Medical Student University of Massachusetts Medical School University of Massachusetts Medical School Worcester, Massachusetts, United States
Background: Ethanolamine containing plasmalogens (PI-PEs) are a unique class of breast milk (BM) glycerophospholipids containing a vinyl-ether at the Sn1 and a polyunsaturated fatty acid (PUFA) at the Sn2 position of the glycerol moiety. PI-PEs are present in the milk fat globule membrane, accumulate in the infant brain and have been implicated in infant development.
Objective: To i) describe the composition of BM PI-PEs and variation in monomers at both Sn1 and Sn2 positions and ii) quantify the associations between BM PI-PEs and maternal predictors (body mass index (BMI), race, dietary fatty acid (FA) intake, gestational age (GA) at birth and days postpartum). Our secondary objectives were to explore the relationship between BM PI-PEs and infant anthropometrics and neurodevelopment.
Design/Methods: This was a secondary analysis of 39 mother-infant dyads in the control group of an RCT of vitamin D during lactation. BM samples and data regarding maternal diet, infant anthropometrics (weight, fat mass index (FMI), and fat-free mass index (FFMI) by DEXA) and infant development were collected at 1 (V1), 4 (V4) and 7 (V7) months. BM PI-PEs were extracted and quantified using UHPLC-HRAM-MS/MS at V1 (n=37) and V4 (n=39) and expressed as percent mass of total phospholipids. Associations with PIs-PEs were modeled using linear regression.
Results: C(18:0) vinyl ethers and C(18:2) PUFAs were the most abundant PI-PEs. Total and specific PI-PEs, as a proportion of total phospholipids, decreased between V1 and V4 (Figure 1). Higher maternal BMI was associated with lower BM PI-PEs in unadjusted models, but this association was attenuated after adjustment for race, diet and days postpartum. Maternal FA intake, GA and days postpartum were not associated with BM PIs-PEs. In our cohort, race was a predictor of BM PI-PEs, but we were underpowered for this analysis. Total PI-PEs negatively correlated with infant FMI (r=-0.37, p=0.024) and positively with infant FFMI (r=0.46, p=0.0045) at V1. BM PI-PE concentrations were not correlated with neurodevelopmental outcomes. Conclusion(s): BM PI-PEs decrease over lactation and are associated with lower infant adiposity and higher lean mass. The mechanisms underlying these association should be explored in large, diverse cohorts with long-term follow up.
Authors/Institutions: Saranya Ramadurai, University of Massachusetts Medical School, Worcester, Massachusetts, United States; Chloe Andrews, Brigham and Women's Hospital, Boston, Massachusetts, United States; Sukhinder K. Cheema, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; Raymond Thomas, Memorial University of Newfoundland, St. John's, Newfoundland, Canada; Carol L. Wagner, Medical University of South Carolina, Charleston, South Carolina, United States; Sarbattama Sen, Brigham and Women's Hospital, Boston, Massachusetts, United States
