Lee G O, Olortegui M Paredes, Salas M Siguas, Yori P Peñataro, Trigoso D Rengifo, Kosek P, Mispireta M L, Oberhelman R, Caulfield L E, Kosek M N
1Department of Epidemiology,University of Michigan School of Public Health,Ann Arbor,MI,USA.
2Asociación Benéfica PRISMA,Iquitos,Peru.
J Dev Orig Health Dis. 2017 Jun;8(3):337-348. doi: 10.1017/S2040174417000071. Epub 2017 Mar 7.
Environmental enteropathy (EE) is a syndrome of altered small intestine structure and function hypothesized to be common among individuals lacking access to improved water and sanitation. There are plausible biological mechanisms, both inflammatory and non-inflammatory, by which EE may alter the cardiometabolic profile. Here, we test the hypothesis that EE is associated with the cardiometabolic profile among young children living in an environment of intense enteropathogen exposure. In total, 156 children participating in the Peruvian cohort of a multicenter study on childhood infectious diseases, growth and development were contacted at 3-5 years of age. The urinary lactulose:mannitol ratio, and plasma antibody to endotoxin core were determined in order to assess intestinal permeability and bacterial translocation. Blood pressure, anthropometry, fasting plasma glucose, insulin, and cholesterol and apolipoprotein profiles were also assessed. Extant cohort data were also used to relate biomarkers of EE during the first 18 months of life to early child cardiometabolic profile. Lower intestinal surface area, as assessed by percent mannitol excretion, was associated with lower apolipoprotein-AI and lower high-density lipoprotein concentrations. Lower intestinal surface area was also associated with greater blood pressure. Inflammation at 7 months of age was associated with higher blood pressure in later childhood. This study supports the potential for a relationship between EE and the cardiometabolic profile.
环境肠病（EE）是一种小肠结构和功能改变的综合征，据推测在无法获得改良水和卫生设施的人群中较为常见。EE可能通过炎症和非炎症这两种合理的生物学机制改变心脏代谢状况。在此，我们检验这样一个假设：在肠道病原体暴露强烈的环境中生活的幼儿中，EE与心脏代谢状况相关。共有156名参与一项关于儿童传染病、生长发育的多中心研究的秘鲁队列研究的儿童在3至5岁时被随访。测定尿乳果糖：甘露醇比值以及血浆内毒素核心抗体，以评估肠道通透性和细菌易位。还评估了血压、人体测量学指标、空腹血糖、胰岛素以及胆固醇和载脂蛋白谱。现有的队列数据也被用于将生命最初18个月期间EE的生物标志物与儿童早期心脏代谢状况联系起来。通过甘露醇排泄百分比评估的较低肠道表面积与较低的载脂蛋白A-I和较低的高密度脂蛋白浓度相关。较低的肠道表面积还与较高的血压相关。7个月大时的炎症与儿童后期较高的血压相关。这项研究支持了EE与心脏代谢状况之间存在关联的可能性。
