Division of Nutrition, St. John's Research Institute, St. John's National Academy of Health Sciences, Bangalore, India.
Department of Biostatistics, St. John's Medical College, St. John's National Academy of Health Sciences, Bangalore, India.
Eur J Clin Nutr. 2023 May;77(5):532-537. doi: 10.1038/s41430-023-01268-w. Epub 2023 Jan 31.
BACKGROUND/OBJECTIVES: Chronic immune activation in Environmental Enteric Dysfunction (EED) could lead to increased fed-state metabolic rate (MR) or total energy expenditure (TEE) and limit the energy available for optimal linear growth. In a secondary analysis, MR and TEE were compared in young Indian children from urban slums, with and without stunting or EED.
SUBJECTS/METHODS: Children (18-24 months, n = 69) were classified into non-stunted (LAZ ≥ -2) and stunted (LAZ < -2), and no-EED (lactulose rhamnose ratio, LRR < 0.068) and EED (LRR ≥ 0.068) groups. Associations between MR and TEE (kcal per kg bodyweight [BW] or fat free mass [FFM]) with stunting and EED were examined using logistic regression.
Median TEE was significantly higher in the stunted compared to non-stunted group (76.8 versus 92.0 kcal/kg BW/day, p = <0.01). The adjusted (for sex, FFM, EED) odds ratio (AOR) for stunting with TEE (kcal/day) was 1.01 (95% CI: 1.00, 1.01), but importantly, there was no interaction between EED and TEE. The median TEE was also significantly higher in the EED compared to the no-EED group (89.1 vs 76.8 kcal/kg BW/day, p = 0.02), and the AOR (adjusted for sex and TEE) for stunting with EED was 3.56 (95% CI:1.09, 11.63). MR (per kg BW or FFM) was not associated with stunting or EED.
Higher TEE and presence of EED were independently and positively associated with stunting. Children with EED also had higher TEE but not MR. Energetically, the higher TEE in stunted children may not specifically be linked to the presence of EED, although the latter independently had higher odds of stunting.
背景/目的：环境肠道功能障碍（EED）中的慢性免疫激活可导致进食状态代谢率（MR）或总能量消耗（TEE）增加，并限制最佳线性生长所需的能量。在二次分析中，比较了来自城市贫民窟的印度幼儿中非消瘦（LAZ≥-2）和消瘦（LAZ<-2）以及无 EED（乳果糖鼠李糖比，LRR<0.068）和 EED（LRR≥0.068）的儿童的 MR 和 TEE。使用逻辑回归检查了 MR 和 TEE（每公斤体重[kcal/kg BW]或去脂体重[FFM]）与消瘦和 EED 之间的关联。
与非消瘦组相比，消瘦组的 TEE 中位数显着更高（76.8 比 92.0 kcal/kg BW/天，p<0.01）。调整（性别，FFM，EED）后，TEE（kcal/天）与消瘦的比值比（AOR）为 1.01（95%CI：1.00，1.01），但重要的是，EED 和 TEE 之间没有相互作用。与无 EED 组相比，EED 组的 TEE 中位数也显着更高（89.1 比 76.8 kcal/kg BW/天，p=0.02），EED 与消瘦的 AOR（调整性别和 TEE）为 3.56（95%CI：1.09，11.63）。MR（每公斤 BW 或 FFM）与消瘦或 EED 无关。
较高的 TEE 和 EED 的存在与消瘦独立且呈正相关。EED 儿童的 TEE 也较高，但 MR 没有。在能量方面，消瘦儿童较高的 TEE 可能与 EED 的存在没有特定联系，尽管后者独立存在较高的消瘦几率。
