The investigation of minerals in human breast milk across lactation stages in six representative areas of China
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摘要:
目的 调查中国不同泌乳期母乳矿物质含量水平，为婴儿配方(简称婴配)食品研发提供科学依据。 方法 在成都市、上海市、天津市、广州市、长春市、兰州市等六地区招募处于不同泌乳期的健康产妇690例，收集产妇产后0~5 d、10~14 d、40~45 d、200~240 d和300~400 d母乳，每个城市每个泌乳期收集23例母乳，将其混成1份混乳，共获30份混乳。采用电感耦合等离子体质谱法测定母乳12种矿物质(钾、钙、钠、镁、磷、铁、铜、锌、硒、锰、钼和铬)含量。 结果 母乳锌含量下降趋势最明显，整个泌乳期下降近90%(均有P＜0.05)；钾、钠、锌、铁、铜和硒的浓度受泌乳时间影响大，随泌乳时间延长呈下降趋势(均有P＜0.05)，200 d后趋于稳定；钙磷浓度的下降趋势较平缓；而镁含量在整个泌乳期变化不大。除钙、磷、铜、镁外，其余矿物质含量在地区间差异无统计学意义(均有P＞0.05)。 结论 不同泌乳期、不同地区间母乳矿物质含量存在差异。婴配食品应考虑中国母乳矿物质含量的代表性水平，并针对不同泌乳期婴幼儿的营养需求进行研发，同时提高矿物质吸收利用率，使其更接近母乳，在满足婴幼儿生长发育需求的基础上，不增加其肾脏负担。 Abstract:Objective The study aimed to investigate the representative mineral levels in breast milk at different lactation stages in China and to provide reference and guidance for future infant formula development. Methods A total of 690 healthy parturients at different lactation stages were recruited in Chengdu, Shanghai, Tianjin, Guangzhou, Changchun, and Lanzhou. Milk was collected from parturients at 0-5 d, 10-14 d, 40-45 d, 200-240 d, and 300-400 d after delivery. Determination of 12 minerals (K, Ca, Na, Mg, P, Fe, Cu, Zn, Se, Mn, Mo and Cr) in breast milk was conducted by inductively coupled plasma-mass spectrometry (ICP-MS). Results Across the 5 lactation periods, Zn dropped dramatically (about 90%) (all P < 0.05). Minerals including K, Na, Zn, Fe, Cu, and Se were significantly affected by lactation time and tended to decrease with the prolonging of lactation time (all P < 0.05), while being stable after 200 days. Ca and P were stable at the early stage and then decreased slightly at the middle-late lactation stage. The content of Mg stayed stable over the lactation period. Except for Ca, P, Cu, and Mg, other minerals showed no significant regional difference (all P > 0.05). Conclusions There were differences in the mineral content of breast milk at different lactation stages and different regions. Infant formula should consider the representative levels of mineral content in Chinese breast milk, and be developed according to the nutritional needs of infants at different lactation stages. Meanwhile, the mineral absorption and utilization ratio should be improved to make it more similar to breast milk, so as to meet the growth and development needs of infants without increasing the burden on their kidneys. -
Key words:
- Chinese breast milk /
- Mineral content /
- Different lactation periods /
- Different regions
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表 1 产妇的人口学特征[n(%)]
Table 1. Demographic characteristics of lactating mothers [n(%)]
基本情况 泌乳期(d) F/χ2值 P值 0~5 10~14 40~45 200~240 300~400 产妇年龄(x±s, 岁) 29.40±3.72 29.63±3.40 29.53±3.49 29.72±3.70 29.69±3.41 0.182 0.948 产前BMI(x±s, kg/m2) 27.30±3.44 27.19±3.49 27.19±2.83 26.75±3.04 26.33±3.18 1.782 0.131 初产妇 86(63.24) 83(62.41) 92(67.15) 88(63.77) 100(74.63) 8.220 0.412 阴道分娩 76(55.88) 77(57.89) 80(58.39) 88(63.77) 84(62.69) 2.548 0.636 文化程度a 7.414 0.829 高中及以下 29(21.32) 23(17.29) 24(17.52) 25(18.12) 29(21.64) 大学/大专 88(64.71) 84(63.16) 93(67.88) 93(67.39) 86(64.18) 硕士及以上 19(13.97) 26(19.55) 20(14.60) 20(14.49) 19(14.18) 注: a表示数据有缺失。 
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表 2 不同泌乳期母乳矿物质含量(x±s)
Table 2. Detailed mineral levels in breast milk at different lactation stages (x±s)
矿物质浓度 泌乳期(d) F值 P值 0~5 10~14 40~45 200~240 300~400 钾(mg/100 mL) 65.06±5.56 abcd 57.24±2.79 bcd 48.06±3.64 cd 40.41±2.20 40.09±1.88 58.817 ＜0.001 钙(mg/100 mL) 24.59±2.11 cd 25.93±1.57 cd 25.74±2.57 cd 22.13±1.50 20.64±1.26 9.391 ＜0.001 钠(mg/100 mL) 42.61±8.31 abcd 24.63±2.47 bcd 15.97±3.75 10.60±1.76 11.85±3.62 49.569 ＜0.001 磷(mg/100 mL) 12.28±2.72 acd 15.07±2.22 cd 12.52±2.21 cd 9.39±2.35 9.28±1.88 6.731 0.001 镁(mg/100 mL) 2.88±0.28 ab 2.52±0.18 2.39±0.21 cd 2.73±0.23 2.74±0.22 4.369 0.008 锌(mg/100 mL) 0.70±0.12 abcd 0.42±0.04 bcd 0.26±0.05 cd 0.12±0.06 0.08±0.00 86.193 ＜0.001 铜(mg/100 mL) e 49.92±4.77 abcd 55.89±3.98 bcd 36.13±3.95 cd 18.52±2.71 15.42±0.42 0.600 0.666 铁(μg/100 mL) 47.93±4.30 abcd 37.34±3.69 bcd 31.91±7.10 cd 21.15±2.25 20.77±4.13 37.719 ＜0.001 锰(ng/100 mL) 0.98±0.23 abcd 0.40±0.07 0.35±0.09 0.29±0.06 d 0.44±0.05 31.620 ＜0.001 硒(μg/100 mL) 2.16±0.61 abcd 1.68±0.22cd 1.34±0.08 1.06±0.14 1.11±0.25 12.453 ＜0.001 钼(μg/100 mL) 1.13±0.21 abcd 0.66±0.24 bcd 0.32±0.08 0.29±0.14 0.22±0.03 33.530 ＜0.001 铬(μg/100 mL) 0.89±0.11 d 0.87±0.32 0.72±0.07 0.69±0.10 0.66±0.16 2.114 0.109 钙磷比 2.05±0.29 1.74±0.17 cd 2.10±0.32 2.49±0.64 2.30±0.44 2.876 0.044 注: a表示与10~14 d比，差异有统计学意义(P < 0.05)；b表示与40~45 d比，差异有统计学意义(P < 0.05)；c表示与200~240 d比，差异有统计学意义(P < 0.05)；d表示与300~400 d比，差异有统计学意义(P < 0.05)；e表示除上海市外其他五个地区铜含量的平均水平。
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