Anne sütündeki leptin, ghrelin, adiponektin ve IGF-1 hormonlarının maternal BKİ ve bebeğin büyümesi ile ilişkisi

Yıl 2021, Cilt: 18 Sayı: 4, 1037 - 1041, 31.12.2021

Tuğçe Tekin Güler Nevra Koç , Aysun Kara Uzun , Mehmet Fisunoğlu

https://doi.org/10.38136/jgon.885842

Öz

Amaç: Maternal beden kütle indeksinin anne sütündeki leptin, ghrelin, adiponektin ve IGF-1 düzeylerine etkisini belirlemek ve anne sütündeki bu hormonların bebeğin büyümesi ile ilişkisini değerlendirmektir.

Gereç ve Yöntemler: Bu araştırmaya Ankara Çocuk Sağlığı ve Hastalıkları Hematoloji Onkoloji Eğitim ve Araştırma Hastanesine başvuran, 2 aylık bebeği olan ve bebeğine sadece anne sütü veren, 20 normal vücut ağırlığına sahip ve 20 obez anne dahil edildi. Bebeklerin doğum ağırlıkları ve boyları hasta dosyasından alındı, 2 aylık değerleri ise muayene sırasında ölçüldü. Anne sütündeki hormon konsantrasyonları uygun Elisa kitleri kullanılarak ölçüldü.

Bulgular: Anne sütündeki leptin, ghrelin, adiponektin ve IGF-1 konsantrasyonları normal vücut ağırlığına sahip anneler ile obez anneler arasında anlamlı bir fark bulunmamıştır (p>0,05). Anne sütündeki leptin hormonu ile gebelik öncesi maternal beden kütle indeksi ve postpartum 2. ay maternal beden kütle indeksi arasında pozitif bir korelasyon gösterilmiştir (sırasıyla r=0,829; p=0,021, r=0,857; p=0,014). Çalışmaya katılan tüm bebeklerin ağırlık kazanımı ile anne sütündeki ghrelin hormonu arasında pozitif bir ilişki varken (r=0,406; p=0,11), adiponektin hormonu ile negatif bir ilişki bulunmuştur (r=-0,336; p=0,034). Bebeklerin 2. aydaki boya göre z skoru değerleri ile normal vücut ağırlığına sahip annelerin anne sütündeki leptin ile negatif (r=-0,857; p=0,014), obez annelerin anne sütündeki ghrelin ile pozitif ilişki tespit edilmiştir (r=0,446; p=0,049).

Sonuç: Maternal beden kütle indeksi anne sütündeki hormon düzeylerini etkileyebilir ve anne sütündeki leptin, adiponektin ve ghrelin düzeyleri bebeğin erken dönemdeki büyümesini etkileyebilmektedir.

Anahtar Kelimeler

anne sütü, bebek büyümesi, maternal BKİ, iştah hormonları

Destekleyen Kurum

TUBİTAK

Proje Numarası

317S038

The Relationship of leptin, ghrelin, adiponectin and IGF-1 hormones in breast milk with maternal BMI and infant growth

Öz

Aim: The aim of this study is to determine the effect of maternal body mass index on leptin, ghrelin, adiponectin and IGF-1 levels in breast milk and to evaluate the relationship of these hormones with infant growth.

Material and Methods: The study was conducted on 20 normal-weight and 20 obese mothers, who had a 2-month-old infants and gave only breast milk to their infants, who applied to Child Health and Diseases, Hematology, Oncology Training and Research Hospital in Ankara. Infant body weight and height at birth were taken from the hospital records, and second month assessments were measured during examination. Hormone concentrations in breast milk were measured by Elisa kits.

Results: There was no significant difference leptin, ghrelin, adiponectin and IGF-1 concentrations in breast milk between normal-weight and obese mothers (p> 0.05). Leptin hormone in breast milk was positively correlated with pre-pregnancy maternal body mass index and postpartum 2nd month maternal body mass index (r = 0.829; p = 0.021, r = 0.857; p = 0.014, respectively). While there was a positive correlation between infants' weight gain and ghrelin hormone in breast milk (r = 0.406; p = 0.11), there was a negative correlation between infants' weight gain and adiponectin hormone (r = -0.336; p = 0.034). Infant weight for length z score at 2 months was negatively correlated with leptin in the breast milk of normal-weight mothers (r = -0.857; p = 0.014), but not ghrelin in the breast milk of obese mothers (r = 0.446; p = 0.049).

Conclusion: Maternal body mass index may affect the hormone levels in breast milk and leptin, adiponectin and ghrelin levels in breast milk may affect the growth of infants during early postnatal life.

Anahtar Kelimeler

breast milk, infant growth, maternal BMI, appetite hormones

Proje Numarası

317S038

Kaynakça

• 1. Kugananthan S, Gridneva Z, Lai CT, Hepworth AR, Mark PJ, Kakulas F, et al. Associations between Maternal Body Composition and Appetite Hormones and Macronutrients in Human Milk. Nutrients. 2017;9(3).
• 2. Breastfeeding. World Health Organization (WHO). Erişim tarihi: 17 Şubat 2021. Available from: https://www.who.int/health-topics/breastfeeding#tab=tab_2.
• 3. Ballard O, Morrow AL. Human milk composition: nutrients and bioactive factors. Pediatric clinics of North America. 2013;60(1):49-74.
• 4. Lawrence R. Breastfeeding. A guide for the medical profession. 6th ed. Philadelphia: Elsevier Mosby. 2005.
• 5. Samur, G. Anne Sütü. Ankara: Sağlık Bakanlığı; 2008. Yayın No: 726.
• 6. Panagos PG, Vishwanathan R, Penfield-Cyr A, Matthan NR, Shivappa N, Wirth MD, et al. Breastmilk from obese mothers has pro-inflammatory properties and decreased neuroprotective factors. Journal of perinatology : official journal of the California Perinatal Association. 2016;36(4):284-90.
• 7. Aktaç Ş. Anne Sütü Hormonları ve Obezite İlişkisi. Turkiye Klinikleri Journal of Nutrition and Dietetics-Special Topics. 2017;3(2):80-7.
• 8. Savino F, Liguori SA, Petrucci E, Lupica MM, Fissore MF, Oggero R, et al. Evaluation of leptin in breast milk, lactating mothers and their infants. European journal of clinical nutrition. 2010;64(9):972-7.
• 9. Aydin S, Aydin S, Ozkan Y, Kumru S. Ghrelin is present in human colostrum, transitional and mature milk. Peptides. 2006;27(4):878-82.
• 10. Martin LJ, Woo JG, Geraghty SR, Altaye M, Davidson BS, Banach W, et al. Adiponectin is present in human milk and is associated with maternal factors. The American journal of clinical nutrition. 2006;83(5):1106-11.
• 11. Lind MV, Larnkjær A, Mølgaard C, Michaelsen KF. Breastfeeding, Breast Milk Composition, and Growth Outcomes. Nestle Nutrition Institute workshop series. 2018;89:63-77.
• 12. Kon IY, Shilina NM, Gmoshinskaya MV, Ivanushkina TA. The study of breast milk IGF-1, leptin, ghrelin and adiponectin levels as possible reasons of high weight gain in breast-fed infants. Annals of nutrition & metabolism. 2014;65(4):317-23.
• 13. Body mass index-BMI. World Health Organization (WHO). Erişim tarihi: 18 Şubat 2021. Available from: https://www.euro.who.int/en/health-topics/disease- prevention/nutrition/a-healthy-lifestyle/body-mass-index-bmi.
• 14. WHO Child Growth Standards based on length/height, weight and age. Acta paediatrica (Oslo, Norway : 1992) Supplement. 2006;450:76-85.
• 15. Kocaadam B, Koksal E, Ozcan KE, Turkyilmaz C. Do the adiponectin and leptin levels in preterm and term breast milk samples relate to infants' short-term growth? Journal of developmental origins of health and disease. 2019;10(2):253-8.
• 16. Chan D, Goruk S, Becker AB, Subbarao P, Mandhane PJ, Turvey SE, et al. Adiponectin, leptin and insulin in breast milk: associations with maternal characteristics and infant body composition in the first year of life. International journal of obesity (2005). 2018;42(1):36-43.
• 17. Sims CR, Lipsmeyer ME, Turner DE, Andres A. Human milk composition differs by maternal BMI in the first 9 months postpartum. The American journal of clinical nutrition. 2020;112(3):548-57.
• 18. Young BE, Patinkin Z, Palmer C, de la Houssaye B, Barbour LA, Hernandez T, et al. Human milk insulin is related to maternal plasma insulin and BMI: but other components of human milk do not differ by BMI. European journal of clinical nutrition. 2017;71(9):1094-100.
• 19. Klok MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2007;8(1):21-34.
• 20. Cesur G, Ozguner F, Yilmaz N, Dundar B. The relationship between ghrelin and adiponectin levels in breast milk and infant serum and growth of infants during early postnatal life. The journal of physiological sciences : JPS. 2012;62(3):185-90.
• 21. Huang LL, Yang F, Xiong F. [Association of leptin, adiponectin, and ghrelin in breast milk with the growth of infants with exclusive breastfeeding]. Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics. 2018;20(2):91-6.
• 22. Khodabakhshi A, Ghayour-Mobarhan M, Rooki H, Vakili R, Hashemy SI, Mirhafez SR, et al. Comparative measurement of ghrelin, leptin, adiponectin, EGF and IGF-1 in breast milk of mothers with overweight/obese and normal-weight infants. European journal of clinical nutrition. 2015;69(5):614-8.
• 23. Woo JG, Guerrero ML, Guo F, Martin LJ, Davidson BS, Ortega H, et al. Human milk adiponectin affects infant weight trajectory during the second year of life. Journal of pediatric gastroenterology and nutrition. 2012;54(4):532-9.
• 24. Woo JG, Guerrero ML, Altaye M, Ruiz-Palacios GM, Martin LJ, Dubert-Ferrandon A, et al. Human milk adiponectin is associated with infant growth in two independent cohorts. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine. 2009;4(2):101-9.
• 25. Galante L, Pundir S, Lagström H, Rautava S, Reynolds CM, Milan AM, et al. Growth Factor Concentrations in Human Milk Are Associated With Infant Weight and BMI From Birth to 5 Years. Frontiers in nutrition. 2020;7:110.