Influence of lactation on oral glucose tolerance in the puerperium

Lenz, Suzan; Kühl, Claus; Hornnes, Peter; Hagen, Claus

doi:10.1530/acta.0.0980428

Cited by 32 publications

(24 citation statements)

References 12 publications

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“…Adiponectin is an adipocyte-derived protein that has been correlated with insulin sensitivity and pancreatic β-cell function and proliferation. (33) In suppressing circulating leptin and adiponectin,(34) prolactin may reduce insulin secretion and enhance sensitivity of the pancreatic β-cells. (32) Lower circulating adiponectin concentrations during lactation are unlikely to adversely affect insulin sensitivity, because glucose uptake by the mammary gland is supported by non-insulin mediated mechanisms.…”

Section: Discussionmentioning

confidence: 99%

Lactation intensity and fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin in postpartum women with recent gestational diabetes mellitus: The SWIFT cohort

et al. 2014

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Objectives Lactation may influence future progression to type 2 diabetes after gestational diabetes mellitus (GDM). However, biomarkers associated with progression to glucose intolerance have not been examined in relation to lactation intensity among postpartum women with previous GDM. This study investigates whether higher lactation intensity is related to more favorable blood lipids, lipoproteins and adipokines after GDM pregnancy independent of obesity, socio-demographics and insulin resistance. Methods The Study of Women, Infant Feeding, and Type 2 Diabetes (SWIFT) is a prospective cohort study that recruited 1,035 women diagnosed with GDM by the 3-hour 100 g oral glucose tolerance tests (OGTTs) after delivery of a live birth in 2008–2011. Research staff conducted 2-hour 75 gram OGTTs, and assessed lactation intensity, anthropometry, lifestyle behaviors and socio-demographics at 6–9 weeks postpartum (baseline). We assayed fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin from stored samples obtained at 6–9 weeks postpartum for in 1,007 of the SWIFT participants who were free of diabetes at baseline. Mean biomarker concentrations were compared among lactation intensity groups using multivariable linear regression models. Results Increasing lactation intensity showed graded monotonic associations with fully adjusted mean biomarkers: 5–8% higher high-density lipoprotein cholesterol (HDL-cholesterol), 20–28% lower fasting triglycerides, 15–21% lower leptin (all trend P-values<0.01), and with 6% lower adiponectin, but only after adjustment for insulin resistance (trend P-value=0.04). Conclusion Higher lactation intensity was associated with more favorable biomarkers for type 2 diabetes, except for lower plasma adiponectin, after GDM delivery. Long-term follow-up studies are needed to assess whether these effects of lactation persist to predict progression to glucose intolerance.

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Section: Discussionmentioning

confidence: 99%

Lactation intensity and fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin in postpartum women with recent gestational diabetes mellitus: The SWIFT cohort

et al. 2014

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“…Lactating compared with nonlactating women display more favorable metabolic parameters, including less atherogenic blood lipids [34], lower fasting and postprandial blood glucose and insulin [27, 28], and greater insulin sensitivity [27]. Exclusive lactation is associated with greater weight loss in some studies, and with the most favorable metabolic profiles [69].…”

Section: Discussionmentioning

confidence: 99%

“…Ingestion of a 30 % higher glucose load by lactating women resulted in similar plasma glucose despite lower insulin concentrations in lactating women [27]. Other studies have reported lower fasting plasma glucose and insulin concentrations in [28], as well as lower plasma insulin concentrations in the postabsorptive state for lactating women [29]. Hubinont et al [30] administered frequently sampled oral glucose tolerance tests (OGTT) with blood samples drawn every 15 minutes for 120 minutes.…”

Section: Blood Glucose and Insulin Sensitivitymentioning

confidence: 99%

Impact of Breastfeeding on Maternal Metabolism: Implications for Women with Gestational Diabetes

Gunderson

2014

Curr Diab Rep

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Lactating compared with nonlactating women display more favorable metabolic parameters, including less atherogenic blood lipids, lower fasting and postprandial blood glucose as well as insulin, and greater insulin sensitivity in the first 4 months postpartum. However, direct evidence demonstrating that these metabolic changes persist from delivery to postweaning is much less available. Studies have reported that longer lactation duration may reduce long-term risk of cardiometabolic disease, including type 2 diabetes, but findings from most studies are limited by self-report of disease outcomes, absence of longitudinal biochemical data, or no assessment of maternal lifestyle behaviors. Studies of women with a history gestational diabetes mellitus (GDM) also reported associations between lactation duration and lower the incidence of type 2 diabetes and the metabolic syndrome. The mechanisms are not understood, but hormonal regulation of pancreatic β-cell proliferation and function or other metabolic pathways may mediate the lactation association with cardiometabolic disease in women.

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“…Several studies conducted during or shortly after lactation have revealed that fasting blood glucose, postprandial blood glucose and insulin concentrations were lower [11,12], atherogenic blood lipid concentrations were lower [13] and insulin sensitivity was improved [11] in healthy, middle-aged lactating women compared with non-lactating women. These short-term observations may be explained by metabolic adaptions to lactogenesis, particularly the diversion of glucose by insulin-independent pathways for uptake by the mammary gland [14].…”

Section: Introductionmentioning

confidence: 99%

Lactation is associated with altered metabolomic signatures in women with gestational diabetes

et al. 2016

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Aims/hypothesis Lactation for >3 months in women with gestational diabetes is associated with a reduced risk of type 2 diabetes that persists for up to 15 years postpartum. However, the underlying mechanisms are unknown. We examined whether in women with gestational diabetes lactation for >3 months is associated with altered metabolomic signatures postpartum. Methods We enrolled 197 women with gestational diabetes at a median of 3.6 years (interquartile range 0.7-6.5 years) after delivery. Targeted metabolomics profiles (including 156 metabolites) were obtained during a glucose challenge test. Comparisons of metabolite concentrations and ratios between women who lactated for >3 months and women who lactated for ≤3 months or not at all were performed using linear regression with adjustment for age and BMI at the postpartum visit, time since delivery, and maternal education level, and correction for multiple testing. Gaussian graphical modelling was used to generate metabolite networks.Results Lactation for >3 months was associated with a higher total lysophosphatidylcholine/total phosphatidylcholine ratio; in women with short-term follow-up, it was also associated with lower leucine concentrations and a lower total branchedchain amino acid concentration. Gaussian graphical modelling identified subgroups of closely linked metabolites within phosphatidylcholines and branched-chain amino acids that were affected by lactation for >3 months and have been linked to the pathophysiology of type 2 diabetes in previous studies. Conclusions/interpretation Lactation for >3 months in women with gestational diabetes is associated with changes in the metabolomics profile that have been linked to the early pathogenesis of type 2 diabetes.

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Influence of lactation on oral glucose tolerance in the puerperium

Cited by 32 publications

References 12 publications

Lactation intensity and fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin in postpartum women with recent gestational diabetes mellitus: The SWIFT cohort

Lactation intensity and fasting plasma lipids, lipoproteins, non-esterified free fatty acids, leptin and adiponectin in postpartum women with recent gestational diabetes mellitus: The SWIFT cohort

Impact of Breastfeeding on Maternal Metabolism: Implications for Women with Gestational Diabetes

Lactation is associated with altered metabolomic signatures in women with gestational diabetes

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