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)：宫内和产后早期的环境和营养暴露对婴儿发育中的代谢特征产生深远影响，影响未来肥胖的风险。在出生后的头4-6个月内，无论采用何种喂养方式，体重都会迅速过度增加，这会增加婴儿日后肥胖的风险。母乳中可能影响体重和肥胖增加的生物活性成分在很大程度上仍不清楚。此外，肥胖和糖尿病等母体代谢障碍如何影响HM的生物活性成分，以及这可能如何影响婴儿的生长仍在很大程度上尚不清楚。孕妇和哺乳妇女中2型糖尿病(T2D)患病率的上升已经超过了目前对这种疾病对HM组成的影响的了解。这项研究将解决这一知识差距。在婴儿出生后的前6个月，普遍推荐纯母乳喂养。考虑到这一建议和令人震惊的儿童肥胖率，了解母亲肥胖，无论是否有胰岛素抵抗，可能如何影响HM成分，以及继发的婴儿肥胖增加，对于解决肥胖的早期风险因素至关重要。推动这项研究的总体假设是，伴随肥胖和T2D的母体代谢功能障碍将影响HM的生物活性成分，并且这些成分将与婴儿在关键的生长窗口中积累的体重增加和体脂的速度相关。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，并在生命的前4个月跟踪60对特征良好的母婴，收集母乳成分、婴儿生长和身体成分的纵向测量。我们将在以下每个研究组中跟踪20对母婴：正常体重(NW)、超重/肥胖(OW/Ob)和T2D妇女。正常血糖的OW/Ob组将使我们能够区分母亲肥胖单独的影响和T2D的胰岛素抵抗对HM成分的影响，以及继而对婴儿生长的影响。目的：我们将使用获得的样本来确定母体特征是否影响HM的生物活性成分：炎症和氧化“负荷”、脂肪因子、胰岛素、葡萄糖和HM的卡路里含量。我们还将确定在哺乳的前4个月中，当两组之间的HM差异更严重时，是否存在关键窗口。最后，我们将确定HM成分的这些差异是否与婴儿体重和脂肪增加的速度有关。影响：对这些问题的回答将对高危妇女及其婴儿的产后早期喂养建议产生临床影响。确定与婴儿体重增加相关的HM的主要成分将为干预提供一条理想的途径，以优化HM的构成并将婴儿风险降至最低。了解导致后来肥胖的最早的产后风险因素将确定改变这些影响的机会，从而潜在地阻断肥胖的代际传播。