母乳中瘦素、脂联素及胃饥饿素与纯母乳喂养婴儿生长的关系

Association of leptin, adiponectin, and ghrelin in breast milk with the growth of infants with exclusive breastfeeding

目的探讨母乳中生物活性成分瘦素、脂联素及胃饥饿素与纯母乳喂养婴儿体重增长速率之间的关系。方法选取定期儿童保健的67例纯母乳喂养的单胎足月婴儿及其乳母作为研究对象,根据测量所得的婴儿体重、身长进行营养状态评价(低体重、生长迟缓、消瘦、超重、肥胖);采用Z积分计算生长速度,并根据ΔZ积分将研究对象分为生长不良组、生长速度低下组和生长速度正常组。采集婴儿母亲成熟乳,用ELISA法检测成熟乳中瘦素、脂联素及胃饥饿素水平。结果消瘦组的母乳瘦素水平低于非消瘦组(P<0.05),超重/肥胖组的母乳脂联素水平低于非超重/肥胖组(P<0.05)。相关性分析显示,母乳胃饥饿素水平与目前体重Z积分、较出生体重相比的ΔZ积分呈正相关关系(分别rs=0.280、0.290,P<0.05)。回归分析显示母乳胃饥饿素水平是影响当前体重Z积分的重要因素(β=0.161,P<0.05)。结论母乳当中的多种活性成分(瘦素、脂联素及胃饥饿素)可能在一定程度上调节婴儿的生长发育,但与子代生长发育的相关性及母乳对子代的健康促进效应原因还有待长期的研究观察。

Objective To investigate the association of leptin, adiponectin, and ghrelin in breast milk with the weight growth velocity of infants with exclusive breastfeeding. Methods A total of 67 full-term singleton infants who received regular child care and exclusive breastfeeding and their mothers were enrolled. The nutritional status was evaluated based on the measurements of body weight and body length（underweight, growth retardation, emaciation, overweight, and obesity）. Z score was used to calculate growth velocity, and according to the ΔZ score, the infants were divided into poor growth group, low growth velocity group, and normal growth velocity group. Mature breast milk samples were collected from their mothers, and ELISA was used to measure the levels of leptin, adiponectin, and ghrelin. Results The emaciation group had a significantly lower level of leptin in breast milk than the non-emaciation group（P〈0.05）, and the overweight/obesity group had a significantly lower level of adiponectin than the non-overweight/obesity group（P〈0.05）. The correlation analysis showed that the level of ghrelin in breast milk was positively correlated with Z score of current body weight and ΔZ score compared with birth weight（rs=0.280 and 0.290 respectively; P〈0.05）. The regression analysis showed that the level of ghrelin in breast milk was an important influencing factor for the Z score of body weight（β=0.161, P〈0.05）. Conclusions Various active constituents in breast milk, including leptin, adiponectin, and ghrelin, may regulate the growth and development of infants to a certain degree, but long-term studies and observation are needed to investigate their association with offspring growth and development and the healthpromoting effect of breast milk on offspring.