环境肠道功能障碍标志物与赞比亚卢萨卡幼儿生长发育不良结局相关。

Markers of Environmental Enteric Dysfunction are Associated with Poor Growth and Developmental Outcomes among Young Children in Lusaka, Zambia.

作者信息

Lauer Jacqueline M, Pyykkö Juha, Chembe Mpela, Billima-Mulenga Tamara, Sikazwe Dorothy, Chibwe Bertha, Henderson Savanna, Parkerson Doug, Leppänen Jukka M, Fink Günther, Locks Lindsey M, Rockers Peter C

机构信息

Department of Health Sciences, Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, MA.

Department of Global Health, Boston University School of Public Health, Boston, MA.

出版信息

J Pediatr. 2025 Feb;277:114408. doi: 10.1016/j.jpeds.2024.114408. Epub 2024 Nov 17.

DOI:10.1016/j.jpeds.2024.114408

PMID:39551093

Abstract

OBJECTIVE

To examine cross-sectional relationships between biomarkers of environmental enteric dysfunction (EED), an acquired subclinical condition of the small intestine, and anthropometric and developmental outcomes among children in Lusaka, Zambia.

STUDY DESIGN

Serum samples were collected from 240 children aged 27 to 35 months enrolled in a cluster-randomized trial assessing the effects of growth charts and small-quantity lipid-based nutrient supplements on linear growth. Samples were analyzed using the 11-plex Micronutrient and EED Assessment Tool, which incorporates 2 biomarkers of EED, namely intestinal fatty acid-binding protein (I-FABP), a marker of epithelial damage, and soluble CD14 (sCD14), a marker of microbial translocation. Associations between log-transformed biomarker concentrations and anthropometric (height-for-age z-score [HAZ], weight-for-height z-score, and weight-for-age z-score) and developmental (Global Scales of Early Development development for age z-score and saccadic reaction time [SRT]) outcomes were assessed using linear regression analyses adjusted for background characteristics.

RESULTS

Mean ± SD HAZ was -1.94 ± 1.10. Higher sCD14 and I-FABP concentrations were significantly associated with lower HAZ (β: -0.21, 95% CI: -0.41, -0.01 and β: -0.20, 95% CI: -0.32, -0.08, respectively). Higher I-FABP concentrations were significantly associated with lower development-for-age z-score (β: -0.22, 95% CI: -0.40, -0.03) and slower SRT (β: 7.37 ms, 95% CI: 2.02, 12.72) as were higher alpha-1-acid glycoprotein concentrations (HAZ β: -0.38, 95% CI: -0.72, -0.03; SRT β: 11.14 ms, 95% CI: 0.94, 21.72).

CONCLUSIONS

In children in Lusaka, biomarkers of EED were associated with poor anthropometric and developmental outcomes, underscoring the need for interventions to address EED to improve child health globally.

CLINICAL TRIAL REGISTRY

ClinicalTrials.gov identifier for parent trial: NCT05120427. https://clinicaltrials.gov/ct2/show/NCT05120427.

摘要

目的

研究环境肠道功能障碍（EED）的生物标志物（一种后天性小肠亚临床病症）与赞比亚卢萨卡儿童的人体测量及发育结果之间的横断面关系。

研究设计

从240名年龄在27至35个月的儿童中收集血清样本，这些儿童参与了一项整群随机试验，该试验评估生长图表和小剂量脂质营养补充剂对线性生长的影响。样本使用11重微量营养素和EED评估工具进行分析，该工具纳入了2种EED生物标志物，即上皮损伤标志物肠脂肪酸结合蛋白（I-FABP）和微生物易位标志物可溶性CD14（sCD14）。使用针对背景特征进行调整的线性回归分析，评估对数转换后的生物标志物浓度与人体测量指标（年龄别身高Z评分[HAZ]、身高别体重Z评分和年龄别体重Z评分）以及发育指标（年龄别早期发育总体量表发育Z评分和扫视反应时间[SRT]）之间的关联。

结果

平均±标准差HAZ为-1.94±1.10。较高的sCD14和I-FABP浓度与较低的HAZ显著相关（β分别为-0.21，95%置信区间：-0.41，-0.01和β为-0.20，95%置信区间：-0.32，-0.08）。较高的I-FABP浓度与较低的年龄别发育Z评分（β为-0.22，95%置信区间：-0.40，-0.03）和较慢的SRT（β为7.37毫秒，95%置信区间：2.02，12.72）显著相关，较高的α1-酸性糖蛋白浓度也有类似情况（HAZβ为-0.38，95%置信区间：-0.72，-0.03；SRTβ为11.14毫秒，95%置信区间：0.94，21.72）。