内脂肪相关。研究设计：为了解决这些基本问题，我们将进行一项纵向队列研究，并在生命的头四个月中遵循60个良好的母/婴儿对，收集母乳组成和婴儿生长和身体组成的纵向测量。我们将在以下每个研究组中关注20个母/婴儿对：正常体重（NW），超重/肥胖（OW/OB）和T2D女性。正常血糖OW/OB组将使我们能够区分孕产妇肥胖的影响与T2D胰岛素抵抗，对HM组成以及对婴儿生长的影响。目的：我们将使用获得的样品来确定母体特征是否影响HM的生物活性成分：炎症和氧化“负载”，脂肪因子，胰岛素，葡萄糖和HM的热量含量。当组之间的HM差异更严重时，我们还将确定在泌乳的前4个月中是否存在关键窗户。最后，我们将确定HM组成中的这些差异是否与婴儿体重和脂肪增加的速率有关。影响：这些问题的答案将对高风险妇女及其婴儿的产后早期喂养建议具有临床意义。确定与风险婴儿体重增加的HM的主要组件将为干预提供优化HM组成并最大程度地降低婴儿风险的理想途径。了解最早促进后来肥胖的产后危险因素将确定改变这些影响的机会，从而可能中断肥胖的代际传播。