Ulijaszek S J
Department of Nutrition, Curtin University School of Public Health, Perth WA, Australia.
Am J Phys Anthropol. 1998 Aug;106(4):515-20. doi: 10.1002/(SICI)1096-8644(199808)106:4<515::AID-AJPA6>3.0.CO;2-H.
Nutrition-infection interactions among poor children of the less-developed world influence growth and development. However, the relative importance of each is difficult to determine, because the relationship is mediated by immunological status. In this analysis, relationships between immunological measures and anthropometry were sought among 41 Anga, Papua New Guinea children aged 0-7 years. These had elevated serum total leucocyte and leucocyte subset counts relative to western reference values. Although there was no correlation between anthropometric nutritional status and total leucocytes and leucocyte subsets for this group, the small group (n=8) with very high total leucocyte count (greater than 15,000/mm2) had significantly lower mean Z score of stature for age (-3.78), and weight for stature (-1.35) than those with leucocyte counts lower than this cut-off (weight for stature Z score: -0.59; stature for age Z score: -2.68, respectively. Low stature-for-age Z score was associated with lower total lymphocyte count and increasing age, against a background of elevated lymphocyte levels relative to western reference values among the older children; low weight-for-stature Z score was associated with lower neutrophil count, against a background of normal neutrophil levels across all age groups. The pattern of weight and stature growth seen in the Anga may reflect extended nutritional deficits which result in stunting of a degree to which the most growth-compromised children die, leaving those above a threshold associated with high mortality alive. Thus, the anthropometric and immunological characteristics of the older children in this small sample may reflect the biology of survival under severe ecological conditions, where poor linear growth and elevated leucocyte status relative to normative values are characteristics of survivorship.
在欠发达世界的贫困儿童中，营养与感染之间的相互作用会影响生长发育。然而，由于这种关系是由免疫状态介导的，所以很难确定二者各自的相对重要性。在本次分析中，研究了41名年龄在0至7岁之间的巴布亚新几内亚安加儿童的免疫指标与人体测量学指标之间的关系。相对于西方参考值，这些儿童的血清总白细胞和白细胞亚群计数升高。虽然该组儿童的人体测量营养状况与总白细胞及白细胞亚群之间没有相关性，但总白细胞计数非常高（大于15,000/mm²）的小组（n = 8），其年龄别身高的平均Z评分（-3.78）和身高别体重的平均Z评分（-1.35）显著低于白细胞计数低于此临界值的儿童（身高别体重Z评分：-0.59；年龄别身高Z评分：-2.68）。在年龄较大儿童相对于西方参考值淋巴细胞水平升高的背景下，年龄别身高Z评分低与总淋巴细胞计数降低及年龄增长有关；身高别体重Z评分低与中性粒细胞计数降低有关，而所有年龄组的中性粒细胞水平均正常。安加儿童的体重和身高增长模式可能反映了长期的营养缺乏，这种缺乏导致了一定程度的发育迟缓，最严重的发育迟缓儿童死亡，而高于高死亡率阈值的儿童存活下来。因此，这个小样本中年龄较大儿童的人体测量学和免疫学特征可能反映了在恶劣生态条件下的生存生物学，在这种条件下，相对于标准值，线性生长不良和白细胞水平升高是生存的特征。
