Enteric dysfunction and other factors associated with attained size at 5 years: MAL-ED birth cohort study findings.
Bangladesh
/ epidemiology
Biomarkers
/ urine
Body Height
Body Mass Index
Body Size
/ physiology
Body Weight
Brazil
/ epidemiology
Child, Preschool
Cohort Studies
Feces
/ chemistry
Female
Follow-Up Studies
Growth Disorders
/ epidemiology
Humans
India
/ epidemiology
Infant
Infant, Newborn
Intestinal Diseases
/ microbiology
Lactulose
/ urine
Male
Mannitol
/ urine
Micronutrients
/ blood
Nepal
/ epidemiology
Peru
/ epidemiology
South Africa
/ epidemiology
Tanzania
/ epidemiology
enteric dysfunction
growth
inflammation
iron
permeability
Journal
The American journal of clinical nutrition
ISSN: 1938-3207
Titre abrégé: Am J Clin Nutr
Pays: United States
ID NLM: 0376027
Informations de publication
Date de publication:
01 07 2019
01 07 2019
Historique:
received:
20
08
2018
accepted:
07
01
2019
pubmed:
28
5
2019
medline:
28
2
2020
entrez:
26
5
2019
Statut:
ppublish
Résumé
Poor growth in early childhood has been associated with increased risk of mortality and morbidity, as well as long-term deficits in cognitive development and economic productivity. Data from the MAL-ED cohort study were used to identify factors in the first 2 y of life that are associated with height-for-age, weight-for-age, and body mass index z-scores (HAZ, WAZ, BMIZ) at 5 y of age. A total of 1017 children were followed from near birth until 5 y of age at sites in Bangladesh, Brazil, India, Nepal, Peru, South Africa, and Tanzania. Data were collected on their growth, environmental enteric dysfunction (EED), micronutrient status, enteric pathogen burden, illness prevalence, dietary intake, and various other socio-economic and environmental factors. EED biomarkers were related to size at 5 y. Mean lactulose:mannitol z-scores during the first 2 y of life were negatively associated with all of the growth measures (HAZ: -0.11 [95% CI: -0.19, -0.03]; WAZ: -0.16 [95% CI: -0.26, -0.06]; BMIZ: -0.11 [95% CI: -0.23, 0.0]). Myeloperoxidase was negatively associated with weight (WAZ: -0.52 [95% CI: -0.78, -0.26] and BMIZ: -0.56 [95% CI: -0.86, -0.26]); whereas α-1-antitrypsin had a negative association with HAZ (-0.28 [95% CI: -0.52, -0.04]). Transferrin receptor was positively related to HAZ (0.18 [95% CI: 0.06, 0.30]) and WAZ (0.21 [95% CI: 0.07, 0.35]). Hemoglobin was positively related to HAZ (0.06 [95% CI: 0.00, 0.12]), and ferritin was negatively related to HAZ (-0.08 [95% CI: -0.12, -0.04]). Bacterial density in stool was negatively associated with HAZ (-0.04 [95% CI: -0.08, 0.00]), but illness symptoms did not have any effect on size at 5 y. EED markers, bacterial density, and iron markers are associated with growth at 5 y of age. Interventions to reduce bacterial burden and EED may improve long-term growth in low-income settings.
Sections du résumé
BACKGROUND
Poor growth in early childhood has been associated with increased risk of mortality and morbidity, as well as long-term deficits in cognitive development and economic productivity.
OBJECTIVES
Data from the MAL-ED cohort study were used to identify factors in the first 2 y of life that are associated with height-for-age, weight-for-age, and body mass index z-scores (HAZ, WAZ, BMIZ) at 5 y of age.
METHODS
A total of 1017 children were followed from near birth until 5 y of age at sites in Bangladesh, Brazil, India, Nepal, Peru, South Africa, and Tanzania. Data were collected on their growth, environmental enteric dysfunction (EED), micronutrient status, enteric pathogen burden, illness prevalence, dietary intake, and various other socio-economic and environmental factors.
RESULTS
EED biomarkers were related to size at 5 y. Mean lactulose:mannitol z-scores during the first 2 y of life were negatively associated with all of the growth measures (HAZ: -0.11 [95% CI: -0.19, -0.03]; WAZ: -0.16 [95% CI: -0.26, -0.06]; BMIZ: -0.11 [95% CI: -0.23, 0.0]). Myeloperoxidase was negatively associated with weight (WAZ: -0.52 [95% CI: -0.78, -0.26] and BMIZ: -0.56 [95% CI: -0.86, -0.26]); whereas α-1-antitrypsin had a negative association with HAZ (-0.28 [95% CI: -0.52, -0.04]). Transferrin receptor was positively related to HAZ (0.18 [95% CI: 0.06, 0.30]) and WAZ (0.21 [95% CI: 0.07, 0.35]). Hemoglobin was positively related to HAZ (0.06 [95% CI: 0.00, 0.12]), and ferritin was negatively related to HAZ (-0.08 [95% CI: -0.12, -0.04]). Bacterial density in stool was negatively associated with HAZ (-0.04 [95% CI: -0.08, 0.00]), but illness symptoms did not have any effect on size at 5 y.
CONCLUSIONS
EED markers, bacterial density, and iron markers are associated with growth at 5 y of age. Interventions to reduce bacterial burden and EED may improve long-term growth in low-income settings.
Identifiants
pubmed: 31127812
pii: S0002-9165(22)01159-5
doi: 10.1093/ajcn/nqz004
pmc: PMC6599740
doi:
Substances chimiques
Biomarkers
0
Micronutrients
0
Mannitol
3OWL53L36A
Lactulose
4618-18-2
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
131-138Subventions
Organisme : NIAID NIH HHS
ID : K01 AI130326
Pays : United States
Informations de copyright
Copyright © American Society for Nutrition 2019.
Références
Lancet Infect Dis. 2018 Nov;18(11):1211-1228
pubmed: 30243583
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S248-54
pubmed: 25305294
Biochim Biophys Acta. 2010 Aug;1800(8):760-9
pubmed: 20304033
Lancet. 2012 Sep 1;380(9844):824-34
pubmed: 22770478
J Pediatr. 2017 Aug;187:225-233.e1
pubmed: 28499715
Vaccine. 2017 Dec 14;35(49 Pt A):6807-6812
pubmed: 28549806
Arch Dis Child. 1999 Feb;80(2):115-9; discussion 119-20
pubmed: 10325724
PLoS Negl Trop Dis. 2018 Jan 19;12(1):e0006205
pubmed: 29351288
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S239-47
pubmed: 25305293
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S193-206
pubmed: 25305287
BMJ Glob Health. 2017 Dec 28;2(4):e000370
pubmed: 29333282
PLoS Med. 2017 Oct 25;14(10):e1002408
pubmed: 29069076
Int J Epidemiol. 2001 Dec;30(6):1457-64
pubmed: 11821364
EBioMedicine. 2016 Aug;10:25-32
pubmed: 27495791
EBioMedicine. 2017 Apr;18:109-117
pubmed: 28396264
Am J Clin Nutr. 2017 Dec;106(Suppl 6):1575S-1580S
pubmed: 29070561
Curr Opin Infect Dis. 2016 Jun;29(3):229-36
pubmed: 26967147
Lancet. 1991 Oct 12;338(8772):907-10
pubmed: 1681266
Am J Trop Med Hyg. 2018 Mar;98(3):904-912
pubmed: 29380724
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S220-4
pubmed: 25305290
Soc Sci Med. 2013 Nov;97:278-87
pubmed: 23769211
Popul Health Metr. 2014 Mar 21;12(1):8
pubmed: 24656134
Lancet. 2012 Dec 15;380(9859):2224-60
pubmed: 23245609
Lancet. 2016 Sep 24;388(10051):1291-301
pubmed: 27673470
Am J Clin Nutr. 2017 Jul;106(Suppl 1):372S-382S
pubmed: 28615256
Eur J Clin Nutr. 1994 Feb;48 Suppl 1:S58-70; discussion S71
pubmed: 8005092
Eur J Clin Nutr. 1994 Feb;48 Suppl 1:S45-57
pubmed: 8005090
Lancet Glob Health. 2015 Sep;3(9):e564-75
pubmed: 26202075
Clin Infect Dis. 2014 Nov 1;59 Suppl 4:S225-32
pubmed: 25305291
Am J Trop Med Hyg. 2017 Feb 8;96(2):465-472
pubmed: 27994110
Ann Epidemiol. 2013 Jun;23(6):314-20
pubmed: 23608305
J Dev Orig Health Dis. 2017 Jun;8(3):337-348
pubmed: 28264759
Am J Clin Nutr. 2017 Jul;106(Suppl 1):359S-371S
pubmed: 28615259
Inflamm Allergy Drug Targets. 2008 Mar;7(1):41-52
pubmed: 18473900
Matern Child Nutr. 2011 Oct;7 Suppl 3:5-18
pubmed: 21929633
Am J Epidemiol. 1986 Jul;124(1):17-27
pubmed: 3521261
J Pediatr Gastroenterol Nutr. 2017 Jul;65(1):31-39
pubmed: 28644347