Idohou-Dossou Nicole, Wade Salimata, Guiro Amadou T, Sarr Cheikh S, Diaham Babou, Cissé Djibril, Beau Jean-Pierre, Chappuis Philippe, Hoffman Daniel, Lemonnier Daniel
Equipe de Nutrition et Alimentation, Laboratoire de Physiologie, Département de Biologie Animale, Faculté des Sciences et Techniques, Université Cheikh Anta Diop de Dakar, Sénégal.
Br J Nutr. 2003 Dec;90(6):1123-32. doi: 10.1079/bjn2003990.
The prevalence of malnutrition remains high in many developing countries. However, data relating to the long-term effects of severe malnutrition, specifically, serum levels of biochemical indicators of nutritional status, are still scarce in the literature. Hence the present study aimed to investigate the nutritional, biological and growth status of Senegalese preschool children previously hospitalised for severe malnutrition. The study involved twenty-four 7-year-old children who had suffered from marasmus 5 years earlier, twenty-four siblings living in the same household, and nineteen age-matched children living in the centre of Dakar. The siblings were of similar age to the post-marasmic children. Anthropometry, serum biochemical indicators of nutritional status, growth factors, and haematological and mineral parameters were measured. The prevalence of stunting and wasting was the same in the post-marasmic children as in the siblings. Body-fat and fat-free-mass (FFM) deficits in both groups were corroborated by abnormally low concentrations of transthyretin, osteocalcin, insulin-like growth factor (IGF)-1, and insulin-like growth factor-binding protein (IGFBP)-3. FFM was positively and significantly correlated with concentrations of IGF-1 and IGFBP-3. In the post-marasmic children, height for age was also correlated with IGF-1. Of the post-marasmic children, 53 % had Fe-deficiency anaemia, as did 35 % of the siblings and 29 % of the controls. No significant associations were found between the serum concentrations of Ca, Cu, K, Mg, Na, P, Se, Zn and growth retardation. At 5 years after nutritional rehabilitation, the post-marasmic children remained stunted with nutritional indices significantly lower than the control children. However, these children were doing as well as their siblings except for minor infections.
在许多发展中国家,营养不良的患病率仍然很高。然而,关于严重营养不良长期影响的数据,特别是营养状况的生化指标血清水平,在文献中仍然很少。因此,本研究旨在调查曾因严重营养不良住院的塞内加尔学龄前儿童的营养、生物学和生长状况。该研究涉及24名7岁儿童,他们在5年前患有消瘦症,24名居住在同一家庭的兄弟姐妹,以及19名年龄匹配、居住在达喀尔市中心的儿童。这些兄弟姐妹与患过消瘦症的儿童年龄相仿。测量了人体测量学指标、营养状况的血清生化指标、生长因子以及血液学和矿物质参数。患过消瘦症的儿童与兄弟姐妹的发育迟缓率和消瘦率相同。两组的体脂和去脂体重(FFM)不足通过转甲状腺素蛋白、骨钙素、胰岛素样生长因子(IGF)-1和胰岛素样生长因子结合蛋白(IGFBP)-3浓度异常低得到证实。FFM与IGF-1和IGFBP-3的浓度呈显著正相关。在患过消瘦症的儿童中,年龄别身高也与IGF-1相关。患过消瘦症的儿童中,53%患有缺铁性贫血,兄弟姐妹中这一比例为35%,对照组为29%。未发现血清钙、铜、钾、镁、钠、磷、硒、锌浓度与生长发育迟缓之间存在显著关联。在营养康复5年后,患过消瘦症的儿童仍然发育迟缓,营养指标显著低于对照儿童。然而,除了轻微感染外,这些儿童的情况与他们兄弟姐妹一样。