Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark.
Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark; Department of Pediatrics and Child Health, School of Medicine College of Health Sciences, Makerere University, Kampala, Uganda.
J Nutr. 2024 Oct;154(10):3105-3115. doi: 10.1016/j.tjnut.2024.08.001. Epub 2024 Aug 5.
Development of body composition (BC) may be disrupted in children with stunting. Such disruption may affect the later risk of excess adiposity and metabolic health, yet few studies have investigated correlates of BC in children with stunting.
We aimed to investigate nutritional status, infection and inflammation, breastfeeding behaviors, and other factors as correlates of BC in children with stunting.
Among Ugandan children with a height-for-age z-score <-2, BC was estimated using bioelectrical impedance analysis and compared with United Kingdom references. We used multiple linear regression analysis to identify correlates of fat mass (FM), fat-free mass (FFM), FM-index (FMI), and FFM index (FFMI) and height, adjusting for gender and age.
In 750 children aged 1-5 y, FMI was 0.46 (95% confidence interval [CI]: 0.38, 0.54] and FFMI 0.18 [95% CI: 0.11, 0.26) z-scores lower than United Kingdom references. Elevated serum α-acid glycoprotein was associated with 1.14 [0.76, 1.52] cm lower height, 0.50 [0.35, 0.65] kg/m less FFMI, and 0.48 [0.31, 0.66] kg/m greater FMI. Similar, weaker, associations for elevated serum C-reactive protein were detected. A positive malaria rapid test was associated with 0.64 [0.25, 1.02] cm shorter height, but 0.36 [0.18, 0.54] kg/m greater FMI. Anemia (according to hemoglobin) was associated with 0.20 [0.07, 0.33] kg less FFM in proportion to shorter height. Longer breastfeeding duration was associated with 0.03 [0.02, 0.04] kg greater FFM per month, in proportion to greater height.
These children exhibited deficits in FM and FFM, proportionally to their stunted height, compared with United Kingdom references. Systemic inflammation correlated inversely with linear growth and FFM but positively with fatness, making it a possible target for intervention where fat-free tissue accretion is desirable. Longer breastfeeding may offer protection to lean linear growth, but findings for micronutrients were less clear. Longitudinal studies are warranted to support these findings. The study was registered at www.isrctn.com (Ref. ISRCTN13093195).
身体成分（BC）的发育在发育迟缓的儿童中可能会受到干扰。这种干扰可能会影响以后超重和代谢健康的风险，但很少有研究调查发育迟缓儿童的 BC 相关因素。
我们旨在研究营养状况、感染和炎症、母乳喂养行为以及其他因素与发育迟缓儿童 BC 的相关性。
在乌干达身高年龄 Z 评分<-2 的儿童中，使用生物电阻抗分析估计 BC，并与英国参考值进行比较。我们使用多元线性回归分析来确定脂肪量（FM）、去脂肪量（FFM）、FM 指数（FMI）和 FFM 指数（FFMI）与身高的相关性，同时调整性别和年龄。
在 750 名 1-5 岁的儿童中，FMI 低 0.46（95%置信区间 [CI]：0.38，0.54），FFMI 低 0.18（95%CI：0.11，0.26），低于英国参考值。血清 α-酸性糖蛋白升高与身高降低 1.14cm（0.76，1.52）、FFMI 降低 0.50kg/m（0.35，0.65）和 FMI 升高 0.48kg/m（0.31，0.66）有关。类似地，较弱地，也检测到血清 C 反应蛋白升高的相关性。疟疾快速检测阳性与身高降低 0.64cm（0.25，1.02）有关，但 FMI 增加 0.36kg/m（0.18，0.54）。贫血（根据血红蛋白）与身高成比例地减少 0.20kg（0.07，0.33）的 FFM 有关。母乳喂养时间较长与每月 FFM 增加 0.03kg（0.02，0.04）有关，与身高增长成比例。
与英国参考值相比，这些儿童的 FM 和 FFM 与他们的身材矮小成比例地存在缺陷。全身炎症与线性生长和 FFM 呈负相关，但与肥胖呈正相关，这使其成为一个可能的干预靶点，因为需要增加无脂肪组织的积累。较长的母乳喂养可能对瘦的线性生长有保护作用，但对微量营养素的研究结果不太明确。需要进行纵向研究来支持这些发现。该研究在 www.isrctn.com 上注册（参考号 ISRCTN83606062）。
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