母乳中瘦素含量及其对新生儿生长调节作用的研究

目的瘦素(Leptin)是脂肪细胞合成分泌的多肽,可负反馈地降低食欲并增强能量代谢,以维持体脂的平衡。在胎儿与新生儿时期,胎盘与乳腺合成分泌瘦素,对胎儿与新生儿发育成熟起调节作用。本研究探讨母乳瘦素的检测方法,并探讨母乳瘦素含量的动态变化及其对新生儿体内瘦素水平的影响。方法采集产妇乳汁5-10 ml(产后1周内母乳),混匀后制作全奶;全奶离心,去除乳脂制作脱脂奶;全奶与脱脂奶经超声振荡处理后离心,取液相,放射免疫检测瘦素含量。新生儿股静脉采血,取血清,放射免疫检测瘦素含量。结果60例母乳全奶中瘦素含量为(53.9±29.1)ng/ml,全奶经脱脂处理后瘦素含量为(6.2±8.3)ng/ml,全奶与脱脂奶瘦素含量有显著性差异(t=8.28,P<0.01)。42例纯母乳喂养新生儿外周静脉血瘦素水平为(2.8±1.2)ng/ml,36例纯配方乳喂养新生儿外周静脉血瘦素水平(1.9±0.9)ng/ml, 两组比较有显著差异(t=3.37,P<0.01)。结论母乳中含有瘦素,且主要与脂肪球结合在一起;母乳喂养可提高新生儿循环血流中瘦素水平,对于新生儿适应宫外环境起积极作用。     

围产期新生儿脐血与静脉血瘦素水平的动态变化

探讨围产期新生儿脐血与静脉血瘦素水平的变化及其在胎儿、新生儿发育成熟中作用。方法　采用放射免疫法 ( RIA)检测孕母外周静脉血、新生儿脐血与周静脉血瘦素水平 ,采用 weststrate公式 [F% =0 .8848×SFT4 0 .0 2 2 ]估测新生儿体脂含量。结果　 6 5例脐血瘦素水平 ( x±s) 1 0 .5 0± 3.45 ng/ml,73例新生儿外周静脉血瘦素水平 ( x± s) 2 .39± 1 .1 5 ng/ml。脐血瘦素水平与孕母外周血瘦素水平无显著相关 ( γ=0 .1 1 ,p>0 .0 5 ) ,与胎盘重量显著相关 ( γ=0 .71 ,p<0 .0 1 )。新生儿外周静脉血瘦素水平与新生儿体脂含量无显著相关 ( γ=0 .2 1 ,p>0 .0 5 ) ,与喂养方式显著相关 ,母乳喂养新生儿外周静脉血瘦素水平显著高于配方乳喂养 ( p<0 .0 1 )。结论　胎盘是脐血瘦素的主要来源 ,母乳是新生儿静脉血瘦素的重要来源 ;围产期新生儿脐血、静脉血瘦素水平的动态变化可能与新生儿宫外生存条件的变化与适应有关。     

围产期新生儿脐血与静脉血瘦素水平的动态变化

探讨围产期新生儿脐血与静脉血瘦素水平的变化及其在胎儿、新生儿发育成熟中作用。方法采用放射免疫法(RIA)检测孕母外周静脉血、新生儿脐血与周静脉血瘦素水平,采用weststrate公式[F％=0.8848×SFT     

母乳瘦素与新生儿体格发育的关系

目的:探讨母乳瘦素对新生儿体格发育的影响.方法:选择2007年1月至2009年6月在本院顺产的健康产妇及其新生儿各120名,根据喂养方式分为纯母乳喂养组、混合喂养组和纯配方奶喂养组,测定分娩时脐血及产后第3、28天新生儿血清和母乳瘦素水平,测量新生儿出生时、生后28天体重和身长,并计算Ponderal指数(PI),比较各组瘦素变化及新生儿体格发育情况,探讨二者之间的关系.结果各组新生儿血清瘦素水平出生时差异无统计学意义(P>0.05),第3天纯配方奶组低于纯母乳组[(1.7±1.2)μg/L比(2.6±1.4)μg/L,P<0.05],第28天纯配方奶组低于纯母乳组和混合喂养组[(2.3±1.1)μg/L比(3.2±1.3)μg/L、(2.9±1.4)μg/L,P均<0.05].新生儿出生时各组PI值差异无统计学意义(P>0.05),第28天纯配方奶组高于纯母乳组和混合喂养组[(2.9±0.3)g/cm3比(2.7±0.2)g/cm3、(2.8±0.3)g/cm3,P均<0.05].产妇母乳瘦素水平第3天各组差异无统计学意义(P>0.05),第28天混合组低于纯母乳组[(11.7±3.8)μg/L比(13.5±4.6)μg/L,P<0.05].结论:不同喂养方式影响新生儿瘦素水平,并进而影响新生儿期体格发育,母乳瘦素是新生儿瘦素的主要来源.     

母乳细胞因子与新生儿免疫

细胞因子是由免疫活性细胞分泌产生的一系列免疫调节因子，在微摩尔或毫摩尔水平能以非酶样的作用方式调节细胞的功能，与神经递质、内分泌激素等共同相互作用，相互调节维持正常的免疫应签能力。母乳细胞也能产生细胞因子，细胞因子对新生儿在抗感染，增进免疫方面的作用已成为一个活跃的研究领域。本文综述了近年来有关母乳中细胞因子与新生儿免疫的研究进展。     

母乳中α—肿瘤坏死因子含量研究

应用酶联免疫法分别测定产后～３天，～７天及～４２天母乳中α－肿瘤坏死因子（α－ＴＮＦ）含量，结果显示：产后～３天组，～７天组α－ＴＮＦ含量较高。～４２天组较低。但Ｐ值均〉０．０５无显著差异，母乳中α－ＴＮＦ含量与孕周胎次及产式相关，早产第二胎及非顺产婴儿包括剖宫产，产钳及胎头吸收者含量较高，Ｐ〈０．０５。于应激状态下如婴儿窒息或宫内窘迫者母乳中α－ＴＮＦ含量增高明显，Ｐ〈０．００５。本研究说明母乳     

母乳中胰岛素样生长因子1水平对新生儿生长发育的影响

目的　动态观察人类母乳中胰岛素样生长因子 1(IGF 1)在初乳及成熟乳中的变化及其与泌乳量的关系 ;探讨母乳中IGF 1水平对新生儿生长发育的影响。方法　监测 38名足月新生儿生后 6周身长、体重、头围的增长及其母亲体重指数。采用双抗放射免疫法测定初乳 (生后 3～ 5d)和成熟乳 (生后 4 2d)中IGF 1的浓度并测量同日母乳量 ,测量新生儿生后 3～ 5d血清IGF 1浓度 ,并分析两者之间的关系。结果　 (1)初乳中IGF 1浓度 [(6 3± 1 6 ) μg/L]显著高于成熟乳 [(4 7± 2 1) μg/L],差异有显著意义 (t=3 2 32 ,P <0 0 5 )。 (2 )初乳和成熟乳中IGF 1的浓度 [分别为 (6 3± 1 6 ) μg/L ,(4 7± 2 1) μg/L]均与同日母乳分泌量 [分别为 (380± 114 )ml/d ,(783± 199)ml/d]呈正相关 (r分别为 0 6 17,0 793) ;乳量绝对不足的母亲初乳中IGF 1浓度 [(4 1± 1 5 ) μg/L]明显低于能维持母乳喂养者 [(6 3± 1 6 ) μg/L],差异有显著意义 (t=4 4 5 4 ,P <0 0 0 1)。 (3)与新生儿体重、头围增长相关的因素按相关性大小依次为成熟乳量、初乳中IGF 1的浓度、新生儿生后早期血清IGF 1水平以及母亲哺乳期的体重指数。结论　初乳中足够的IGF 1浓度是启动泌乳并使之得以维持的重要条件 ,乳腺分泌的IGF 1可能通过促进     

新生儿母乳性黄疸177例

母乳性黄疸的早期干预治疗非常重要 ,现将我院产科分娩的新生儿 786例 ,发生母乳性黄疸 177例 ,总结如下。临床资料一、一般资料　 1996～ 1998年我院产科分娩新生儿 786例 ,按喂养方式分成三组 :混合喂养组 2 6 0例 ,婴儿生后 3ｄ因母乳不足加喂牛乳或代乳粉 ,早发性母乳性黄疸 19例 ,迟发性 2例。纯母乳喂养 2 40例 ,除母乳喂养外不加代乳品包括水 ,早发性母乳性黄疸 71例 ,迟发性 3例。母乳干预组2 86例 ,早发性母乳性黄疸 80例 ,迟发性 2例。共确诊母乳性 177例。其中早发性 170例 ,男 88例 ,女 82例。迟发性母乳性黄疸 7例 ,男 4例 ,女…     

口服金双歧辅助治疗新生儿母乳性黄疸

目的观察口服金双歧对新生儿母乳性黄疸的疗效。方法将符合诊断标准的126例患儿分为观察组和对照组。观察组65例是在常规治疗（服用鲁米那、尼可刹米、维生素C）的基础上口服金双歧，两组均服药5天，治疗前后经皮测定胆红素值。结果两组新生儿的皮肤黄疸均有不同程度的减轻。但治疗组的疗效明显优于对照组（P〈0．001），差异有非常显著性。结论口服金双歧治疗新生儿母乳性黄疸，疗效确切，方法简便，易被家长及新生儿接受。无任何不良反应。     

Alpha-1-antitrypsin concentration in human milk

Alpha-1-antitrypsin concentration was analyzed by immunoelectrophoresis in samples of human colostrum (n = 3) and of mature milk from mothers between 2 to 52 wk postpartum (n = 39), one of whom was known to be PiMZ with a PiZZ infant. All milk samples tested contained alpha-1-antitrypsin. The three colostrum samples contained 140, 520, and 250 mg/liter. The mature milk of women who had been lactating less than 6 months had a higher concentration (7.2 +/- 3.6 mg/liter) (mean +/- SD) than in the women who had been lactating 6-12 months (4.8 +/- 1.8 mg/liter) (p less than 0.03). The milk of the woman of Pi type MZ had an alpha-1-antitrypsin concentration of 7.0 mg/liter at 7 wk postpartum and 4.1 mg/liter at 52 wk. It has been previously demonstrated that enhanced absorption of intact proteins occurs in early infancy. The presence of antiproteases in human milk provided during early infancy may serve to inhibit the absorption of intact proteases, limiting their entry into the portal circulation.     

妊娠糖尿病母亲母乳中真胰岛素水平及对婴儿生长的影响

目的:探讨妊娠糖尿病(GDM)哺乳期妇女初乳、42天和90天成熟乳中真胰岛素水平,分析其相关因素及其对婴儿体格发育的影响.方法:采用双位点单克隆抗体夹心放大酶联免疫分析法(BA-ELISA)测定GDM产妇和健康产妇初乳、42天和90天成熟乳及新生儿脐血中真胰岛素水平,监测婴儿90天内生长情况.结果GDM组初乳及90天成熟乳中真胰岛素水平均高于对照组(22.8μU/ml比20.4μU/ml,33.6μU/ml比23.5μU/ml,P均<0.05).母亲孕前、产前、产后42天和90天的体质指数(BMI)与90天成熟乳中真胰岛素水平正相关,产后42天BMI与42天成熟乳中真胰岛素水平正相关,孕期糖化血红蛋白百分比与90天成熟乳中真胰岛素水平正相关,剖宫产者初乳真胰岛素水平低于阴道分娩者(21.2μU/ml比96.3μU/ml,P<0.05).42天时高母乳喂养组母乳中真胰岛素水平低于低母乳喂养组(29.7μU/ml比69.6μU/ml,P<0.05).脐血中真胰岛素水平与出生体重和身长正相关,42天成熟乳中真胰岛素水平与出生至42天的体重增长值负相关,90天成熟乳中真胰岛素水平与90天头围负相关.结论:GDM哺乳期妇女母乳中真胰岛素水平较正常哺乳期妇女高,分娩方式和喂养方式对成熟乳中真胰岛素水平有影响,母乳中真胰岛素水平与孕产妇的BMI值呈正相关,对婴儿体格生长起调节作用.     

Osteoprotegerin in human milk: a potential role in the regulation of bone metabolism and immune development

Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily. It is a soluble "decoy" receptor for tumor necrosis factor-related apoptosis-inducing ligand and ligand of the receptor activator of NF-kappaB. As such, OPG inhibits osteoclast activity and regulates the immune system. Human milk is a complex biologic fluid that supplies nutritional and protective factors to the breast-fed infant. In the present study, human milk samples at various times postpartum were assessed for the presence of OPG. Using biochemical as well as immunologic and biologic techniques we showed that human milk contains OPG at a level that is 1000-fold higher than that found in normal human serum. We observed that human breast milk cells and the human mammary epithelial cell line MCF-7 express OPG, indicating that both cell types are possible sources of milk OPG in vivo. In vitro studies demonstrated that milk OPG is biologically active and suggested that it may contribute to the antiresorptive activity of milk on bone, as well as tumor necrosis factor-related apoptosis-inducing ligand-induced inhibition of T cell proliferation. OPG-like activity was also observed in bovine colostrum and milk. Furthermore, we were able to detect human OPG in the sera of rats gavaged with human milk. We discuss the relevance of our findings for the breast-fed infant and for the prevention of immune and bone disorders.     

Polyamine concentration in rat milk and food, human milk, and infant formulas.

The polyamine concentration in rat milk and food, human milk, and infant formulas was estimated by HPLC. In rat milk, the concentration of putrescine and spermine was low (generally under 2.5 nmol.mL-1 for putrescine and under 1 nmol.mL-1 for spermine). The spermidine concentration was higher and seemed to increase during lactation. The rat food was richer in polyamines than the rat milk (about 150 times for putrescine and spermine, about 30 times for spermidine). We already proved that ingestion of spermine or spermidine can induce precocious maturation of the rat intestine. The present observations suggest that polyamines contained in rat food could play an important role in postnatal maturation of the rat intestine. The polyamine concentration of human milk was measured from 60 different mothers during a period extending from the 1st wk to the 6th mo of lactation. Great variation was observed. During the 1st mo of lactation, the general pattern was as follows: putrescine concentration generally varied little (from 1 to 3 nmol.mL-1), spermine and spermidine concentrations showed a similar pattern (the highest values appeared at the end of the 1st wk of suckling). After the 4th mo of lactation, putrescine concentration increased slightly, whereas spermine and spermidine concentration stayed almost stable. The concentrations of polyamines in 18 powdered milks for babies were estimated. Spermine and spermidine contents were lower than those in human milk. A protective effect of spermine or spermidine against alimentary allergies is suggested.     

Leptin determination in colostrum and early human milk from mothers of preterm and term infants

Background

Leptin is involved in the regulation of food intake and energy expenditure and is therefore important for growth and brain development. Analytical methods used for leptin measurement in human milk differ widely in the literature and yield varying results.

Aims

To compare different preparation methods for the analysis of leptin in human milk and to investigate the leptin levels in colostrum and mature human milk from mothers of preterm or term infants.

Methods

Mothers delivering a preterm (n = 37) or a term infant (n = 40) were recruited for a prospective study and were ask to collect breast milk on the 3rd and 28th day of lactation. Leptin, protein and fat concentrations were analysed. Clinical data of mother and child were recorded prospectively.

Results

Skim milk was most appropriate for leptin analysis. Human milk leptin concentrations did not differ between preterm and term human milk. In term milk, leptin concentration on day 28 was lower than on day 3 (p < 0.05). Milk leptin levels on the 3rd and 28th day were positively correlated with mothers' body mass index, but not with fat content in milk.

Conclusion

Skim milk was the most stabile preparation for leptin analysis. Preterm and term human milk contain leptin in equal concentrations. Human milk leptin depends on mothers' body mass index.     

Do breast milk derived hormones play a role in neonatal development?

Many hormones and several growth factors are present in significant concentrations in breast milk. That these substances are of physiologic significance has been suggested by many investigators. This review summarizes the biological roles of thyroid hormones and epidermal growth factor (EGF) derived from breast milk in a variety of developing mammals.