发育迟缓、消瘦与身体成分之间的关联：一项针对6至15个月大肯尼亚儿童的纵向研究。

Associations between Stunting, Wasting and Body Composition: A Longitudinal Study in 6- to 15-Month-Old Kenyan Children.

作者信息

Konyole Silvenus O, Omollo Selina A, Kinyuru John N, Owuor Bethwell O, Estambale Benson B, Ritz Christian, Michaelsen Kim F, Filteau Suzanne M, Wells Jonathan C, Roos Nanna, Friis Henrik, Owino Victor O, Grenov Benedikte

机构信息

Department of Nutritional Sciences, Masinde Muliro University of Science and Technology, Kakamega, Kenya.

Institute of Tropical and Infectious Diseases, University of Nairobi, Nairobi, Kenya.

出版信息

J Nutr. 2023 Apr;153(4):970-978. doi: 10.1016/j.tjnut.2023.02.014. Epub 2023 Feb 14.

DOI:10.1016/j.tjnut.2023.02.014

PMID:36796480

Abstract

BACKGROUND

Early growth and body composition may influence the risk of obesity and health in adulthood. Few studies have examined how undernutrition is associated with body composition in early life.

OBJECTIVES

We assessed stunting and wasting as correlates of body composition in young Kenyan children.

METHODS

Nested in a randomized controlled nutrition trial, this longitudinal study assessed fat and fat-free mass (FM, FFM) using deuterium dilution technique among children at age 6 and 15 months. This trial was registered at http://controlled-trials.com/ (ISRCTN30012997). Cross-sectional and longitudinal associations between z-score categories of length-for-age (LAZ) or weight-for-length (WLZ) and FM, FFM, fat mass index (FMI), fat-free mass index (FFMI), triceps, and subscapular skinfolds were analyzed by linear mixed models.

RESULTS

Among the 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32%, and wasting remained at 2% to 3% between 6 and 15 mo. Compared with LAZ >0, stunted children had a 1.12 kg (95% CI: 0.88, 1.36; P < 0.001) lower FFM at 6 mo and increased to 1.59 kg (95% CI: 1.25, 1.94; P < 0.001) at 15 mo, corresponding to differences of 18% and 17%, respectively. When analyzing FFMI, the deficit in FFM tended to be less than proportional to children's height at 6 mo (P ≤ 0.060) but not at 15 mo (P > 0.40). Stunting was associated with 0.28 kg (95% CI: 0.09, 0.47; P = 0.004) lower FM at 6 mo. However, this association was not significant at 15 mo, and stunting was not associated with FMI at any time point. A lower WLZ was generally associated with lower FM, FFM, FMI, and FFMI at 6 and 15 mo. Differences in FFM, but not FM, increased with time, whereas FFMI differences did not change, and FMI differences generally decreased with time.

CONCLUSIONS

Overall, low LAZ and WLZ among young Kenyan children were associated with reduced lean tissue, which may have long-term health consequences.

摘要

背景

早期生长和身体成分可能会影响成年期肥胖和健康风险。很少有研究探讨营养不良与生命早期身体成分之间的关联。

目的

我们评估了发育迟缓与消瘦作为肯尼亚幼儿身体成分的相关因素。

方法

这项纵向研究嵌套于一项随机对照营养试验中，使用氘稀释技术评估了6个月和15个月大儿童的脂肪和去脂体重（FM、FFM）。该试验已在http://controlled-trials.com/（ISRCTN30012997）注册。通过线性混合模型分析年龄别身长（LAZ）或身长别体重（WLZ）的z评分类别与FM、FFM、脂肪量指数（FMI）、去脂体重指数（FFMI）、肱三头肌和肩胛下皮褶厚度之间的横断面和纵向关联。

结果

在纳入的499名儿童中，6至15个月期间，母乳喂养率从99%降至87%，发育迟缓率从13%升至32%，消瘦率维持在2%至3%。与LAZ>0的儿童相比，发育迟缓儿童在6个月时的FFM低1.12 kg（95%CI：0.88，1.36；P<0.001），在15个月时增加至1.59 kg（95%CI：1.25，1.94；P<0.001），分别对应18%和17%的差异。在分析FFMI时，6个月时FFM的不足往往与儿童身高不成比例（P≤0.060），但15个月时并非如此（P>0.40）。发育迟缓与6个月时FM低0.28 kg（95%CI：0.09，0.47；P = 0.004）相关。然而，这种关联在15个月时不显著，且发育迟缓在任何时间点均与FMI无关。较低的WLZ通常与6个月和15个月时较低的FM、FFM、FMI和FFMI相关。FFM的差异随时间增加，但FM的差异不随时间增加，而FFMI的差异不变，FMI的差异通常随时间减少。