Faculty of Medicine and Health Technology, Center for Child Health Research, Tampere University, Tampere, Finland.
Program in International and Community Nutrition, University of California, Davis, CA.
J Pediatr Gastroenterol Nutr. 2019 Oct;69(4):431-437. doi: 10.1097/MPG.0000000000002435.
The determinants of gut microbiota composition and its effects on common childhood illnesses are only partly understood, especially in low-income settings. The aim of the present study was to investigate whether morbidity predicts gut microbiota composition in Malawian children and whether microbiota predicts subsequent morbidity. We tested the hypothesis that common infectious disease symptoms would be predictive of lower microbiota maturity and diversity.
We used data from 631 participants in a randomized-controlled nutrition intervention trial, in which a small-quantity lipid-based nutrient supplement was provided to pregnant and lactating mothers and their children at 6 to 18 months of age. Fecal samples were collected from the children at 6, 12, 18, and 30 months of age and analyzed using 16S rRNA sequencing. Microbiota variables consisted of measures of microbiota diversity (Shannon Index), microbiota maturity (microbiota-for-age z score), and the relative abundances of taxa. Morbidity variables included gastrointestinal and respiratory symptoms and fever.
Diarrhea and respiratory symptoms from 11 to 12 months were predictive of lower microbiota-for-age z score and higher Shannon Index, respectively (P = 0.035 and P = 0.023). Morbidity preceding sample collection was predictive of the relative abundances of several bacterial taxa at all time points. Higher microbiota maturity and diversity at 6 months were predictive of a lower incidence rate of fever in the subsequent 6 months (P = 0.007 and P = 0.031).
Our findings generally do not support the hypothesis that morbidity prevalence predicts a subsequent decrease in gut microbiota maturity or diversity in rural Malawian children. Certain morbidity symptoms may be predictive of microbiota maturity and diversity and relative abundances of several bacterial taxa. Furthermore, microbiota diversity and maturity may be associated with the subsequent incidence of fever.
肠道微生物群落组成及其对常见儿童疾病的影响的决定因素尚未完全阐明，尤其是在低收入环境中。本研究旨在调查马拉维儿童的发病率是否能预测肠道微生物群落组成，以及微生物群落是否能预测随后的发病率。我们检验了以下假设，即常见感染性疾病症状与较低的微生物群落成熟度和多样性相关。
我们使用了 631 名参与随机对照营养干预试验的参与者的数据，该试验在母亲怀孕和哺乳期以及 6 至 18 个月大的儿童中提供了小剂量的基于脂质的营养补充剂。在 6、12、18 和 30 个月时收集儿童的粪便样本，并使用 16S rRNA 测序进行分析。微生物群落变量包括微生物群落多样性（Shannon 指数）、微生物群落成熟度（微生物群落年龄 z 分数）和分类群的相对丰度。发病率变量包括胃肠道和呼吸道症状以及发热。
11 至 12 个月的腹泻和呼吸道症状分别预测了较低的微生物群落年龄 z 分数和较高的 Shannon 指数（P = 0.035 和 P = 0.023）。在所有时间点，发病前的发病率均预测了几种细菌分类群的相对丰度。6 个月时较高的微生物群落成熟度和多样性预测了随后 6 个月内发热的发生率较低（P = 0.007 和 P = 0.031）。
我们的研究结果通常不支持发病率流行率预测农村马拉维儿童肠道微生物群落成熟度或多样性随后下降的假设。某些发病率症状可能与微生物群落成熟度和多样性以及几种细菌分类群的相对丰度有关。此外，微生物群落多样性和成熟度可能与随后发热的发生率有关。
