目的 系统分析母乳羟基脂肪酸酯（fatty acid esters of hydroxy fatty acids, FAHFAs）随泌乳进程的变化特征,探讨影响其水平的相关因素。方法 纳入65名孕周≥37 w、拟纯母乳喂养的单胎孕妇,分别于产后3 d（V1）、42 d（V2）和3个月（V3）采集母乳;依据孕前身体质量指数（body mass index,BMI）将研究对象分为正常体重组、超重/肥胖组;采用超高效液相色谱-串联质谱（UHPLC-MS/MS）定量检测各FAHFA异构体含量,通过24 h膳食回顾调查乳母膳食摄入及膳食补充剂使用情况;构建多元线性回归模型,评估乳母膳食、泌乳阶段、胎产次等因素对母乳FAHFAs浓度的独立效应。结果 与正常体重乳母相比,超重/肥胖乳母初乳（V1）中5-羟基硬脂酸棕榈酸酯（5-PAHSA）、成熟乳（V2）中9-羟基硬脂酸硬脂酸酯（9-SAHSA）含量显著升高（校正P值分别为0.013、0.044）,而成熟乳（V2、V3）中13-羟基亚油酸亚油酸酯（13-LAHLA）含量显著降低（校正P值分别为0.028、0.005）;多元线性回归分析显示,鱼虾摄入为母乳13-LAHLA浓度的独立正向影响因素,孕前BMI为其独立负向影响因素;DHA摄入、泌乳时长对9-羟基硬脂酸油酸酯（9-OAHSA）浓度存在正向独立作用,胎产次对9-羟基硬脂酸棕榈油酸酯（9-POHSA）含量存在负向独立效应,泌乳阶段为10-羟基硬脂酸油酸酯（10-OAHSA）浓度的独立正向预测因素。结论 乳母鱼虾摄入、DHA摄入、孕前BMI、泌乳阶段及胎产次均可在一定程度上影响母乳FAHFAs浓度,为母乳FAHFAs水平的潜在影响因素。
Abstract
Objective To analyze fatty acid esters of hydroxy fatty acids (FAHFAs) concentrations in breast milk across lactation stages and their influencing factors. Methods A total of 65 singleton pregnant women with gestational age ≥37 weeks who intended to exclusively breastfeed were enrolled in this study. Breast milk samples were collected at 3 days (V1), 42 days (V2), and 3 months (V3) postpartum. Participants were categorized into normal-weight and overweight/obese groups according to their pre-pregnancy body mass index (BMI). The concentrations of individual FAHFA isomers were quantified using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS). Dietary intake was assessed using the 24-hour dietary recall method and information on dietary supplement use was collected. Multiple linear regression models were applied to analyze the effects of maternal diet, lactation stage, parity and other factors on breast milk FAHFAs levels. Results Compared with the normal-weight lactating women, overweight/obese women had significantly higher concentrations of 5-PAHSA in colostrum (V1) and 9-SAHSA in mature milk (V2) (adjusted P = 0.013 and 0.044, respectively), but significantly lower concentrations of 13-LAHLA in mature milk (V2 and V3) (adjusted P = 0.028 and 0.005, respectively). Multiple linear regression revealed that maternal fish and shrimp intake was an independent positive influencing factor for breast milk 13-LAHLA concentration, while pre-pregnancy BMI served as its independent negative influencing factor. DHA intake and lactation duration exerted positive independent effects on 9-oleoylstearic acid ester of 9-hydroxy stearic acid (9-OAHSA) concentration and parity had a negative independent effect on 9-palmitoleoylstearic acid ester of 9-hydroxy stearic acid (9-POHSA) levels, while lactation stage was an independent positive predictor of 10-oleoylstearic acid ester of 10-hydroxy stearic acid (10-OAHSA) concentration. Conclusion Maternal fish and shrimp intake, DHA intake, pre-pregnancy BMI, lactation stage and parity can affect breast milk FAHFA concentrations to a certain extent and act as potential influencing factors for breast milk FAHFA levels.
关键词
母乳 /
羟基脂肪酸酯 /
影响因素
Key words
breast milk /
fatty acid esters of hydroxy fatty acids /
influencing factors
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基金
合生元营养与护理研究院“母婴营养与护理研究基金”项目（No.2022BINCMCF019）
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