PMID- 37711904
OWN - NLM
STAT- MEDLINE
DCOM- 20230918
LR  - 20230919
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 14
DP  - 2023
TI  - Prolactin does not seem to mediate the improvement on insulin resistance markers 
      and blood glucose levels related to breastfeeding.
PG  - 1219119
LID - 10.3389/fendo.2023.1219119 [doi]
LID - 1219119
AB  - INTRODUCTION: The prevalence of type 2 diabetes mellitus (T2DM) is increasing 
      worldwide. Strategies to decrease this risk should be strongly encouraged. 
      Lactation has been associated, for the mother, with reduction in future T2DM risk 
      in several studies. The mechanisms behind this phenomenon, however, are poorly 
      understood. The aims of this study were, first, to compare blood glucose levels 
      and markers of insulin resistance (MIR) in early postpartum women with 
      overweight/obesity according to their breastfeeding status and, second, to 
      evaluate whether prolactin (PRL) levels could mediate improvements in these 
      parameters. METHODS: The prospective study followed 95 women older than 18 years 
      from early pregnancy for up to 60 to 180 days postpartum. All participants had a 
      BMI > 25 kg/m(2) and a singleton pregnancy. At each visit, questionnaires and 
      clinical and biochemical evaluations were performed. Participants were divided 
      into two groups according to the breastfeeding status as "yes" for exclusive or 
      predominant breastfeeding, and "no" for not breastfeeding. RESULTS: Breastfeeding 
      women (n = 44) had significantly higher PRL levels [47.8 (29.6-88.2) vs. 20.0 
      (12.0-33.8), p< 0.001]. They also had significantly lower fasting blood glucose 
      levels [89.0 (8.0) vs. 93.9 (12.6) mg/dl, p = 0.04], triglycerides (TG) [92.2 
      (37.9) vs. 122.4 (64.4) mg/dl, p = 0.01], TG/HDL ratio [1.8 (0.8) vs. 2.4 (1.6) 
      mg/dl, p = 0.02], TyG index [8.24 (0.4) vs. 8.52 (0.53), p = 0.005], fasting 
      serum insulin [8.9 (6.3-11.6) vs. 11.4 (7.7-17.0), p = 0.048], and HOMA-IR [2.0 
      (1.3-2.7) vs. 2.6 (1.6-3.9), p = 0.025] in the postpartum period compared to the 
      non-breastfeeding group. Groups were homogeneous in relation to prevalence of 
      GDM, pre-gestational BMI, as well as daily caloric intake, physical activity, and 
      weight loss at postpartum. Linear regression analysis with adjustments for 
      confounders showed a statistically significant association of breastfeeding with 
      fasting blood glucose [-6.37 (-10.91 to -1.83), p = 0.006], HOMA-IR [-0.27 (-0.51 
      to -0.04), p = 0.024], TyG index [-0.04 (-0.06 to -0.02), p = 0.001], and TG/HDL 
      ratio [-0.25 (-0.48 to -0.01), p = 0.038]. Mediation analysis showed that PRL did 
      not mediate these effects. Sensitivity analyses considering different cutoffs for 
      PRL levels also did not show modification effect in the mediation analyses. 
      CONCLUSION: Breastfeeding was associated with improvement in glucose metabolism 
      and MIR 60 to 180 days after birth in overweight and obese women, even when 
      adjusted for confounders. PRL levels were not found to mediate the association 
      between breastfeeding and improvement in MIR.
CI  - Copyright (c) 2023 Oliveira, Dualib, Ferraro, Carvalho, Mattar, Dib and 
      Almeida-Pititto.
FAU - de Oliveira, Julia Martins
AU  - de Oliveira JM
AD  - Post-Graduation Program in Endocrinology and Metabology, Universidade Federal de 
      Sao Paulo, Sao Paulo, Brazil.
FAU - Dualib, Patricia Medici
AU  - Dualib PM
AD  - Post-Graduation Program in Endocrinology and Metabology, Universidade Federal de 
      Sao Paulo, Sao Paulo, Brazil.
AD  - Department of Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
FAU - Ferraro, Alexandre Archanjo
AU  - Ferraro AA
AD  - Department of Pediatrics, Universidade de Sao Paulo, Sao Paulo, Brazil.
FAU - Carvalho, Camila Rodrigues de Souza
AU  - Carvalho CRS
AD  - Post-Graduation Program in Endocrinology and Metabology, Universidade Federal de 
      Sao Paulo, Sao Paulo, Brazil.
FAU - Mattar, Rosiane
AU  - Mattar R
AD  - Department of Obstetrics, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
FAU - Dib, Sergio Atala
AU  - Dib SA
AD  - Post-Graduation Program in Endocrinology and Metabology, Universidade Federal de 
      Sao Paulo, Sao Paulo, Brazil.
AD  - Department of Medicine, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
FAU - de Almeida-Pititto, Bianca
AU  - de Almeida-Pititto B
AD  - Post-Graduation Program in Endocrinology and Metabology, Universidade Federal de 
      Sao Paulo, Sao Paulo, Brazil.
AD  - Department of Preventive Medicine, Universidade Federal de Sao Paulo, Sao Paulo, 
      Brazil.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230830
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
RN  - 9002-62-4 (Prolactin)
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Pregnancy
MH  - Humans
MH  - Female
MH  - Prolactin
MH  - Blood Glucose
MH  - *Diabetes Mellitus, Type 2/epidemiology
MH  - *Insulin Resistance
MH  - Overweight
MH  - Prospective Studies
PMC - PMC10499379
OTO - NOTNLM
OT  - breastfeeding
OT  - gestational diabetes mellitus
OT  - glucose tolerance
OT  - insulin resistance
OT  - postpartum
OT  - prolactin levels
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/09/15 06:42
MHDA- 2023/09/18 12:44
PMCR- 2023/01/01
CRDT- 2023/09/15 03:59
PHST- 2023/05/08 00:00 [received]
PHST- 2023/07/25 00:00 [accepted]
PHST- 2023/09/18 12:44 [medline]
PHST- 2023/09/15 06:42 [pubmed]
PHST- 2023/09/15 03:59 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2023.1219119 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2023 Aug 30;14:1219119. doi: 
      10.3389/fendo.2023.1219119. eCollection 2023.