Endocrine control of metabolic adaptation during lactation

Uptake of radioactively labelled insulin by the mammary gland of the rat increased 12-fold in lactation compared with non-lactating controls. This uptake was decreased by the presence of unlabelled insulin, indicating that it occurred via insulin receptors. The plasma half-life of insulin is decreased in lactation from 9.4 min to 4.8 min, and the metabolic clearance rate for insulin increased from 7.26 to 13.03 ml/kg body wt. per min. The basal insulin and glucose concentrations in the plasma were decreased in lactation. Infusion of insulin at a dose which led to a small physiological rise in plasma insulin concentration increased lipogenic rates in the mammary gland by 100% without causing marked hypoglycaemia. It is concluded that the lactating mammary gland is a highly insulin-sensitive tissue and that the lower plasma insulin during lactation occurs primarily as a result of this sensitivity increasing extraction of glucose by the gland and thus producing a decrease in the plasma glucose concentration. It is suggested that a secondary result of the fall in plasma insulin concentration is the preferential direction of substrates (glucose and non-esterified fatty acids) towards the lactating mammary gland and away from adipose tissue and the liver.

Lactogenesis signals the shift from uterine nutrient transfer to the fetus to neonatal nourishment at the mammary gland. Metabolic adaptations involved in this process are under endocrine regulation. Key events include an increase in blood flow to mammary tissue, a decrease in nutrient utilization by peripheral tissues and an increase in nutrient utilization by mammary tissue for milk synthesis. Deficits of certain substrates during early lactation require mobilization of those substrates from depot stores. Changes in metabolism of various tissues are related to changes in hormone receptor populations of those tissues and hormone concentrations in blood. Hormone receptors are therefore the primary mechanism by which information from the endocrine systems is linked to cellular metabolism. Endocrine changes at parturition result in dramatic changes in receptor populations of key tissues such as adipose and mammary tissues. Knowledge in this area, however, is incomplete. Relationship between hormone receptors and specific cellular metabolic pathways remains unresolved.