Ghrelin, adiponectin, leptin and true insulin levels in human milk from mothers with gestational diabetes mellitus and its relationship with infant growth / 中华围产医学杂志

ABSTRACT

Objective To evaluate the levels of ghrelin, adiponectin, leptin and true insulin in human milk from mothers with and without gestational diabetes mellitus (GDM), and to assess the effects of these parameters on infant growth. Methods Fifty-two GDM mothers and their healthy infants (GDM group) and 49 non-GDM mothers and their healthy infants (control group) were enrolled from Beijing Obstetrics and Gynecology Hospital and Peking Union Medical College Hospital from January 2010 to August 2010. The levels of ghrelin, adiponectin, leptin and true insulin in colostrum and human milk 90 days postpartum (mature milk) were determined by enzyme-linked immunosorbent assay. Infant weight, length and head circumference at birth and at 90 days old were measured. The two-sample t-test, sum-rank test and Spearman correlation analysis were used for statistical analysis. Results Compared with the control group, ghrelin was significantly lower in human milk from GDM mothers both in colostrum [136.7 (102.7-181.4) vs 175.4 (137.5-235.0) ng/L, t= -2.737] and mature milk [111.8 (77.5-184.2) vs 210.9 (147.3-381.9) ng/L, t= -3.268]. Adiponectin was also significantly lower in human milk from GDM mothers both in colostrum [21.7 (14.6-51.8) vs 57.0 (23.1-113.9)μg/L, t=-2.858] and mature milk [11.7 (8.4-14.4) vs 15.1 (11.9-18.5)μg/L, t=-2.625], however, true insulin level was higher in colostrum [22.8 (13.4-50.2) vs 20.4 (7.8-30.8) mU/L, t=-2.007] and mature milk [33.6 (22.5-54.1) vs 23.5 (13.5-31.6) mU/L, t=-2.009]. The differences were statistically significant (all P < 0.05). (2) In the colostrums of the GDM group, true insulin level was negatively associated with ghrelin (r=-0.342), but positively associated with adiponectin (r=0.305). In the control group, the level of true insulin in mature milk was positive associated with leptin in colostrums( r=0.456)and mature milk(r=0.629). The differences were statistically significant (all P < 0.05). (3) In the GDM group, adiponectin level in colostrum was negatively associated with neonatal birth weight (r= - 0.323, P=0.025); the leptin/adiponectin ratio was negatively associated with neonatal birth weight (r= -0.403, P=0.005) and head circumference (r= -0.327, P=0.039) at birth. Adiponectin level in mature milk was negatively associated with infant length 90 days postpartum (r=-0.406, P=0.040). In the control group, the leptin/adiponectin ratio in colostrum was negatively associated with neonatal head circumference at birth (r= -0.370, P=0.024). Adiponectin level in mature milk was positively associated with infant weight 90 days postpartum (r=0.432, P=0.007). Conclusion Women with GDM have different levels of ghrelin, adiponectin and true insulin in their milk from the normal controls, which may affect infant growth.