Markers of Environmental Enteric Dysfunction are Associated with Poor Growth and Developmental Outcomes among Young Children in Lusaka, Zambia.

IF 3.9 2区医学 Q1 PEDIATRICS Journal of Pediatrics Pub Date : 2024-11-17 DOI:10.1016/j.jpeds.2024.114408

Jacqueline M Lauer, Juha Pyykkö, Mpela Chembe, Tamara Billima-Mulenga, Dorothy Sikazwe, Bertha Chibwe, Savanna Henderson, Doug Parkerson, Jukka M Leppänen, Günther Fink, Lindsey M Locks, Peter C Rockers

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Abstract

Objective: To examine cross-sectional relationships between biomarkers of environmental enteric dysfunction (EED), an acquired subclinical condition of the small intestine, and anthropometric and developmental outcomes among children in Lusaka, Zambia.

Study design: Serum samples were collected from 240 children aged 27 to 35 months enrolled in a cluster-randomized trial assessing the effects of growth charts and small-quantity lipid-based nutrient supplements on linear growth. Samples were analyzed using the 11-plex Micronutrient and EED Assessment Tool, which incorporates 2 biomarkers of EED, namely intestinal fatty acid-binding protein (I-FABP), a marker of epithelial damage, and soluble CD14 (sCD14), a marker of microbial translocation. Associations between log₂-transformed biomarker concentrations and anthropometric (height-for-age z-score [HAZ], weight-for-height z-score, and weight-for-age z-score) and developmental (Global Scales of Early Development development for age z-score and saccadic reaction time [SRT]) outcomes were assessed using linear regression analyses adjusted for background characteristics.

Results: Mean ± SD HAZ was -1.94 ± 1.10. Higher sCD14 and I-FABP concentrations were significantly associated with lower HAZ (β: -0.21, 95% CI: -0.41, -0.01 and β: -0.20, 95% CI: -0.32, -0.08, respectively). Higher I-FABP concentrations were significantly associated with lower development-for-age z-score (β: -0.22, 95% CI: -0.40, -0.03) and slower SRT (β: 7.37 ms, 95% CI: 2.02, 12.72) as were higher alpha-1-acid glycoprotein concentrations (HAZ β: -0.38, 95% CI: -0.72, -0.03; SRT β: 11.14 ms, 95% CI: 0.94, 21.72).

Conclusions: In children in Lusaka, biomarkers of EED were associated with poor anthropometric and developmental outcomes, underscoring the need for interventions to address EED to improve child health globally.

Clinical trial registry: ClinicalTrials.gov identifier for parent trial: NCT05120427. https://clinicaltrials.gov/ct2/show/NCT05120427.

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环境肠道功能紊乱的标志物与赞比亚卢萨卡幼儿生长发育不良有关。

目的研究设计：研究赞比亚卢萨卡儿童环境肠道功能障碍（EED）生物标志物（一种后天性小肠亚临床症状）与人体测量和发育结果之间的横断面关系：研究设计：研究人员收集了 240 名 27 至 35 个月大的儿童的血清样本，这些儿童参加了一项分组随机试验，评估生长图表和小量脂质营养补充剂对线性生长的影响。样本采用 11 种微量营养素和 EED 评估工具进行分析，该工具包含两种 EED 生物标记物，即肠道脂肪酸结合蛋白 (I-FABP) 和可溶性 CD14 (sCD14)，前者是上皮损伤的标记物，后者是微生物转移的标记物。采用线性回归分析评估了对数2转换的生物标记物浓度与人体测量（身高与年龄Z值[HAZ]、体重与身高Z值、体重与年龄Z值0）和发育（全球早期发育量表[GSED]年龄发育Z值[DAZ]和眼动反应时间[SRT]）结果之间的关系，并对背景特征进行了调整：HAZ 的平均值（± SD）为 -1.94 ± 1.10。较高的 sCD14 和 I-FABP 浓度与较低的 HAZ 显著相关（β：-0.21，95% CI：-0.41，-0.01；β：-0.20，95% CI：-0.32，-0.08）。I-FABP浓度越高，DAZ越低（β：-0.22，95% CI：-0.40，-0.03），SRT越慢（β：7.37 ms，95% CI：2.02，12.72），α-1酸糖蛋白浓度越高（HAZ β：-0.38，95% CI：-0.72，-0.03；SRT β：11.14 ms，95% CI：0.94，21.72）：在卢萨卡的儿童中，EED 的生物标志物与不良的人体测量和发育结果有关，这表明需要采取干预措施来解决 EED 问题，以改善全球儿童的健康状况。

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来源期刊

Journal of Pediatrics 医学-小儿科

CiteScore

6.00

自引率

2.00%

发文量

696

审稿时长

31 days

期刊介绍： The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy. Topics covered in The Journal of Pediatrics include, but are not limited to: General Pediatrics Pediatric Subspecialties Adolescent Medicine Allergy and Immunology Cardiology Critical Care Medicine Developmental-Behavioral Medicine Endocrinology Gastroenterology Hematology-Oncology Infectious Diseases Neonatal-Perinatal Medicine Nephrology Neurology Emergency Medicine Pulmonology Rheumatology Genetics Ethics Health Service Research Pediatric Hospitalist Medicine.