635 - Adiponectin and leptin in preterm human milk diets and infant body composition

Publication Number: 635.3671

Lindsay Ellsworth, University of Michigan Medical School, Chelsea, MI, United States; Adrienne Bruder, University of Michigan Medical School, Ann Arbor, MI, United States; Brigid Gregg, University of Michigan Medical School, Ann Arbor, MI, United States; Subramaniam Pennathur, University of Michigan Medical School, Ann Arbor, MI, United States

Background: Human milk is a complex biofluid containing adipokines including adiponectin and leptin that influence appetite, metabolic regulation, energy expenditure, and weight gain. Evaluating adipokine levels in the diets of preterm infants is key to assessing the impact on the lactational programming of infant growth.

Objective: To measure adiponectin and leptin in fortified mother’s own milk (MOM) and heat pasteurized donor human milk (HPDHM) received by preterm infants and evaluate the association with weight trajectory and body composition through hospital discharge.

Design/Methods: This study includes a subset of mother-infant dyads from a prospective, observational cohort study of infants born ≤34 weeks gestational age or ≤1800 grams birth weight with milk samples from the 3-week postpartum timepoint. Fortified milk samples were obtained documenting volume, type of human milk (MOM, HPDHM), and type of fortification (human milk-based: HMB, bovine-based: BB). Adiponectin and leptin were measured from whole milk using enzyme linked immunoassay. Infant weight and length were collected from birth to discharge, with Z-scores calculated. Infant body composition was measured at discharge or 40 weeks using air displacement plethysmography. Fat free mass (FFM), fat mass (FM), and percent body fat were obtained, with Z-scores calculated. Analyses were conducted with Mann-Whitney U test, Spearman correlations, and linear regression.

Results: A subset of 68 mother-infant dyads were included with 63% on BB fortification and 37% on HMB fortification at the 3 week timepoint. Average gestational age was 30.75 weeks (range 24-34 weeks). Milk adiponectin was higher in human milk diets with HMB fortifier (41.55±15.00 ng/mL) compared to BB fortifier (15.45±12.70 ng/mL) (p < 0.0001, Figure 1A). There was no difference in milk leptin based on type of fortification (p=0.63, Figure 1B). Body composition showed mean (SD) Z-scores for FM 0.79 (±0.92), FFM -1.27 (±0.85), and body fat percentage 1.27 (±1.00). There were no associations between milk adiponectin or leptin content with infant FM, FFM, body fat percentage Z-score. Milk leptin was positively associated with change in weight Z-score from birth to discharge (β 0.53, p=0.01) while there was no association with adiponectin.

Conclusion(s): The type of preterm milk fortification impacts adiponectin content with no difference in leptin content. While milk adiponectin and leptin were not associated with body fat composition, higher milk leptin was associated with increased preterm infant weight trajectory suggesting a role for milk adipokines in the developmental programming of growth.

Figure 1. Milk adiponectin and leptin concentrations based on type of milk fortification.
****p < 0.0001. Abbreviation: Not significant (ns).