PDF(Pubmed)
Abstract：
BACKGROUND: Little information is available on B vitamin concentrations in human milk or on how they are affected by maternal B vitamin deficiencies, antiretroviral therapy, or maternal supplementation.
OBJECTIVE: The objective was to evaluate the effects of antiretroviral therapy and/or lipid-based nutrient supplements (LNSs) on B vitamin concentrations in breast milk from HIV-infected women in Malawi.
METHODS: Breast milk was collected from 537 women recruited within the Breastfeeding, Antiretrovirals, and Nutrition study at 2 or 6 wk and 24 wk postpartum. Women were assigned to receive antiretrovirals and LNSs, antiretrovirals only, LNSs only, or a control. Antiretrovirals and LNSs were given to the mothers from weeks 0 to 28. The antiretrovirals were zidovudine/lamivudine and nelfinavir or lopinavir/ritonavir. LNSs provided 93-118% of the Recommended Dietary Allowances of thiamin, riboflavin, niacin, pyridoxine, and vitamin B-12. Infants were exclusively breastfed.
RESULTS: LNSs increased milk concentrations of all vitamins except thiamin, whereas antiretrovirals lowered concentrations of nicotinamide, pyridoxal, and vitamin B-12. Although antiretrovirals alone had no significant effect on riboflavin concentrations, they negatively affected the LNS-induced increase in this vitamin. Thiamin was not influenced by the study interventions. Concentrations of all B vitamins were much lower than usually accepted values.
CONCLUSIONS: All B vitamins were low in milk, and all but thiamin were increased by maternal supplementation with LNSs. Antiretrovirals alone decreased concentrations of some B vitamins in milk. When LNS was given in addition to antiretrovirals, the negative effect of antiretrovirals offset the positive effect of LNSs for all vitamins except thiamin. This trial was registered at clinicaltrials.gov as NCT00164762.
OBJECTIVE: The objective was to evaluate the effects of antiretroviral therapy and/or lipid-based nutrient supplements (LNSs) on B vitamin concentrations in breast milk from HIV-infected women in Malawi.
METHODS: Breast milk was collected from 537 women recruited within the Breastfeeding, Antiretrovirals, and Nutrition study at 2 or 6 wk and 24 wk postpartum. Women were assigned to receive antiretrovirals and LNSs, antiretrovirals only, LNSs only, or a control. Antiretrovirals and LNSs were given to the mothers from weeks 0 to 28. The antiretrovirals were zidovudine/lamivudine and nelfinavir or lopinavir/ritonavir. LNSs provided 93-118% of the Recommended Dietary Allowances of thiamin, riboflavin, niacin, pyridoxine, and vitamin B-12. Infants were exclusively breastfed.
RESULTS: LNSs increased milk concentrations of all vitamins except thiamin, whereas antiretrovirals lowered concentrations of nicotinamide, pyridoxal, and vitamin B-12. Although antiretrovirals alone had no significant effect on riboflavin concentrations, they negatively affected the LNS-induced increase in this vitamin. Thiamin was not influenced by the study interventions. Concentrations of all B vitamins were much lower than usually accepted values.
CONCLUSIONS: All B vitamins were low in milk, and all but thiamin were increased by maternal supplementation with LNSs. Antiretrovirals alone decreased concentrations of some B vitamins in milk. When LNS was given in addition to antiretrovirals, the negative effect of antiretrovirals offset the positive effect of LNSs for all vitamins except thiamin. This trial was registered at clinicaltrials.gov as NCT00164762.
摘要：
背景：关于人乳中B族维生素浓度或母体B族维生素缺乏如何影响它们的信息很少。抗逆转录病毒治疗,或母亲的补充。
目的：目的是评估抗逆转录病毒疗法和/或基于脂质的营养补充剂（LNS）对马拉维HIV感染妇女母乳中B族维生素浓度的影响。
方法：从母乳喂养中招募的537名女性中收集母乳，抗逆转录病毒药物,产后2、6周和24周的营养研究。妇女被分配接受抗逆转录病毒药物和LNS，只有抗逆转录病毒药物,仅限LNS,或控制。从第0周到第28周给母亲服用抗逆转录病毒药物和LNS。抗逆转录病毒药物为齐多夫定/拉米夫定和奈非那韦或洛匹那韦/利托那韦。LNS提供了93-118%的推荐膳食补充剂，核黄素,烟酸,吡哆醇,和维生素B-12.婴儿是纯母乳喂养的。
结果：LNS增加了除硫胺素以外的所有维生素的牛奶浓度，而抗逆转录病毒药物降低了烟酰胺的浓度，吡哆醛,和维生素B-12.尽管单独抗逆转录病毒药物对核黄素浓度没有显著影响，它们对LNS诱导的这种维生素增加产生了负面影响。硫胺素不受研究干预的影响。所有B族维生素的浓度远低于通常接受的值。
结论：所有B族维生素在牛奶中的含量都很低，母亲补充LNS后，除硫胺素外，其他所有物质均增加。单独使用抗逆转录病毒药物可降低牛奶中某些B族维生素的浓度。当除抗逆转录病毒药物外还给予LNS时，抗逆转录病毒药物的负面作用抵消了LNS对除硫胺素以外的所有维生素的正面作用.该试验在clinicaltrials.gov注册为NCT00164762。
目的：目的是评估抗逆转录病毒疗法和/或基于脂质的营养补充剂（LNS）对马拉维HIV感染妇女母乳中B族维生素浓度的影响。
方法：从母乳喂养中招募的537名女性中收集母乳，抗逆转录病毒药物,产后2、6周和24周的营养研究。妇女被分配接受抗逆转录病毒药物和LNS，只有抗逆转录病毒药物,仅限LNS,或控制。从第0周到第28周给母亲服用抗逆转录病毒药物和LNS。抗逆转录病毒药物为齐多夫定/拉米夫定和奈非那韦或洛匹那韦/利托那韦。LNS提供了93-118%的推荐膳食补充剂，核黄素,烟酸,吡哆醇,和维生素B-12.婴儿是纯母乳喂养的。
结果：LNS增加了除硫胺素以外的所有维生素的牛奶浓度，而抗逆转录病毒药物降低了烟酰胺的浓度，吡哆醛,和维生素B-12.尽管单独抗逆转录病毒药物对核黄素浓度没有显著影响，它们对LNS诱导的这种维生素增加产生了负面影响。硫胺素不受研究干预的影响。所有B族维生素的浓度远低于通常接受的值。
结论：所有B族维生素在牛奶中的含量都很低，母亲补充LNS后，除硫胺素外，其他所有物质均增加。单独使用抗逆转录病毒药物可降低牛奶中某些B族维生素的浓度。当除抗逆转录病毒药物外还给予LNS时，抗逆转录病毒药物的负面作用抵消了LNS对除硫胺素以外的所有维生素的正面作用.该试验在clinicaltrials.gov注册为NCT00164762。
