Department of International Health, Johns Hopkins Bloomberg School of Public Health; Baltimore, MD, USA.
Devil's Staircase Consulting, West Vancouver, BC, Canada.
EBioMedicine. 2024 Oct;108:105362. doi: 10.1016/j.ebiom.2024.105362. Epub 2024 Sep 27.
Small-quantity lipid-based nutrient supplements (SQ-LNS), which has been widely tested to reduce child stunting, has largely modest effects to date, but the mechanisms underlying these modest effects are unclear. Child stunting is a longstanding indicator of chronic undernutrition and it remains a prevalent public health problem. The infant gut microbiome may be a key contributor to stunting; and mother and infant fucosyltransferase (FUT) phenotypes are important determinants of infant microbiome composition.
We investigated whether mother-infant FUT status (n = 792) and infant gut microbiome composition (n = 354 fecal specimens from 172 infants) modified the impact of an infant and young child feeding (IYCF) intervention, that included SQ-LNS, on stunting at age 18 months in secondary analysis of a randomized trial in rural Zimbabwe.
We found that the impact of the IYCF intervention on stunting was modified by: (i) mother-infant FUT2+/FUT3- phenotype (difference-in-differences -32.6% [95% CI: -55.3%, -9.9%]); (ii) changes in species composition that reflected microbiome maturation (difference-in-differences -68.1% [95% CI: -99.0%, -28.5%); and (iii) greater relative abundance of B. longum (differences-in-differences 49.1% [95% CI: 26.6%, 73.6%]). The dominant strains of B. longum when the intervention started were most similar to the proficient milk oligosaccharide utilizer subspecies infantis, which decreased with infant age and differed by mother-infant FUT2+/FUT3- phenotypes.
These findings indicate that a persistently "younger" microbiome at initiation of the intervention reduced its benefits on stunting in areas with a high prevalence of growth restriction.
Bill and Melinda Gates Foundation, UK DFID/Aid, Wellcome Trust, Swiss Agency for Development and Cooperation, US National Institutes of Health, UNICEF, and Nutricia Research Foundation.
小剂量脂质营养素补充剂（SQ-LNS）已广泛用于减少儿童发育迟缓，但其效果迄今仅为适度，但适度效果的机制尚不清楚。儿童发育迟缓是长期慢性营养不良的一个指标，仍然是一个普遍存在的公共卫生问题。婴儿肠道微生物群可能是发育迟缓的关键贡献者；母亲和婴儿岩藻糖基转移酶（FUT）表型是婴儿微生物群组成的重要决定因素。
我们研究了母婴 FUT 状况（n=792）和婴儿肠道微生物群组成（n=172 名婴儿的 354 份粪便样本）是否改变了婴儿和幼儿喂养（IYCF）干预对 18 个月大儿童发育迟缓的影响，这是津巴布韦农村地区一项随机试验的二次分析。
我们发现 IYCF 干预对发育迟缓的影响受到以下因素的影响：（i）母婴 FUT2+/FUT3-表型（差异-差异-32.6%[95%CI：-55.3%，-9.9%]）；（ii）反映微生物群成熟的物种组成变化（差异-差异-68.1%[95%CI：-99.0%，-28.5%]）；（iii）B.longum 的相对丰度增加（差异-差异 49.1%[95%CI：26.6%，73.6%]）。干预开始时占主导地位的 B.longum 菌株与高效利用乳寡糖的婴儿亚种最相似，随着婴儿年龄的增长而减少，并因母婴 FUT2+/FUT3-表型而异。
这些发现表明，在干预开始时，持续存在的“更年轻”微生物群会降低其对高流行地区生长受限的益处。
比尔和梅林达·盖茨基金会、英国国际发展部/援助、惠康信托基金、瑞士发展合作署、美国国立卫生研究院、联合国儿童基金会和纽迪希亚研究基金会。
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