Maternal weight and lean body mass may influence the lactation-related bone changes in young undernourished Indian women

摘要

Lactation is known to be associated with a transient loss of bone mineral density (BMD) during 3–6 months post-partum. Bone changes duringnlactation in women consuming low dietary calcium are not sufficiently studied. The present longitudinal study examined the BMD changesnduring lactation in undernourished women and the relationship of bone changes to the nutritional status. Whole-body bone mineral content andnBMD at hip, lumbar spine and forearm were assessed using dual-energy X-ray absorptiometry in thirty-six lactating women from the low socio-econ-nomic group at four time points – within 1 month after delivery (baseline), and at 6, 12 and 18 months after delivery. Maternal body composition andnbiochemical parameters of bonemetabolismwere estimated at the same time. Itwas observed that femoral neck BMDreduced by 4·6%at 6months, butnrecovery to the baseline was incomplete at 18 months with a deficit of 2%. Hip BMD reduction at 6 months was transient. Lumbar spine BMD did notnshow significant loss at 6 months and BMD increased by 3·6 and 6·3% at 12 and 18 months, respectively. Regression analyses indicated that baselinenlean mass was the most important determinant of bone preservation at femoral neck, hip as well as whole body, whereas baseline body weight was thenmost important determinant of per cent gain in lumbar spine.Maternal nutritional status as indicated by bodyweight and leanmass appears to influencenthe lactation-related BMD changes in undernourished women from the low socio-economic group in India.