母乳IGF-Ⅱ与婴儿体格生长指标关联性分析及影响因素研究

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摘要目的描述哺乳期各阶段母乳IGF-Ⅱ浓度的变化,探讨哺乳期不同阶段母乳IGF-Ⅱ与婴儿体格生长指标的关联,以及可能影响母乳IGF-Ⅱ浓度的因素。方法 2020年10月至2021年9月于北京大学人民医院招募32名满足纳入排除标准的分娩妇女,分别于分娩后48 h、产后15 h、产后42 h、6个月、9个月及12个月采集妇女母乳标本,同时收集婴儿身长、体重等生长发育指标。采用酶联免疫吸附方法检测母乳IGF-Ⅱ水平。使用广义估计方程(GEE)分析母乳IGF-Ⅱ水平与婴儿体格生长指标之间的关联以及可能影响母乳IGF-Ⅱ水平的因素。结果母乳IGF-Ⅱ中位浓度在12月成熟乳中最高(82.5 ng/mL),6月成熟乳中最低(55.3 ng/mL),呈先下降再升高趋势,但各阶段中位浓度间未见明显差异;在调整母亲年龄、孕前BMI、孕周、母亲民族、孕产史、孕期并发症情况(妊娠期糖尿病、妊娠期高血压、妊娠期甲状腺疾病)、婴儿喂养方式及婴儿性别后,研究结果显示初乳中IGF-Ⅱ含量与婴儿身长呈正相关关系(β=0.9,P＜0.01),初乳、42d成熟乳、12月成熟乳中的IGF-Ⅱ含量与婴儿体重呈正相关关系(P=0.02,P＜0.01和P=0.01)。将膳食炎症指数(DII)按三分位法分为三组(Q1:最抗炎倾向组,Q2:中间组,Q3:最促炎倾向组)纳入GEE模型,结果显示,第三分位组(即最促炎倾向组)与母乳IGF-Ⅱ含量正相关(β=28.6,P=0.01)。结论母乳IGF-Ⅱ对婴儿身长、体重存在一定的促进作用,孕期促炎饮食与母乳IGF-Ⅱ含量相关。

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	张金娟
	郭倩颖
	崔铭萱
	杨晨
	彭小雨
	潘丽娜
	李威
	汪家琦
	刘晨迪
	王琳琳
	柳鹏
	刘菊芬

关键词 ：母乳, 胰岛素样生长因子-Ⅱ, 婴儿生长发育, 膳食

Abstract：Objective To describe the changes of IGF-Ⅱ concentration in breast milk during lactation and investigate the association between breast milk IGF-Ⅱ and physical growth index of infants, and to explore the influencing factors of breast milk IGF-Ⅱ during lactation. Methods 32 women who met the inclusion and exclusion criteria were recruited From October 2020 to September 2021 in Peking University People′s Hospital. Breast milk samples were collected at 48 hours after delivery, 15 days after delivery, 42 days after delivery, 6 months, 9 months and 12 months after delivery, and growth indicators including body length and body weight were collected. Breast milk IGF-Ⅱ was detected by enzyme-linked immunosorbent assay. Generalized Estimation Equations (GEE) were used to analyze the association between maternal IGF-Ⅱ and infant physical growth indexes, factors that may affect breast milk IGF-Ⅱ were estimated. Results The median concentration of IGF-Ⅱ in breast milk was the highest (82.5 ng/mL) in 12-month mature milk and the lowest (55.3 ng/mL) in 6-month mature milk, which showed a trend of first decreasing and then increasing, but there was no significant difference between the median concentration in each stage. After adjusting for maternal age, pre-pregnancy BMI, gestational age, maternal nationality, maternal history, pregnancy complications (gestational diabetes mellitus, gestational hypertension, gestational thyroid disease), infant feeding pattern and infant sex, the results showed that IGF-Ⅱ content in colostrum was positively correlated with infant body length (β=0.9, P ＜0.01). IGF-Ⅱ content in colostrum, 42-day-old milk and 12-month-old milk was positively correlated with infant body weight (P=0.02, P＜0.01 and P=0.01). The Dietary Inflammation Index (DII) was divided into three groups by its tertiles (Q1:the most anti-inflammatory group, Q2:the middle group, Q3:the most pro-inflammatory group) into GEE model, and the results showed that Q3 was positively correlated with the content of IGF-Ⅱ in breast milk (β=28.6, P=0.01). Conclusion Breast milk IGF-Ⅱ has a certain promoting effect on infant length and weight. Pro-inflammatory diet during pregnancy was associated with breast milk IGF-Ⅱ concentration.

Key words： breast milk insulin-like growth factor-Ⅱ diet infant growth and development

收稿日期: 2023-05-17

ZTFLH:

R17

基金资助:澳优乳业(中国)有限公司科研课题(20190590);北京大学人民医院研究与发展基金(RDX2019-10);湖南省营养健康品工程技术研究中心创新平台与人才计划(2019TP2066)

通讯作者: 刘菊芬(liujufen@bjmu.edu.cn);郭倩颖(mia1014@bjmu.edu.cn)

引用本文:

张金娟, 郭倩颖, 崔铭萱, 杨晨, 彭小雨, 潘丽娜, 李威, 汪家琦, 刘晨迪, 王琳琳, 柳鹏, 刘菊芬. 母乳IGF-Ⅱ与婴儿体格生长指标关联性分析及影响因素研究[J]. 中国生育健康杂志, 2024, 35(2): 134-141. ZHANG Jinjuan, GUO Qianying, CUI Mingxuan, YANG Chen, PENG Xiaoyu, PAN Lina, LI Wei, WANG Jiaqi, LIU Chendi, WANG Linlin, LIU Peng, LIU Jufen. Association between human milk insulin like growth factor Ⅱ and infant physical growth indicators and its influencing factors. Chinese Journal of Reproductive Health, 2024, 35(2): 134-141.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2024/V35/I2/134

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