母乳脂联素浓度变化与婴儿生长发育的相关性研究

目的 分析母乳脂联素(adiponectin,APN)浓度变化,探讨其与婴儿血APN的相关性,及其与0～1岁婴儿生长发育的关系.方法 选择2008年3-12月在上海国际和平妇婴保健院出生的健康足月儿及其母亲73对入组.收集母亲产后2、4、l3、26周母乳,用ELISA法测定母乳APN浓度.分析母乳APN浓度变化趋势及其与婴儿体格生长指标的关系,并运用多元回归方法分析与婴儿生长指标相关的影响因素.且于出生26周时收集婴儿血标本,探讨母乳APN与婴儿血APN的相关性.结果 产后2、4、13、26周母乳APN浓度分别为:14.62(5.93～140.40)、7.32(2.04～29.35)、6.84(2.72～15.65)、4.88(1.12～13.38)μg/L.其中产后2周母乳APN与婴儿13、26、52周年龄别体重Z分值(WAZ)均呈负相关(P＜0.05);4周母乳APN与婴儿4、13、26、52周WAZ、身长别体重Z分值(WLZ)、体重指数Z分值(zBMI)均呈负相关(P＜0.05);13周母乳APN与婴儿13、26、52周WAZ、WLZ、zBMI均呈显著负相关(P＜0.01);26周母乳APN与婴儿52周WAZ、WLZ、zBMI呈负相关关系(P＜0.05).多元线性回归分析发现母乳APN均为13、26及52周WAZ、WLZ、zBMI最重要的影响因素.婴儿26周血APN与13、26周母乳APN呈正相关(P＜0.05).结论 随泌乳期的延续,母乳APN浓度呈下降趋势.母乳中APN浓度越高,婴儿体重则明显偏低.婴儿血APN与母乳APN显著相关.

Abstract：

Objective To investigate the variation of human breast milk adiponectin (APN)concentration during lactation, analyze the relationship of APN concentrations in human breast milk with APN in infant serum, determine the association between maternal milk APN and infant body proportionality in the first year of life, and the period of greatest human milk exposure.Method Subjects included 73mother-infant pairs from Shanghai International Peace Maternity & Child Health Hospital.Maternal milk was collected at 2, 4, 13, 26 weeks and infant serum was collected at 26 weeks.The concentration of APN in maternal milk and infant serum were measured with commercially available ELISAs (R&D Systems).Weight-for-age Z-scores (WAZ) , length-for-age Z-scores ( LAZ ) , weight-for-length Z-scores ( WLZ ) and body mass index Z-scores ( zBMI ) of infants up to 1 year of age were calculated using World Health Organization (WHO) standards.Then the variation of maternal milk APN was investigated, the correlation between maternal milk APN and infant serum APN was analyzed; multivariate regression analysis was used to analyze covariates correlated with infant body proportionality, meanwhile determined the association between maternal milk APN and infant anthropometrics.Result The concentration of APN in maternal milk at 2, 4,13, 26 weeks was respectively (14.62 μg/L, 5.93-140.40 μg/L), (7.32 μg/L, 2.04-29.35 μg/L),(6.84 μg/L, 2.72-15.65 μg/L) and (4.88 μg/L, 1.12-13.38 μg/L).Higher milk APN in postpartum 2weeks was associated with lower infant WAZ at 13, 26 and 52 weeks ( P ＜ 0.05 ).Milk APN in postpartum 4 weeks was inversely related to infant WAZ, WLZ, zBMI at 13, 26 and 52 weeks ( all P ＜ 0.05 ).Meanwhile, milk APN in postpartum 13 weeks had significantly negative correlation with infant WAZ, WLZ,zBMI at 13, 26 and 52 weeks (P＜0.01).Milk APN in postpartum 26 weeks also was inversely associated with infant WAZ, WLZ and zBMI at 52 weeks (P ＜0.05).After adjusting covariates like birth weight using multivariate regression analysis, milk APN level is the most important influence factor to infant WAZ, WLZ,zBM1 at 13, 26 and 52 weeks.There was a positive correlation between maternal milk APN and infant serum APN at 13, 26 weeks.Conclusion Milk APN concentration declines throughout lactation.Maternal milk APN may play a vital role in the growth and development of breastfed infants, particularly closely associated with infant weight.Infant serum APN clearly correlated with maternal milk APN.

Variation of maternal milk adiponectin and its correlation with infant growth

Objective To investigate the variation of human breast milk adiponectin (APN)concentration during lactation, analyze the relationship of APN concentrations in human breast milk with APN in infant serum, determine the association between maternal milk APN and infant body proportionality in the first year of life, and the period of greatest human milk exposure.Method Subjects included 73mother-infant pairs from Shanghai International Peace Maternity & Child Health Hospital.Maternal milk was collected at 2, 4, 13, 26 weeks and infant serum was collected at 26 weeks.The concentration of APN in maternal milk and infant serum were measured with commercially available ELISAs (R&D Systems).Weight-for-age Z-scores (WAZ) , length-for-age Z-scores ( LAZ ) , weight-for-length Z-scores ( WLZ ) and body mass index Z-scores ( zBMI ) of infants up to 1 year of age were calculated using World Health Organization (WHO) standards.Then the variation of maternal milk APN was investigated, the correlation between maternal milk APN and infant serum APN was analyzed; multivariate regression analysis was used to analyze covariates correlated with infant body proportionality, meanwhile determined the association between maternal milk APN and infant anthropometrics.Result The concentration of APN in maternal milk at 2, 4,13, 26 weeks was respectively (14.62 μg/L, 5.93-140.40 μg/L), (7.32 μg/L, 2.04-29.35 μg/L),(6.84 μg/L, 2.72-15.65 μg/L) and (4.88 μg/L, 1.12-13.38 μg/L).Higher milk APN in postpartum 2weeks was associated with lower infant WAZ at 13, 26 and 52 weeks ( P ＜ 0.05 ).Milk APN in postpartum 4 weeks was inversely related to infant WAZ, WLZ, zBMI at 13, 26 and 52 weeks ( all P ＜ 0.05 ).Meanwhile, milk APN in postpartum 13 weeks had significantly negative correlation with infant WAZ, WLZ,zBMI at 13, 26 and 52 weeks (P＜0.01).Milk APN in postpartum 26 weeks also was inversely associated with infant WAZ, WLZ and zBMI at 52 weeks (P ＜0.05).After adjusting covariates like birth weight using multivariate regression analysis, milk APN level is the most important influence factor to infant WAZ, WLZ,zBM1 at 13, 26 and 52 weeks.There was a positive correlation between maternal milk APN and infant serum APN at 13, 26 weeks.Conclusion Milk APN concentration declines throughout lactation.Maternal milk APN may play a vital role in the growth and development of breastfed infants, particularly closely associated with infant weight.Infant serum APN clearly correlated with maternal milk APN.