Table 3.
Differences and changes in metabolic health, C reactive protein (CRP), and bone density at 1 year postpartum according to breastfeeding category in women with prior GDM
| n=171 | BF <6 (n=69) |
BF ≥6 (n=102) |
Model 1* | Model 2† | ||
| Mean±SD | Mean±SD | β (95% CI) | P value | β (95% CI) | P value | |
| Body composition | ||||||
| Weight (kg) | 78.6±17.9 | 68.5±14.0 | −10.15 (−15.09, 5.21) | <0.001 | −3.44 (−6.08, −0.79) | 0.01 |
| Weight retention (kg) | 5.4±6.9 | 2.4±4.5 | −2.92 (−4.66, 1.17) | <0.01 | −2.40 (−4.24, 0.56) | 0.01 |
| Body fat (BIA, kg) | 30.8±11.6 | 23.6±8.9 | −7.11 (−10.29, 3.92) | <0.001 | −2.72 (−4.47, 0.98) | <0.01 |
| Fat-free mass (BIA, kg) | 47.9±7.2 | 44.1±5.4 | −3.77 (−5.73, 1.82) | <0.001 | −1.55 (−2.93, 0.16) | 0.03 |
| ΔBody composition between 1 year and 6–8 weeks postpartum | ||||||
| Weight difference (kg) | 0.6±5.0 | −1.7±4.3 | −2.26 (−3.72, 0.80) | <0.01 | −1.57 (−3.07, 0.07) | 0.04 |
| Body fat difference (BIA, kg) | −0.2±4.3 | −2.3±3.7 | −2.09 (−3.34, 0.84) | <0.01 | −1.44 (−2.71, 0.18) | 0.03 |
| Fat-free mass difference (BIA, kg) | 0.7±2.4 | 0.1±2.5 | −0.68 (−1.45, 0.08) | 0.08 | −0.55 (−1.36, 0.26) | 0.18 |
| Body composition by DEXA | ||||||
| Body fat (kg) | 31.5±12.4 | 25.1±10.0 | −6.43 (−10.93, 1.93) | 0.01 | −2.46 (−4.83, 0.09) | 0.04 |
| Lean mass (kg) | 43.6±6.4 | 40.2±5.4 | −2.82 (−5.19, 0.46) | 0.02 | −1.61 (−3.48, 0.26) | 0.09 |
| Fat mass index (kg/m2) | 11.5±4.5 | 9.4±3.7 | −2.09 (−3.75, 0.43) | 0.01 | −0.64 (−1.43, 0.15) | 0.11 |
| Visceral adipose tissue (kg) | 0.7±0.5 | 0.5±0.4 | −0.22 (−0.40, 0.03) | 0.02 | −0.07 (−0.17, 0.04) | 0.20 |
| Insulin resistance/secretion | ||||||
| HOMA-IR | 3.9±2.5 | 2.7±1.9 | −1.25 (−1.94, 0.56) | <0.001 | −0.57 (−1.15, 0.01) | 0.06 |
| HOMA-B | 54.4±35.7 | 37.6±25.6 | −16.82 (−26.38, 7.26) | <0.01 | −7.38 (−15.66, 0.89) | 0.08 |
| Matsuda | 4.8±3.7 | 6.0±3.4 | 1.22 (0.05, 2.39) | 0.04 | −0.14 (−1.13, 0.84) | 0.77 |
| AUC | 0.6±0.5 | 0.5±0.2 | −0.15 (−0.27, 0.04) | 0.01 | −0.06 (−0.17, 0.05) | 0.27 |
| ISSI-2 | 2.1±0.8 | 2.3±0.9 | 0.25 (−0.03, 0.53) | 0.08 | 0.05 (−0.23, 0.33) | 0.72 |
| Inflammation | ||||||
| CRP (mg/L)* | 0.7 (−0.1, 1.6) | 0.2 (−0.5, 0.9) | −0.52 (−0.88, 0.15) | 0.01 | −0.37 (−0.73, 0.01) | 0.04 |
| TNF-α (pg/mL)* | −0.6 (0.9, –0.3) | −0.7 (−1.1, –0.3) | −0.10 (−0.35, 0.15) | 0.42 | −0.08 (−0.33, 0.17) | 0.53 |
| IL-6 (pg/mL)* | −0.5 (−1.1, 0.1) | −0.7 (−1.1, 0.1) | −0.21 (−0.57, 0.15) | 0.25 | −0.23 (−0.61, 0.16) | 0.25 |
| Bone density | ||||||
| Bone mineral density (L1–L4, g/cm2) | 1.176±0.096 | 1.169±0.147 | −0.01 (−0.06, 0.04) | 0.79 | 0.01 (−0.05, 0.06) | 0.81 |
| T-score (L1–L4, g/cm2) | −0.1±0.8 | −0.1±1.2 | −0.05 (−0.48, 0.38) | 0.82 | 0.06 (−0.38, 0.50) | 0.79 |
| Z-score (L1–L4, g/cm2) | −0.1±0.8 | −0.2±1.2 | −0.10 (−0.53, 0.33) | 0.65 | −0.02 (−0.47, 0.42) | 0.91 |
Data are expressed as mean±SD and β (95% CI). Data marked by * were log-transformed and are expressed as median (IQR).
*Adjusted for group allocation.
†Adjusted for group allocation, pre-pregnancy BMI, educational level, and glucose-lowering treatment in pregnancy.
AUC, area under the curve insulin/glucose; BF <6, no or <6 months of breastfeeding; BF ≥6, ≥6 months of breastfeeding; BIA, bioelectrical impedance analysis; BMI, body mass index; DEXA, dual-energy X-ray absorptiometry; GDM, gestational diabetes mellitus; HOMA-B, Homeostatic Model Assessment of β-cell index; HOMA-IR, Homeostatic Model Assessment for Insulin Resistance; IL-6, interleukin 6; ISSI-2, Insulin Secretion-Sensitivity Index-2; TNF-α, tumor necrosis factor α; Δ, change or difference.