title: Associations of prenatal metabolic abnormalities with insulin and adiponectin concentrations in human milk.
abstract: BACKGROUND
  Emerging evidence indicates that metabolic hormones are present in human milk, but, to our knowledge, no studies have investigated the impact of maternal metabolic status assessed during pregnancy on insulin and adiponectin concentrations in milk.
  
  
  OBJECTIVE
  We aimed to investigate the associations of prenatal metabolic abnormalities with insulin and adiponectin in human milk and to compare the concentrations of these hormones in early and mature milk.
  
  
  METHODS
  Pregnant women aged ≥20 y with intention to breastfeed and without preexisting type 1 or 2 diabetes were recruited. Participants (n = 170) underwent a 3-h oral-glucose-tolerance test at 30 wk (95% CI: 25, 33 wk) gestation and donated early (the first week postpartum) and mature (3 mo postpartum) milk.
  
  
  RESULTS
  Adiponectin and insulin concentrations in early milk were higher than those in mature milk (both P < 0.0001). Prenatal metabolic abnormalities, including higher pregravid BMI (β ± SEE: 0.053 ± 0.014; P = 0.0003) and gravid hyperglycemia (0.218 ± 0.087; P = 0.01), insulin resistance (0.255 ± 0.047; P < 0.0001), lower insulin sensitivity (-0.521 ± 0.108; P < 0.0001), and higher serum adiponectin (0.116 ± 0.029; P < 0.0001), were associated with higher insulin in mature milk after covariate adjustment. Prenatal metabolic measures were not associated with milk adiponectin, but obstetrical measures that included nulliparity (0.171 ± 0.058; P = 0.004), longer duration of gestation (0.546 ± 0.146; P = 0.0002), and unscheduled cesarean delivery (0.387 ± 0.162; P = 0.02) were associated with higher adiponectin in early milk after covariate adjustment, including the time elapsed from delivery to milk collection.
  
  
  CONCLUSIONS
  Maternal prenatal metabolic abnormalities are associated with high insulin concentrations in mature milk, whereas only obstetrical variables are associated with adiponectin concentrations in early milk.
authors.affiliation: Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
authors.forename: Sylvia H
authors.initials: SH
authors.lastname: Ley
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hanley
authors.forename: Mathew
authors.initials: M
authors.lastname: Sermer
authors.forename: Bernard
authors.initials: B
authors.lastname: Zinman
authors.forename: Deborah L
authors.initials: DL
authors.lastname: O'Connor
mesh_terms: D052242:Adiponectin / Q000097:blood / Q000378:metabolism*; D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section; D016640:Diabetes, Gestational / Q000097:blood / Q000378:metabolism; D005260:Female; D044882:Glucose Metabolism Disorders / Q000097:blood / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000378:metabolism; D007328:Insulin / Q000097:blood / Q000378:metabolism*; D007333:Insulin Resistance; D008895:Milk, Human / Q000378:metabolism*; D010298:Parity; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000378:metabolism*; D011263:Pregnancy Trimester, Third; D011273:Pregnancy, Prolonged / Q000097:blood / Q000378:metabolism; D011795:Surveys and Questionnaires
chemical_list: C499918:ADIPOQ protein, human; D052242:Adiponectin; D007328:Insulin