Appetite-regulating hormone trajectories and relationships with fat mass development in term-born infants during the first 6\xa0months of life

Kirsten S De Fluiter,Gerthe F Kerkhof,Leonie C Van Vark-Van Der Zee,Laura M Breij,Marieke Abrahamse-Berkeveld,Anita C S Hokken-Koelega,Inge A L P Van Beijsterveldt,Monique T Mulder

doi:10.1007/s00394-021-02533-z

Kirsten S De Fluiter, Gerthe F Kerkhof + Show 6 more

Open Access

https://doi.org/10.1007/s00394-021-02533-z

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Abstract

BackgroundThe first 6 months of life are a critical window for adiposity programming. Appetite-regulating hormones (ARH) are involved in food intake regulation and might, therefore, play a role in adiposity programming. Studies examining ARH in early life are limited.PurposeTo investigate ghrelin, peptide YY (PYY) and leptin until 6 months and associations with fat mass percentage (FM%), infant feeding and human milk macronutrients.ProceduresIn 297 term-born infants (Sophia Pluto Cohort), ghrelin (acylated), PYY and leptin were determined at 3 and 6 months, with FM% measurement by PEAPOD. Exclusive breastfeeding (BF) was classified as BF ≥ 3 months. Human milk macronutrients were analyzed (MIRIS Human Milk Analyzer).Main findingsGhrelin increased from 3 to 6 months (p < 0.001), while PYY decreased (p < 0.001), resulting in increasing ghrelin/PYY ratio. Leptin decreased. Leptin at 3 months was higher in girls, other ARH were similar between sexes. Leptin at 3 and 6 months correlated with FM% at both ages(R ≥ 0.321, p ≤ 0.001) and gain in FM% from 1 to 6 months(R ≥ 0.204, p = 0.001). In BF infants, also ghrelin and ghrelin/PYY ratio correlated with this gain in FM%. Exclusively BF infants had lower ghrelin and higher PYY compared to formula fed infants at 3 months (p ≤ 0.039). ARH did not correlate with macronutrients.ConclusionsIncreasing ghrelin and decreasing PYY, thus increasing ghrelin/PYY ratio, suggests an increasing orexigenic drive until 6 months. ARH were different between BF and FF infants at 3 months, but did not correlate with human milk macronutrients. Ghrelin and leptin, but not PYY, correlated with more FM development during the first 6 months, suggesting that they might be involved in adiposity programming.

Highlights

Appetite-regulating hormones (ARH) are involved in the regulation of food intake through specific brain centers, such as the hypothalamus that plays a key role in controlling glucose, energy homeostasis and food intake [1, 2]
In a large group of healthy, term-born infants, we found that ghrelin levels and ghrelin/peptide YY (PYY) ratio increased from 3 to 6 months, while PYY and leptin levels decreased
Leptin correlated with FM% at 3 and 6 months and the gain in FM% from 1 to 6 months, a critical window for adiposity programming, in BF and FF infants

Summary

Introduction

Appetite-regulating hormones (ARH) are involved in the regulation of food intake through specific brain centers, such as the hypothalamus that plays a key role in controlling glucose, energy homeostasis and food intake [1, 2]. We have shown that the change in fat mass percentage (FM%) during the first 6 months, in contrast to the 6- to 12-month period, is associated with higher FM% and abdominal subcutaneous FM at the age of 2 years [12] These first 6 months after birth are considered a critical window for adiposity programming [9, 10], ARH trajectories might be of importance in unraveling this early adiposity programming. Purpose To investigate ghrelin, peptide YY (PYY) and leptin until 6 months and associations with fat mass percentage (FM%), infant feeding and human milk macronutrients. But not PYY, correlated with more FM development during the first 6 months, suggesting that they might be involved in adiposity programming

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