(LB03-21-24) The Association Between Mode of Feeding, Hyperglycemic Excursion, and Growth During Infancy

Objectives: 1,5 anhydroglucitrol (1,5-AG) is a measure of hyperglycemic excursions (HEs) in the preceding 10-14 days. Serum and saliva 1,5-AG levels decrease during HEs due to increased urinary excretion. We examined associations between saliva and serum 1,5-AG levels with primary feeding mode and early weight gain.

Methods: Subjects included a subsample of 76 full-term, generally healthy infants from the ongoing MINT clinical trial. Demographics, anthropometrics, and feeding mode were recorded. Saliva (n=68) and serum (n=60) were collected at 4-6 months of age before complementary foods were introduced for 1,5-AG analysis using a LC/MS method. Rapid weight gain (RWG) was classified as a ≥0.67 increase in WHO weight-for-age Z-score (WAZ) between birth and 4-6 months.

Results: The sample included 38 males and 38 females; 75% were white; 40 were exclusively breastfed (BF), 21 were exclusively formula-fed (FF), and 15 were mixed-fed (MF). The mean±SD were for age: 154.2±11.4 days; birthweight: 3255±463 g; saliva 1,5-AG: 1.04±1.00 µg/dL; serum 1,5-AG: 35.6 ± 20.9 µg/dL; weight gain: 23.0±5.3 g/day; n=14 had RWG. Changes in WAZ were not different by sex. Serum and saliva 1,5-AG levels were correlated (r=0.53, p< 0.001, n=57). Saliva 1,5-AG (mean±SE) was significantly lower in the FF group (0.38±0.15 µg/dL) compared with BF (1.36±0.17 µg/dL, p< 0.001) and MF groups (1.10±0.20 µg/dL, p< 0.01). Saliva 1,5-AG was negatively associated (ß: -0.42±0.13, p< 0.01) with an increase in WAZ after controlling for age and primary feeding mode, but not when adjusted for WAZ at birth. A one-tailed t-test indicated that saliva 1,5-AG was significantly lower (p < 0.05) in children with RWG (0.62±0.14 µg/dL) than those without RWG (1.12±0.15 µg/dL). No significant differences were found for serum 1,5-AG.

Conclusions: Saliva 1,5-AG suggests FF infants have more frequent HEs, was associated with an increase in WAZ, and with RWG suggesting HEs have a metabolic impact on infant growth.

Funding Sources: NIDDK, National Dairy Council