Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine.
Children's Hospital, University Teaching Hospitals, Lusaka, Zambia.
J Pediatr Gastroenterol Nutr. 2020 Apr;70(4):513-520. doi: 10.1097/MPG.0000000000002633.
Glucagon-like peptide 2 (GLP-2) is a 33 amino acid peptide hormone released from enteroendocrine L-cells following nutrient ingestion. It has been shown to exert trophic effects on the gut. We set out to measure GLP-2 concentrations in blood in children with diarrhoea and malnutrition.
GLP-2 levels were measured in blood samples collected from 5 different groups of children (n = 324) at different time points: those with acute diarrhoea, during illness and 3 weeks after recovery; persistent diarrhoea and severe acute malnutrition; controls contemporaneous for diarrhoea; stunted children from the community; and controls contemporaneous for the stunted children. Stool biomarkers and pathogen analysis were carried out on the children with stunting.
GLP-2 concentrations were higher during acute diarrhoea (median 3.1 ng/mL, interquartile range 2.1, 4.4) than on recovery (median 1.8, interquartile range 1.4, 3.1; P = 0.001), but were not elevated in children with persistent diarrhoea and severe acute malnutrition. In stunted children, there was a progressive decline in GLP-2 levels from 3.2 ng/mL (1.9, 4.9) to 1.0 (0.0, 2.0; P < 0.001) as the children became more stunted. Measures of seasonality (rainfall, temperature,Food Price Index, and Shiga toxin-producing Escherichia coli) were found to be significantly associated with GLP-2 concentrations in multivariable analysis. We also found a correlation between stool inflammatory biomarkers and GLP-2.
In diarrhoea, GLP-2 levels increased in acute but not persistent diarrhoea. Malnutrition was associated with reduced concentrations. GLP-2 displayed seasonal variation consistent with variations in nutrient availability.
胰高血糖素样肽 2（GLP-2）是一种 33 个氨基酸的肽类激素，在摄入营养物质后从肠内分泌 L 细胞释放。它已被证明对肠道具有营养作用。我们旨在测量腹泻和营养不良儿童血液中的 GLP-2 浓度。
在不同时间点从 5 个不同组别的儿童（n = 324）的血液样本中测量 GLP-2 水平：急性腹泻患儿、患病期间和康复后 3 周；持续性腹泻和严重急性营养不良；同期腹泻对照儿童；社区发育迟缓儿童；同期发育迟缓儿童对照。对发育迟缓儿童进行粪便生物标志物和病原体分析。
急性腹泻期间 GLP-2 浓度较高（中位数 3.1ng/mL，四分位距 2.1，4.4），而在康复期间较低（中位数 1.8，四分位距 1.4，3.1；P = 0.001），但持续性腹泻和严重急性营养不良儿童的 GLP-2 浓度并未升高。在发育迟缓儿童中，GLP-2 水平从 3.2ng/mL（1.9，4.9）逐渐下降至 1.0（0.0，2.0；P < 0.001），随着儿童变得更加发育迟缓。多变量分析发现，季节性因素（降雨量、温度、食品价格指数和产志贺毒素大肠杆菌）与 GLP-2 浓度显著相关。我们还发现粪便炎症生物标志物与 GLP-2 之间存在相关性。
在腹泻中，GLP-2 水平在急性腹泻中增加，但在持续性腹泻中不增加。营养不良与浓度降低有关。GLP-2 显示出与营养物质可用性变化一致的季节性变化。
