儿童环境肠道功能障碍生物标志物与生长速度的关联
创作:尹小甜 审核:Epi汪 2021年04月23日
  • 纳入津巴布韦1169名儿童队列,粪便在1、3、6、12、18个月时进行随访,测量身高,收集粪便和血液样本;
  • 共检测11种环境肠功能障碍(EED)相关的生物标志物;
  • 12个月时血浆中犬尿酸:色氨酸的比例与12-18月内儿童身高增长速度降低相关;
  • 6个月时的甘露醇排泄速率与6-12个月的身高增长速度增加相关;
  • 1月时的胰岛素样生长因子-1的浓度与1-3月时身高增长速度增加有关;
  • 没有发现任何EED相关生物标志物与生长速度之间的线性关联。
主编推荐语
Epi汪
环境肠道功能障碍 (EED)是一种以绒毛萎缩和隐窝增生为特征的获得性小肠亚临床疾病,病因不明,可能占所有发育迟缓病例的40%以上。因此,本研究希望通过挖掘EED相关的分子标志物与儿童生长之间的关联,探索其中可能具有的临床价值。虽然一些时间点的生长速度与其标志物存在关联,但是这种关联并没有持续性,线性相关并不明显。
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ASN Neuro [IF:5.2]

Biomarkers of environmental enteric dysfunction are not consistently associated with linear growth velocity in rural Zimbabwean infants

津巴布韦农村婴儿的环境肠道功能障碍的生物标志物与线性生长速度并不一致

10.1093/ajcn/nqaa416

2021-03-19, Article

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Background: Child stunting remains a poorly understood, prevalent public health problem. Environmental enteric dysfunction (EED) is hypothesized to be an important underlying cause.
Objectives: Within a subgroup of 1169 children enrolled in the SHINE (Sanitation Hygiene Infant Nutrition Efficacy) trial in rural Zimbabwe, followed longitudinally from birth to 18 mo of age, we evaluated associations between the concentration of 11 EED biomarkers and linear growth velocity.
Methods: At infant ages 1, 3, 6, 12, and 18 mo, nurses measured child length and collected stool and blood; the lactulose-mannitol urine test was also conducted at all visits except at 1 mo. Stool neopterin, α-1 antitrypsin, myeloperoxidase, and regenerating gene 1β protein; urinary lactulose and mannitol; and plasma kynurenine, tryptophan, C-reactive protein, insulin-like growth factor-1 (IGF-1), soluble CD14, intestinal fatty acid binding protein, and citrulline were measured. We analyzed the change in relative [ length-for age z score (LAZ)/mo] and absolute (length/mo) growth velocity during 4 age intervals (1–3 mo; 3–6 mo; 6–12 mo; and 12–18 mo) per SD increase in biomarker concentration at the start of each age interval.
Results: In fully adjusted models, we observed only 3 small, statistically significant associations: kynurenine:tryptophan ratio at 12 mo was associated with decreased mean LAZ velocity during the 12–18 mo interval (−0.015 LAZ/mo; 95% CI: −0.029, −0.001 LAZ/mo); mannitol excretion at 6 mo was associated with increased LAZ velocity during the 6–12 mo interval (0.013 LAZ/mo; 95% CI: 0.001, 0.025 LAZ/mo), and plasma IGF-1 at 1 mo was associated with increased LAZ velocity during the 1–3 mo interval (0.118 LAZ/mo; 95% CI: 0.024, 0.211 LAZ/mo). Results for absolute growth velocity were similar, except IGF-1 was also associated with growth during the 12–18 mo interval. We found no other associations between any EED biomarker and linear growth velocity.
Conclusions: None of 11 biomarkers of EED were consistently associated with linear growth among Zimbabwean children. This trial was registered at clinicaltrials.gov as NCT01824940.

First Authors:
Kuda Mutasa

Correspondence Authors:
Andrew J Prendergast

All Authors:
Kuda Mutasa,Robert Ntozini,Mduduzi NN Mbuya,Sandra Rukobo,Margaret Govha,Florence D Majo,Naume Tavengwa,Laura E Smith,Laura Caulfield,Jonathan R Swann,Rebecca J Stoltzfus,Lawrence H Moulton,Jean H Humphrey,Ethan K Gough,Andrew J Prendergast

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