Typical Leptin Fall Is Mitigated by Breastfeeding in Female Infants

Prospective Association between Total and Trimester-Specific Gestational Weight Gain Rate and Physical Growth Status in Children within 24 Months after Birth

In this study, our aim was to investigate the potential correlation between the mother's total gestational weight gain (GWG) rate and the trimester-specific GWG rate (GWGR) with the physical development status of the child within 24 months of age. We utilized linear regression models and linear mixed effects models to explore both time point and longitudinal relationships between GWGR and children's anthropometric outcome z-scores at 0, 1, 2, 4, 6, 9, 12, 18, and 24 months. To examine the critical exposure windows, we employed multiple informant models. We also conducted a stratified analysis considering pre-pregnancy BMI and the gender of the children. Our findings revealed notable positive associations between total GWGR and z-scores for body mass index for age (BMIZ), head circumference for age (HCZ), weight for age (WAZ), length for age (LAZ), and weight for length (WHZ) across different trimesters of pregnancy (pint < 0.05). The GWGR during the first two trimesters mainly influenced the relationship between total GWGR and BMIZ, WAZ, and LAZ, while the GWGR during the first trimester had a significant impact on the correlation with HCZ (0.206, 95% CI 0.090 to 0.322). Notably, the associations of GWGR and children's BMIZ were pronounced in male children and pre-pregnancy normal-weight women. In conclusion, our study findings indicated that a higher GWGR during each trimester was associated with greater physical growth during the first 24 months of life, especially GWGR in the first and second trimesters.

Vaspin, a Compensatory Mechanism Against High Glucose Levels Since Birth?

OBJECTIVE

Hormones produced by fat tissue, adipokines, produced during intrauterine life have recently been implicated in fetal growth. Vaspin is an adipokine expressed in visceral adipose tissue and has insulin-sensitizing effects. Elevated serum vaspin concentrations are associated with alterations in insulin sensitivity. We aimed to determine if vaspin concentrations in cord blood from healthy, term newborns differ among those born small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). A secondary objective was to determine whether an association existed between vaspin and anthropometric measurements, glucose and insulin levels in the newborn.

METHODS

The study population included healthy term newborns, 30 subjects in the SGA, 12 in the AGA, and 34 in the LGA group. Anthropometry was documented in all subjects. Blood was taken from the umbilical cord vein from each child for later analysis for vaspin, insulin and glucose concentrations.

RESULTS

Cord blood vaspin, insulin and glucose concentrations were not different between the three study groups. A negative correlation between vaspin and glucose concentrations was demonstrated in the whole cohort (r=-0.364, p=0.001). This correlation was also observed in the LGA group (r=-0.482, p=0.004). Glucose concentrations significantly predicted vaspin concentrations (r²=0.132, p=0.001).

CONCLUSION

We found a negative association between glucose and vaspin concentrations in umbilical cord blood. In addition there was a predictive association between blood glucose and resulting vaspin concentration, suggesting that vaspin can be used as a predictor of alterations in the insulin-glucose metabolism from birth.

Association of Total and Trimester-Specific Gestational Weight Gain Rate with Early Infancy Weight Status: A Prospective Birth Cohort Study in China

Studies to examine the associations of gestational weight gain (GWG) with offspring weight status during infancy are needed, especially among Asian populations. We examined 801 mother–infant pairs from a prospective cohort study in China to assess the associations of total and trimester-specific GWG with early infant weight status. We used linear mixed effects models and linear regression models to examine the longitudinal and time-point associations of GWG rate (kg/week) with infant growth measures (z-scores of body-mass-index (BMIZ), weight-for-age (WFAZ) and length-for-age (LFAZ)) at birth, 1, 3, and 6 months. Greater total GWG rate was associated with higher BMIZ (β:1.34 SD units (95% CI: 0.84, 1.83) per 1 kg/week increase in GWG) and higher WFAZ (β:1.18 SD units (95% CI: 1.01, 2.28)) across the first 6 months of life. GWG rate in the first two trimesters but not in the third trimester was positively associated with infant BMIZ. The association between GWG rate and infant BMIZ was significant at all timepoints and more pronounced in normal weight women and among male infants. In conclusion, greater GWG rate is positively associated with offspring BMIZ in the first 6 months of life, the association is mostly driven by GWG in the first two trimesters.

Impact of maternal pre-pregnancy overweight on infant overweight at 1 year of age: associations and sex-specific differences

BACKGROUND

Maternal overweight or obesity (OWOB) is linked to gestational diabetes, fetal macrosomia and higher rates of caesarean delivery.

OBJECTIVES

The study aims to assess whether maternal pre-pregnancy OWOB is associated with infant overweight in a sex-dependent manner, independent of microbiota-altering variables.

METHODS

Weight and length measurements of 955 mother-infant pairs were obtained from the Canadian Healthy Infant Longitudinal Development cohort. Maternal pre-pregnancy weight was defined as follows: normal, overweight (25 ≤ body mass index < 30) and obese (body mass index ≥ 30). Age and sex-adjusted weight-for-length z-scores >97th percentile were classified as infant overweight at age 1 year. Associations between pre-pregnancy and infant overweight were determined by linear and logistic regression, adjusting for covariates.

RESULTS

Maternal pre-pregnancy OWOB were associated with infant weight-for-length and overweight risk at 1 year. Except for pre-pregnancy obesity, these associations were not attenuated appreciably after adjustment for birth mode, exclusivity of breastfeeding, exposure to antibiotics and infant sex. Yet only boys born to mothers with obesity were three times more likely to become overweight at age 1 independent of microbiota-altering variables. Pre-pregnancy obesity was associated with weight-for-length in male and female infants.

CONCLUSIONS

Maternal pre-pregnancy OWOB increases the risk of infant overweight, and this association is more evident in male infants.

Early feeding of larger volumes of formula milk is associated with greater body weight or overweight in later infancy

Background

The relation between infant feeding and growth has been extensively evaluated, but studies examining the volume of formula milk consumption on infant growth are limited. This study aimed to examine the effects of early feeding of larger volumes of formula on growth and risk of overweight in later infancy.

Methods

In total, 1093 infants were studied prospectively. Milk records collected at 3 mo of age were used to define the following 3 feeding groups: breast milk feeding (BM, no formula), lower-volume formula milk feeding (LFM, <840 ml formula/d), and higher-volume formula milk feeding (HFM, ≥840 ml formula/d). Body weight and length were measured at 3 time points of 3, 6 and 12 mo of age.

Results

The results showed that the difference in weight and length between the HFM and BM infants was significant at 3 mo of age (P < 0.05) and continued until 12 mo of age (P < 0.001). The adjusted mean changes in weight-for-length z-scores (WLZ) and BMI-for-age z-scores (BAZ) from 3 to 6 mo of age were significantly higher in HFM and LFM group than in BM group. Two-way interactions between feeding practice and age intervals were significant for WLZ changes (P = 0.002) and BAZ changes (P = 0.017). Compared with BM-fed infants, infants fed with HFM had 1.60-fold (95% CI 1.05–2.44) higher odds of greater body weight (1SD < WLZ ≤2 SD) at the age of 6 mo and 1.55-fold (95% CI 1.01–2.37) higher odds of greater body weight and 2.13-fold (95% CI 1.03–4.38) higher odds of overweight (WLZ > 2 SD) at the age of 12 mo.

Conclusion

Feeding higher volumes of formula in early infancy is associated with greater body weight and overweight in later infancy.

Adding Multiple Adipokines into the Model do not Improve Weight Gain Prediction by Leptin Levels in Newborns

OBJECTIVE

Most adipose tissue programming is realized in early life. Also, the postnatal three months, rather than the later phases of infancy, may be more relevant in the development of an adverse cardiometabolic risk profile. The adipokines phenotype, as a predictor of early-life weight gain, has been recently explored in cord blood. To determine whether in addition to leptin levels in cord samples, adiponectin, interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1), resistin, plasminogen activator inhibitor-1 (PAI-1), and tumor necrosis factor alpha (TNF-α) levels improve weight gain prediction during the first three months of life.

METHODS

Adiponectin, IL-6, MCP-1, leptin, resistin, PAI-1, and TNF-α were measured by multiplex immunoassay in a subsample of 86 healthy term newborns.

RESULTS

Leptin levels significantly predicted weight gain at 3 months of follow-up (r2=0.09, p=0.006). In the multivariate analysis, including additional adipokines in the model, stepwise or all at once, did not increase the prediction of weight gain after the first three months of life.

CONCLUSION

Adding adiponectin, IL-6, MCP-1, resistin, PAI-1, and TNF-α to the prediction model of weight gain in healthy newborns did not prove to be useful. It is probable that their relative contribution to weight gain is not important. Only leptin was relevant as a predictor of weight gain at the 3-month endpoint.

Leptin, IL-6 and TNF-α levels in umbilical cord blood of healthy term newborns in relation to mode of delivery

In the development of the foetal immune system, cytokines play an important role in its function. Therefore, we sought to determine whether the mode of delivery affects the expression of leptin, IL-6 and TNF-α in umbilical cord blood in healthy term newborns. We collected 125 samples of umbilical cord blood to analyse leptin, IL-6 y TNF-α levels with multiplex immunoassay (MIA). The samples were classified according to mode of delivery: vaginal delivery (VD) and caesarean section (CS). Leptin and IL-6 had higher concentrations in umbilical cord blood in VD than in CS: 42.55 ng/ml (11.92-104.28) versus 35.20 ng/ml (3.26-9326.76), p  =  0.039; 9.32 pg/ml (1.13-2020.31) versus 3.81 pg/ml (0.52-834.69) p < 0.001, respectively. Also, a weak correlation between TNF-α and IL-6 was found (r = 0.238, p = 0.007). The most important finding in our study was the differential concentrations of leptin and IL-6 according to mode of delivery.

Sexually dimorphic response to feeding mode in the growth of infants

BACKGROUND

The relation between infant feeding and growth has been extensively evaluated, but studies examining sex differences in the influence of infant milk feeding on growth are limited.

OBJECTIVE

We examined the interaction of infant feeding and sex in relation to infant growth and compared growth trajectories in breastfed and formula-fed boys and girls.

DESIGN

In 932 infants in a Singapore mother-offspring cohort, feeding practices in the first 6 mo were classified into the breastfeeding group (BF), mixed feeding group (MF), and formula feeding group (FF). Infant weight and length were measured and converted to WHO standards for weight-for-age z scores (WAZs) and length-for-age z scores (LAZs). Differences in WAZ and LAZ from birth to 6 mo, 6 to 12 mo, and 12 to 24 mo of age were calculated. Three-way interactions were examined between feeding mode, sex, and age intervals for WAZ and LAZ changes, with adjustment for confounders.

RESULTS

The interaction between feeding mode, sex, and age intervals was significant for LAZ changes (P = 0.003) but not WAZ changes (P = 0.103) after adjustment for potential confounders. Compared with BF girls, BF boys showed similar LAZ gain (+0.28 compared with +0.39, P = 0.544) from 0 to 6 mo of age but greater LAZ gain from 6 to 12 mo of age (+0.39 compared with -0.10, P = 0.008). From 0 to 6 mo of age, FF boys and girls showed greater LAZ gains than their BF counterparts; from 6 to 12 mo of age, FF girls showed higher LAZ gain (+0.25 compared with -0.10, P = 0.031) than BF girls, which was not seen in boys.

CONCLUSIONS

During infancy, there is a sexually dimorphic growth response to the mode of infant milk feeding, raising questions about whether formula feeding ought to remain sex neutral. However, further investigations on sex-specific feeding and infant growth are warranted before a conclusive message can be drawn based on our current findings. This trial was registered at www.clinicaltrials.gov as NCT01174875.

Maternal characteristics associated with milk leptin content in a sample of Filipino women and associations with infant weight for age

BACKGROUND

Human milk contains many metabolic hormones that may influence infant growth. Milk leptin is positively associated with maternal adiposity and inversely associated with infant growth. Most research has been conducted in populations with higher leptin levels; it is not well understood how milk leptin may vary in lean populations or the associations that reduced leptin may have with infant size for age. It is also largely unknown if associations between maternal body composition and milk leptin persist past 1 year of age.

OBJECTIVES

We investigated the association between maternal body composition and milk leptin content in a sample of lean Filipino women and the association between milk leptin content and infant size for age.

METHODS

Milk samples were collected at in-home visits from 113 mothers from Cebu, Philippines. Milk leptin content was measured using EIA techniques; anthropometric data, dietary recalls, and household information were also collected.

RESULTS

Mean ± standard deviation (SD) milk leptin in this sample was 300.7 ± 293.6 pg/mL, among the lowest previously reported. Mean ± SD maternal percentage body fat was 24.8% ± 3.5%. Mean ± SD infant age was 9.9 ± 7.0 months, and mean ± SD weight for age z-score was -0.98 ± 1.06. Maternal percentage body fat was a significant, positive predictor of milk leptin content. Milk leptin was a significant, inverse predictor of infant weight and body mass index z-scores in infants 1 year old or younger.

CONCLUSION

The association between maternal body composition, milk leptin, and infant growth persists in mothers with lean body composition. Milk leptin is not associated with growth in older infants.

Measurement of Leptin by RIA Versus MIA in a Population of Healthy Newborns

BACKGROUND

Assays based on multiplex immunoassay (MIA) technology have demonstrated advantages over enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA). Its acceptance depends on how well it performs in comparison to older techniques. The aim is to compare the results of leptin using RIA versus MIA.

METHODS

We analyzed 81 samples of umbilical cord blood of healthy term newborns by RIA and MIA.

RESULTS

The concordance correlation coefficient was 0.158 (95% CI 0.10-0.21). Pearson's correlation coefficient was 0.6651 (95% CI 0.52-0.77; P < 0.0001). In the Bland-Altman plot, concordance is acceptable because most of the measurements are within a mean of ±1.96 SD.

CONCLUSIONS

As shown by the Bland-Altman plot, there is concordance by both methods, but with a weak correlation.

Feeding choice has a gender-associated effect on infant growth

BACKGROUND

Appropriate nutrition during childhood is important for preventing future development of lifestyle-related diseases. The effect of feeding choice on infant growth in Japan is not known.

METHODS

Data from 204 healthy schoolchildren (age, 6-9 years) were obtained retrospectively from their parents by questionnaires. Breast-fed (BF) and formula-fed (FF) groups were defined as those fed only breast milk or formula milk at 4 months of age, respectively. There were 71 children (M/F, 31/40) in BF and 30 (M/F, 19/11) in FF. Anthropometric data at birth, and at 1, 4, 7, 10, 18, and 36 months of age in male and female infants were compared between the groups.

RESULTS

In male infants, height was significantly lower at 4 months, bodyweight was lower from 4 to 18 months, and body mass index (BMI) was lower from 10 to 36 months in BF than in FF. The standard deviation scores (SDS) for height, weight and BMI had a similar pattern. No significant differences were observed for these variables for female infants in BF compared with FF. Multiple regression analysis showed that birthweight, mother's pre-pregnancy weight, and infant feeding choice were significant factors associated with weight-SDS at 18 and 36 months. Feeding choice was the only factor associated with BMI-SDS at 18 months.

CONCLUSIONS

Infant feeding choice had a gender-associated effect on growth during infancy. When evaluating infant growth, not only birthweight and mother's pre-pregnancy weight, but also infant feeding choice and gender should be considered.

Weight status and dietary intake determine serum leptin concentrations in pregnant and lactating women and their infants

Leptin regulates energy homeostasis and immune and metabolic functions. Highly elevated leptin concentrations during pregnancy may be associated with aberrations in maternal metabolism and long-term health consequences both in women and children. The objective of the present study was to evaluate whether dietary counselling, probiotic supplementation, maternal characteristics or dietary intake during pregnancy has an impact on serum leptin concentrations in women, cord blood or in children. A total of 256 pregnant women were randomised to a control group (n 85) or to receive dietary counselling with probiotics (n 85) or placebo (n 86). Dietary counselling aimed at affecting the type of fat used and to increase the amount of fibre in the women's diet. Women's dietary intake and serum leptin concentrations were analysed at the first and third trimesters of pregnancy and at 1 month postpartum. Furthermore, leptin concentrations were measured from the cord blood and from children's serum at 1 and 6 months of age. Weight status and dietary composition were the key determinants of leptin concentrations. Specifically, high dietary fibre and low SFA intakes were related to low serum leptin concentrations in women. Female sex and birth weight were associated with higher infant leptin, whereas cord blood leptin was additionally affected by maternal leptin concentration and protein intake. Probiotics or dietary counselling did not affect leptin concentrations. Weight control to recommended levels and modification of diet towards higher fibre and lower SFA intakes during pregnancy may through leptin concentrations provide health benefits to both women and children.