Oslo Met - Oslo Metropolitan University, Oslo.
Centre for International Health, University of Bergen, Bergen.
J Pediatr Gastroenterol Nutr. 2018 Aug;67(2):242-249. doi: 10.1097/MPG.0000000000001990.
Environmental enteropathy (EE) is likely associated with growth retardation in children, but the association between EE and length velocity z score (LVZ) has not been investigated. The objective of the study was to assess associations between fecal markers for intestinal inflammation and LVZ and whether these associations were influenced by micronutrient adequacy among 9 to 24 months old children in Bhaktapur, Nepal.
Data were divided into 5 time slots (9-12, 12-15, 15-18, 18-21, and 21-24 months). Anthropometric measurement and dietary assessment (by 24 hour recall) were performed monthly. Mean nutrient density adequacy was calculated based on nutrient density adequacy of 10 micronutrients (thiamin, riboflavin, niacin, vitamin B6, folate, vitamin C, vitamin A, calcium, iron, and zinc). Anti-1-antitrypsin (AAT), myeloperoxidase (MPO), and neopterin (NEO) were measured in stool samples collected at the beginning of each time slot. An EE score was calculated based on all 3 fecal markers. Associations between AAT, MPO, NEO and EE score and LVZ were assessed by multiple linear regression analyses and Generalized Estimating Equations models.
Associations between fecal markers and EE score and LVZ were generally weak. EE score and MPO for 3-month and MPO for 6-month growth periods were significantly associated with LVZ from 9 to 24 months. These associations were slightly modified by mean nutrient density adequacy.
EE score and MPO were significantly associated with LVZ in 9 to 24 months old Nepali children. Further studies to establish the usefulness of AAT, MPO, and NEO in assessing EE and growth retardation are warranted.
环境肠病（EE）可能与儿童生长迟缓有关，但 EE 与身长速度 z 评分（LVZ）之间的关系尚未得到研究。本研究的目的是评估粪便肠道炎症标志物与 LVZ 之间的关系，以及这些关系是否受尼泊尔巴克塔普尔 9 至 24 个月儿童微量营养素充足性的影响。
数据分为 5 个时间段（9-12、12-15、15-18、18-21 和 21-24 个月）。每月进行人体测量和饮食评估（通过 24 小时回顾）。根据 10 种微量营养素（硫胺素、核黄素、烟酸、维生素 B6、叶酸、维生素 C、维生素 A、钙、铁和锌）的微量营养素充足性来计算平均营养素密度充足性。在每个时间段开始时收集粪便样本，测量抗 1-抗胰蛋白酶（AAT）、髓过氧化物酶（MPO）和新蝶呤（NEO）。基于所有 3 种粪便标志物计算 EE 评分。采用多元线性回归分析和广义估计方程模型评估 AAT、MPO、NEO 和 EE 评分与 LVZ 之间的关系。
粪便标志物与 EE 评分和 LVZ 之间的关系通常较弱。3 个月和 6 个月的 EE 评分和 MPO 与 9 至 24 个月的 LVZ 显著相关。这些关联在一定程度上受到平均营养素密度充足性的影响。
EE 评分和 MPO 与尼泊尔 9 至 24 个月儿童的 LVZ 显著相关。需要进一步研究以确定 AAT、MPO 和 NEO 在评估 EE 和生长迟缓方面的有用性。
