TY - JOUR
T1 - Lactation versus formula feeding
T2 - Insulin, glucose, and fatty acid metabolism during the postpartum period
AU - Ramos-Roman, Maria A.
AU - Syed-Abdul, Majid M.
AU - Adams-Huet, Beverley
AU - Casey, Brian M.
AU - Parks, Elizabeth J.
N1 - Funding Information:
Acknowledgments. The authors thank the postpartum participants, the research coordinating efforts of Linda Flores (Department of Internal Medicine, Division of Endocrinology, University of Texas Southwestern Medical Center), and the biostatistical assistance of Xilong Li (Department of Population and Data Sciences, University of Texas Southwestern Medical Center), senior database analyst. The authors used the services of the Clinical Research Unit and the Advanced Imaging Research Center at University of Texas Southwestern. Funding. This work was supported by the American Diabetes Association (1-14-TS-33) and the National Institutes of Health (R03-DK-097463). Duality of Interest. No potential conflicts of interest relevant to this article were reported. Author Contributions. M.A.R.-R. contributed to the execution of the study, analysis and interpretation of the results, and manuscript writing. M.M.S.-A. contributed to analysis and interpretation of the results and manuscript writing. B.A.-H. contributed to the statistical analysis and interpretation of the results. B.M.C. contributed to the execution of the study and the interpretation of the results. E.J.P. contributed to the analysis and interpretation of the results and manuscript writing. M.A.R.-R. is the guarantor of this work and, as such, had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Funding Information:
The authors thank the postpartum participants, the research coordinating efforts of Linda Flores (Department of Internal Medicine, Division of Endocrinology, University of Texas Southwestern Medical Center), and the biostatistical assistance of Xilong Li (Department of Population and Data Sciences, University of Texas Southwestern Medical Center), senior database analyst. The authors used the services of the Clinical Research Unit and the Advanced Imaging Research Center at University of Texas Southwestern. Funding. This work was supported by the American Diabetes Association (1-14-TS-33) and the National Institutes of Health (R03-DK-097463). Duality of Interest. No potential conflicts of interest relevant to this article were reported.
Publisher Copyright:
© 2020 by the American Diabetes Association. Reader.
PY - 2020/8
Y1 - 2020/8
N2 - Milk production may involve a transient development of insulin resistance in nonmammary tissues to support redistribution of maternal macronutrients to match the requirements of the lactating mammary gland. In the current study, adipose and liver metabolic responses were measured in the fasting state and during a two-step (10 and 20 mU/m2/min) hyperinsulinemic-euglycemic clamp with stable isotopes, in 6-week postpartum women who were lactating (n = 12) or formula-feeding (n = 6) their infants and who were closely matched for baseline characteristics (e.g., parity, body composition, and intrahepatic lipid). When controlling for the low insulin concentrations of both groups, the lactating women exhibited a fasting rate of endogenous glucose production (EGP) that was 2.6-fold greater and a lipolysis rate that was 2.3-fold greater than the formula-feeding group. During the clamp, the groups exhibited similar suppression rates of EGP and lipolysis. In the lactating women only, higher prolactin concentrations were associated with greater suppression rates of lipolysis and lower intrahepatic lipid and plasma triacylglycerol concentra-tions. These data suggest that whole-body alterations in glucose transport may be organ specific and facilitate nutrient partitioning during lactation. Recapitulating a shift toward noninsulin-mediated glucose uptake could be an early postpartum strategy to enhance lactation success in women at risk for delayed onset of milk production.
AB - Milk production may involve a transient development of insulin resistance in nonmammary tissues to support redistribution of maternal macronutrients to match the requirements of the lactating mammary gland. In the current study, adipose and liver metabolic responses were measured in the fasting state and during a two-step (10 and 20 mU/m2/min) hyperinsulinemic-euglycemic clamp with stable isotopes, in 6-week postpartum women who were lactating (n = 12) or formula-feeding (n = 6) their infants and who were closely matched for baseline characteristics (e.g., parity, body composition, and intrahepatic lipid). When controlling for the low insulin concentrations of both groups, the lactating women exhibited a fasting rate of endogenous glucose production (EGP) that was 2.6-fold greater and a lipolysis rate that was 2.3-fold greater than the formula-feeding group. During the clamp, the groups exhibited similar suppression rates of EGP and lipolysis. In the lactating women only, higher prolactin concentrations were associated with greater suppression rates of lipolysis and lower intrahepatic lipid and plasma triacylglycerol concentra-tions. These data suggest that whole-body alterations in glucose transport may be organ specific and facilitate nutrient partitioning during lactation. Recapitulating a shift toward noninsulin-mediated glucose uptake could be an early postpartum strategy to enhance lactation success in women at risk for delayed onset of milk production.
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U2 - 10.2337/db19-1226
DO - 10.2337/db19-1226
M3 - Article
C2 - 32385056
AN - SCOPUS:85088494980
SN - 0012-1797
VL - 69
SP - 1624
EP - 1635
JO - Diabetes
JF - Diabetes
IS - 8
ER -