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Biomedical subjects

D Holmberg-Marttila

Publications and source records attributed to D Holmberg-Marttila.

10 recordsLinked to original sources
PubMed2003

Bone turnover markers during lactation, postpartum amenorrhea and resumption of menses.

Changes in bone turnover, and consequent bone loss and recovery during lactation and the postweaning period, are likely modulated by varying estrogen levels inherent in these time periods. To address this question we measured serum biochemical markers of bone formation (bone-specific alkaline phosphatase, amino-terminal propeptide of type I procollagen, osteocalcin), of bone resorption (type I collagen carboxy-terminal telopeptide), and serum female sex hormones (estradiol, luteinizing hormone and follicle-stimulating hormone) in 32 healthy mothers prospectively after delivery, 3 months postpartum, after postpartum amenorrhea and 1 year after resumption of menses. During postpartum amenorrhea (mean 5.7, SD 2.9 months) bone mineral density decreased significantly, some 2% at the lumbar spine and some 3% at the femoral neck, but subsequently recovered completely at the former site and partially at the latter. Bone turnover marker levels were elevated at parturition and still at the end of postpartum amenorrhea. Subsequent to parturition the bone resorption marker level showed a decreasing trend while the formation marker levels continued increasing, and eventually coincided with the resorption level within the very first months postpartum. Both lactation and hormonal status modulated bone turnover marker levels. Maternal age was positively associated with increased bone turnover. Interestingly, higher parity and longer history of previous lactation were associated with lower bone turnover marker levels postpartum as compared with previously nulliparous women of the same age. The regression models explained typically some 20-30% of the variability in the bone turnover marker levels. The dynamic pattern in bone turnover is dissimilar to that occurring at menopause and it indicates that the bone loss most likely occurs in the beginning of postpartum period. It also seems that estrogen has a specific influence on bone turnover only during the first months of lactation.

Adult↗
PubMed2001

Polyunsaturated fatty acids in maternal diet, breast milk, and serum lipid fatty acids of infants in relation to atopy.

BACKGROUND: The increased consumption of n-6 polyunsaturated fatty acids (PUFA) has been shown to coincide with the increased prevalence of atopic diseases. We aimed to investigate whether maternal diet and atopic status influence the PUFA composition of breast milk and the serum lipid fatty acids of infants. METHODS: Maternal diet was assessed by a food questionnaire. The PUFA composition of breast milk obtained at 3 months from 20 allergic and 20 healthy mothers and of their infants' (10 atopic and 10 nonatopic/group of mothers) serum lipids was analyzed. RESULTS: Although no differences in maternal PUFA intake were observed, the breast milk of allergic mothers contained less gamma-linolenic acid (18:3 n-6) than that of healthy mothers. Similarly, atopic infants had less gamma-linolenic acid in phospholipids than healthy infants, although n-6 PUFA were elevated in other serum lipid fractions in atopic infants. The serum lipid fatty acids in atopic infants did not correlate with those in maternal breast milk. CONCLUSION: Our results suggest that dietary n-6 PUFA are not as readily transferred into breast milk or incorporated into serum phospholipids, but may be utilized for other purposes, such as eicosanoid precursors, in allergic/atopic individuals. Subsequently, high dietary proportions of n-6 PUFA, or reduced proportions of regulatory PUFA, such as gamma-linolenic acid and n-3 PUFA, may be a risk factor for the development of atopic disease.

Cholesterol Esters↗
PubMed2001

Do combined elimination diet and prolonged breastfeeding of an atopic infant jeopardise maternal bone health?

BACKGROUND: Prolonged breastfeeding, and intervention in the maternal diet during breastfeeding, have been suggested as a means to treat atopic symptoms of infants. The impact of these actions on the mother's skeletal health has remained unclear. OBJECTIVE: The purpose of this study was to determine factors that are associated with bone mineral density (BMD) and serum lipid fatty acid profile in mothers of atopic infants. METHODS: BMD at the lumbar spine, right femoral neck and dominant distal radius of 24 mothers of atopic infants (study group) and 25 mothers of healthy infants (control group) were measured with dual energy X-ray absorptiometry postpartum after the resumption of menses. In addition, the fatty acid profile of their serum cholesteryl esters was determined. RESULTS: A systematic trend for 4-6% lower BMD was observed in the study group, but this difference was mainly attributable to a difference in body weight between the groups. In addition, the omega (omega)-3 fatty acid metabolite EPA showed a positive association with femoral neck BMD. Mothers of atopic infants had a significantly lower proportion of omega-6 fatty acid parent LA and a higher proportion of omega-6 fatty acid metabolite GLA than the control mothers. These differences were associated not only with dietary factors but also with the duration of postpartum amenorrhea and total lactation. CONCLUSIONS: Neither the breastfeeding nor the mother's short-term elimination diet per se seemed to be associated with low BMD in the mothers of atopic infants. Thus, if an elimination diet benefits the infant, it can be recommended for a limited period. However, it may be advisable to give special dietary counselling, especially to low body weight mothers, in order to ensure adequate nutrient intake and to minimize the possible risk of potential bone loss.

Adult↗
PubMed2000

Vitamin D and estrogen receptor polymorphisms and bone mineral changes in postpartum women.

BsmI restriction fragment length polymorphism (RFLP) of the vitamin D receptor (VDR) gene and PvuII RFLPs of the estrogen receptor (ER) gene and their relation to changes in areal bone mineral density (BMD) were examined in 43 healthy postpartum Finnish women aged 31.3 (SD 4.7) years. BMD was measured by dual energy X-ray absorptiometry at lumbar spine, right femoral neck, and dominant distal radius immediately after delivery, 1 month after resumption of menses, and 1 year thereafter. The RFLPs were represented as Bb (BsmI) and Pp (PvuII), the capital letters denoting the absence of and the small letters the presence of the restriction sites. The frequency of VDR alleles was as follows: bb (20.9%), Bb (60.5%), and BB (18.6%), and that of ER alleles was pp (39.5%), Pp (51.2%), and PP (9.3%). Altogether, BMD decreased significantly during postpartum amenorrhea at all sites [the mean bone loss ranging from -1.2 (SD 3.6)% at the distal radius to -3.7 (2.9)% at the femoral neck], and increased after resumption of menses [the 1-year follow-up BMD values ranging from -1.0 (2.4)% at the femoral neck to +3.3 (4.0)% at the lumbar spine as compared with baseline]. No obvious genotype-related differences were found between these changes. These results suggest that the BsmI and PvuII polymorphisms may not have substantial influence on BMD changes postpartum.

Adult↗
PubMed2000

Factors underlying changes in bone mineral during postpartum amenorrhea and lactation.

To determine the physiologic and habitual factors that may modulate changes in bone mineral density (BMD) postpartum, dual-energy X-ray absorptiometry was performed at the lumbar spine, right femoral neck and dominant distal radius immediately after delivery, after resumption of menses, and 1 year thereafter in a cohort of 41 healthy postpartum Finnish women aged 31.5 (SD 4.6) years. Mean durations of lactation and postpartum amenorrhea (PPA) were 7.7 (3.7) and 5.9 (2.9) months, respectively. After PPA, significant bone losses of 2%-4% were observed at the lumbar spine and femoral neck. Duration of PPA and different lactational variables explained (adjusted R2) from 21% to 27% of the variability in changes in BMD during PPA. A recovery to postpregnancy BMD levels was observed at the lumbar spine; in contrast BMD at the femoral neck showed only a partial recovery. The duration of unsupplemented lactation was weakly (adjusted R2 = 0.13) associated with recovery at the lumbar spine, while a long duration of total lactation also showed a weak association (adjusted R2 = 0.02) with delayed recovery at the femoral neck. In conclusion, a systematic bone loss occurs during PPA, and after resumption of menstruation BMD recovers despite continued lactation. However, the time of bony recovery back to postpregnancy level seems to be modulated slightly by lactation habits. It is obvious that the control of postpartum BMD changes is a multifactorial process that may be specific to the skeletal site of interest.

Absorptiometry, Photon↗
PubMed1999

Changes in bone mineral density during pregnancy and postpartum: prospective data on five women.

Areal bone mineral density (BMD, g/cm(2)) of five healthy women (aged 26-30 years) was measured at the lumbar spine, right femoral neck and dominant distal radius with dual-energy X-ray absorptiometry before pregnancy, immediately after delivery, 1 month after the resumption of menses and 1 year thereafter. Because of the small number of subjects, only individual changes in BMD that were greater than 2 radical2 times the short-term in vivo precision were considered as significant changes. To obtain a further perspective, the reproduction-related BMD changes were compared with twice the standard deviation (SD) of the BMD changes in healthy premenopausal women (about +/- 5%), and with the SD of the BMD in a cross-sectional sample of young healthy women. The duration of postpartum amenorrhea (PPA) and of lactation in our subjects ranged from about 2 months to 1 year and from 5 months to almost 2 years, respectively. No clear association between PPA and lactation could be seen. The magnitudes of reproduction-related BMD changes in general seemed not to differ substantially from about +/- 5% variability in BMD changes in healthy nonpregnant and nonlactating women. There was, however, some tendency toward systematic bone loss at the lumbar spine (about -3%) during pregnancy and at the femoral neck during PPA (about -5% as compared with prepregnancy data). Some individuals can yet show large, systematic bone losses comparable to 1 SD in magnitude. The site-specific reproduction-induced bone loss and consequent recovery are apparently multifactorial phenomena that may be related not only to duration and magnitude of lactation and/or duration of postpartum amenorrhea, but also to prevailing biomechanical and dietary factors, and other yet unknown individually modulated factors.

Absorptiometry, Photon↗
PubMed1999

Analysis of estrogen receptor dinucleotide polymorphism by capillary gel electrophoresis with a population genetic study in 180 Finns.

We developed a suitable method for analysing dinucleotide repeats found in the upstream of human alpha-estrogen receptor (ER) gene by applying capillary electrophoresis and automatic analysis. This method omits the gel-casting step as well as difficult handling of long polyacrylamide sequencing gels. Use of radioactive materials is also avoided. Using this method, the frequency distribution of ER alleles, determined in 180 Finnish individuals showed two peaks at 12 and 14 repeats (166 and 168 bp) and also at 22 and 24 repeats (184 and 186 bp). The overall distribution of alleles seemed to be similar to that found among Italian and Japanese populations.

Adult↗
PubMed1999

Benefits and risks of elimination diets.

Elimination diets have been used for the prevention or treatment of allergic disease with the diet of the pregnant or breastfeeding mother or the child, or both, being modulated as deemed appropriate. Evidence from studies published so far suggests that dietary restrictions are in fact effective only in the treatment of specific food allergies, not in allergy prevention. An elimination diet of a child or a breastfeeding mother entails a risk to normal nutrition and growth of the child. Although studies are lacking, dietary restrictions during lactation may well be harmful also to the mother's health. Substitution of nutritionally important foods and professional guidance are necessary for the successful treatment of food allergies.

Breast Feeding↗