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（由申请方提供）：宫内和产后早期的环境和营养暴露对婴儿的发育代谢特征产生深远影响，影响未来的肥胖风险。在出生后的前4-6个月内，无论喂养方式如何，体重迅速和过度增加都会使婴儿日后患肥胖症的风险增加。人乳（HM）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然未知。此外，母体代谢紊乱如肥胖症和糖尿病如何影响人乳的生物活性成分，以及这又如何影响婴儿生长仍然是未知的。孕妇和哺乳期妇女中2型糖尿病（T2 D）患病率的上升超过了目前对这种疾病对HM组成影响的认识。本研究将解决这一知识差距。全母乳喂养是普遍建议在生命的前6个月。考虑到这一建议，以及儿童肥胖的惊人流行，了解母亲肥胖，有或没有胰岛素抵抗，可能会影响人乳成分，其次是婴儿肥胖的增加是至关重要的，以解决肥胖的早期风险因素。推动这项研究的过度假设是，伴随肥胖和T2 D的母体代谢功能障碍将影响人乳的生物活性成分，并且这些成分将与婴儿在关键生长窗口期间体重增加和体脂积累的速率相关。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，并在出生后的前4个月内跟踪60对特征良好的母亲/婴儿，收集母乳成分和婴儿生长和身体成分的纵向测量结果。我们将在以下每个研究组中随访20对母亲/婴儿：正常体重（NW），超重/肥胖（OW/Ob）和T2 D女性。血糖正常的OW/Ob组将使我们能够区分单独的母体肥胖与T2 D的胰岛素抵抗对人乳组成的影响，其次是对婴儿生长的影响。目的：我们将使用所获得的样本来确定母体特征是否影响HM的生物活性成分：HM的炎症和氧化“负荷”、脂肪因子、胰岛素、葡萄糖和卡路里含量。我们还将确定当组间HM差异更严重时，在泌乳的前4个月是否存在关键窗口。最后，我们将确定人乳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：这些问题的答案将对高危妇女及其婴儿的产后早期喂养建议产生临床意义。确定与危险婴儿体重增加相关的人乳主要成分将为干预提供理想的途径，以优化人乳成分并最大限度地降低婴儿风险。了解促进后来肥胖的最早的产后风险因素将确定修改这些影响的机会，从而有可能中断肥胖的代际传递。