Rikimaru T, Taniguchi K, Yartey J E, Kennedy D O, Nkrumah F K
Institute for International Cooperation, JICA, Tokyo, Japan.
Eur J Clin Nutr. 1998 May;52(5):344-50. doi: 10.1038/sj.ejcn.1600560.
To examine the relationship between immunological variables and the different types and severity of malnutrition in Ghanaian children.
Case-control study.
The study was done at Princess Marie Louise Hospital, Accra, Ghana.
One hundred and seventy children, aged 8-36 months, were recruited at the clinical ward and public health service section of the hospital: 61 normal children, 49 moderately malnourished (underweight) children and 60 severely malnourished children (19 kwashiorkor, 30 marasmus, and 11 marasmic kwashiorkor children).
The children underwent clinical observations, anthropometric measurements and blood sampling for biochemical analysis to evaluate their nutritional and immunological status. Serum immunoglobulins (IgA subclasses, IgG subclasses and IgM), complements (C3 and C4) and lymphocyte subpopulations (T cells, B cells, CD4+, CD8+, NK cells and HLADR) were determined for the assessment of humoral and cell-mediated immunity.
Serum levels of IgA1, IgA2 and C4 tended to be higher in severely malnourished children than in normal children, while serum level of C3 and the proportion of B cells were significantly lower in the severely malnourished children than in the normal children (P < 0.05). There were no notable differences in most immunological parameters among the three severely malnourished groups. No differences were observed in the immunological parameters except for the proportion of B cells between normal and moderately malnourished children. Factor analysis revealed that C3 levels were positively correlated with a factor which was strongly associated with weight-for-height z-score and biochemical indicators for evaluating protein nutrition. In addition, IgA2, IgG1 and IgM levels were positively correlated with a factor which was associated with C-reactive protein.
Several immunological variables responded positively or negatively with the different levels of severity of malnutrition, but most variables did not on the different types of malnutrition. The changes of C3 level were more associated with the severity of malnutrition.
研究加纳儿童免疫变量与不同类型及严重程度营养不良之间的关系。
病例对照研究。
研究在加纳阿克拉的玛丽·路易丝公主医院进行。
从医院临床病房和公共卫生服务部门招募了170名8至36个月大的儿童：61名正常儿童、49名中度营养不良（体重不足）儿童和60名重度营养不良儿童（19名夸希奥科病患儿、30名消瘦症患儿和11名消瘦型夸希奥科病患儿）。
对儿童进行临床观察、人体测量和血液采样以进行生化分析，评估其营养和免疫状况。测定血清免疫球蛋白（IgA亚类、IgG亚类和IgM）、补体（C3和C4）以及淋巴细胞亚群（T细胞、B细胞、CD4 +、CD8 +、NK细胞和HLADR），以评估体液免疫和细胞介导免疫。
重度营养不良儿童的血清IgA1、IgA2和C4水平往往高于正常儿童，而重度营养不良儿童的血清C3水平和B细胞比例显著低于正常儿童（P < 0.05）。三个重度营养不良组之间的大多数免疫参数无显著差异。正常儿童和中度营养不良儿童之间，除了B细胞比例外，免疫参数没有差异。因子分析显示，C3水平与一个与身高别体重Z评分和评估蛋白质营养的生化指标密切相关的因子呈正相关。此外，IgA2、IgG1和IgM水平与一个与C反应蛋白相关的因子呈正相关。
几个免疫变量对不同严重程度的营养不良有正向或负向反应，但大多数变量对不同类型的营养不良没有反应。C3水平的变化与营养不良的严重程度更相关。
