Original Article | Published:

Carbohydrates, insulin resistance and diabetes mellitus

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 volume 71, pages 10941100 (2017) | Download Citation

Abstract

Background/Objectives:

The impact of maternal BMI and insulin sensitivity on bioactive components of human milk (HM) is not well understood. As the prevalence of obesity and diabetes rises, it is increasingly critical that we understand how maternal BMI and hormones associated with metabolic disease relate to concentrations of bioactive components in HM.

Subjects/Methods:

This longitudinal cohort design followed 48 breastfeeding mothers through the first four months of lactation, collecting fasting morning HM samples at 2-weeks and 1, 2, 3 and 4-months, and fasting maternal blood at 2-weeks and 4-months. Insulin, glucose, adipokines leptin and adiponectin, appetite regulating hormone ghrelin, marker of oxidative stress 8OHdG and inflammatory cytokines (IL-6, IL-8, and TNF-a) were measured in HM and maternal plasma.

Results:

A total of 26 normal weight (NW) (BMI=21.4±2.0 kg/m2) and 22 overweight/obese (OW/Ob) (BMI=30.4±4.2 kg/m2) were followed. Of all HM analytes measured, only insulin and leptin were different between groups – consistently higher in the OW/Ob group (leptin: P<0.001; insulin: P<0.03). HM insulin was 98% higher than maternal plasma insulin at 2-weeks and 32% higher at 4-months (P<0.001). Maternal fasting plasma insulin and HOMA-IR were positively related to HM insulin at 2-weeks (P<0.001, R20.38, n=31), and 4-months (P0.005, R20.20, n=38).

Conclusions:

The concentrations of insulin in HM are higher than in maternal plasma and are related to maternal BMI and insulin sensitivity. With the exception of leptin, there were minimal other differences observed in HM composition across a wide range in maternal BMI.

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Acknowledgements

We wish to deeply thank the mothers and infants who participated in this research. We also acknowledge Claire Westcott, BS; Catherine Chartier-Logan, MPH; Melanie Reece, PhD; and Regina Reynolds, MD for support with study execution. We would also like to thank the National Institute of Health (NIH)/NICHD F32-HD0978068 (PI: BEY); Thrasher Research Fund Early Career Award (PI: BEY); Center for Women’s Health Research at the University of Colorado Anschutz Medical Campus (PI: BEY); Colorado Clinical & Translational Sciences Institute (CCTSI) with the Development and Informatics Service Center (DISC) grant support (Colorado CTSI Grant Number NIH/NCATS UL1-TR001082; PI: BEY); NIH/NIDDK K24-DK083772 (PI: NFK); NIH/NIDDK T32-DK007658-21 (PI: NFK).

Author information

Affiliations

  1. Department of Pediatrics, Section of Nutrition, School of Medicine, University of Colorado, Aurora, CO, USA

    • B E Young
    • , Z Patinkin
    • , C Palmer
    •  & N F Krebs
  2. Department of Pediatrics, Section of Neonatology, School of Medicine, University of Colorado, Aurora, CO, USA

    • B de la Houssaye
    •  & J E Friedman
  3. Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, School of Medicine, University of Colorado, Aurora, CO, USA

    • L A Barbour
    • , T Hernandez
    •  & J E Friedman
  4. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, School of Medicine, University of Colorado, Aurora, CO, USA

    • L A Barbour
    •  & T Hernandez
  5. College of Nursing, University of Colorado, Aurora, CO, USA

    • T Hernandez

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to B E Young.

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DOI

https://doi.org/10.1038/ejcn.2017.75

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