营养不良非洲儿童营养恢复的激素相关因素和预测因素。
Hormonal Correlates and Predictors of Nutritional Recovery in Malnourished African Children.
机构信息
MRC Unit The Gambia, Banjul, The Gambia.
MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, London, UK.
出版信息
J Trop Pediatr. 2018 Oct 1;64(5):364-372. doi: 10.1093/tropej/fmx075.
BACKGROUND
Malnourished children show variable growth responses to nutritional rehabilitation. We aimed to investigate whether these differences could be explained by variations in growth and energy-regulating hormones.
METHODS
Quasi-experimental study: Children aged 6-24 months in rural Gambia were recruited to controls if weight-for-height z-score (WHZ) > -2 (n = 22), moderate acute malnutrition if WHZ < -2 and > -3 (n = 18) or severe acute malnutrition if WHZ < -3 (n = 20). Plasma hormone and salivary CRP levels were determined by ELISA.
RESULTS
In univariable analyses, increases in weight-for-age z-score (WAZ) in malnourished children were positively correlated with insulin (F-ratio 7.8, p = 0.006), C-peptide (F-ratio 12.2, p < 0.001) and cortisol (F-ratio 5.0, p = 0.03). In multivariable analysis, only baseline C-peptide (F-ratio 7.6, p = 0.009) predicted the changes in WAZ over 28 days of interventions.
CONCLUSION
In rural Gambian, malnourished children, although it cannot be used in isolation, baseline C-peptide was a predictor of future response to rehabilitation.
背景
营养不良的儿童对营养康复的生长反应各不相同。我们旨在研究这些差异是否可以通过生长和能量调节激素的变化来解释。
方法
准实验研究：在冈比亚农村地区，招募年龄在 6-24 个月的儿童，如果体重身高 z 分数（WHZ）> -2（n = 22），则为对照组；如果 WHZ < -2 且> -3（n = 18），则为中度急性营养不良；如果 WHZ < -3（n = 20），则为严重急性营养不良。通过 ELISA 测定血浆激素和唾液 CRP 水平。
结果
在单变量分析中，营养不良儿童体重与年龄 z 分数（WAZ）的增加与胰岛素（F 比 7.8，p = 0.006）、C 肽（F 比 12.2，p < 0.001）和皮质醇（F 比 5.0，p = 0.03）呈正相关。在多变量分析中，只有基线 C 肽（F 比 7.6，p = 0.009）可以预测干预后 28 天 WAZ 的变化。
结论
在冈比亚农村地区，虽然不能单独使用，但基线 C 肽是未来对康复反应的预测指标。
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