| Popis: |
Obesity is associated with chronic inflammation and is a risk factor for insufficient milk production. Inflammation-mediated suppression of lipoprotein lipase could inhibit mammary uptake of long-chain fatty acids (LCFAs,16C).In an ancillary case control analysis, we investigated whether women with low milk production despite regular breast emptying have elevated inflammation and disrupted transfer of LCFAs from plasma into milk.Data and specimens from a low milk supply study and an exclusively breastfeeding control group were analyzed, with milk production measured by 24-hour test-weighing at 2-10 weeks postpartum. Low milk supply groups were defined as very low (VL,300 mL/d; n = 23) or moderate (MOD, ≥300 mL/d; n = 20) milk production, and compared to controls (≥699 mL/d; n = 18). Serum and milk fatty acids (weight% of total) were measured by gas chromatography, serum and milk TNF-α by ELISA, and serum high-sensitivity C-reactive protein (hsCRP) by clinical analyzer. Group differences were assessed by linear regression models, Chi-square exact tests, and Kruskal Wallis nonparametric tests.VL cases, as compared to MOD and controls, had higher prevalence of elevated serum hsCRP (5 mg/L, 57%, 15%, 22%, respectively, p = 0.004), detectable milk TNF-α (67%, 32%, 33%, respectively, p = 0.04), and obesity (78%, 40%, 22%, respectively, p = 0.003). VL cases had lower LCFAs in milk (Mean[±SD], 60[±3%]) compared to MOD (65[±4%]) and controls (66[±5%]; (p 0.001). Milk and serum LCFAs were strongly correlated in controls (r = 0.82, p 0.001), but not in MOD (r = 0.25, p = 0.30) or VL (r = 0.20, p = 0.41) groups (pint 0.001).Mothers with very low milk production have significantly higher obesity and inflammatory biomarkers, lower LFCAs in milk, and disrupted association between plasma and milk LCFAs. These data support the hypothesis that inflammation disrupts normal mammary gland fatty acid uptake. Further research should address impacts of inflammation and obesity on mammary fatty acid uptake for milk production. |
