Prebiotic galacto-oligosaccharides mitigate the adverse effects of iron fortification on the gut microbiome: a randomised controlled study in Kenyan infants
Prebiotic galacto-oligosaccharides mitigate the adverse effects of iron fortification on the gut microbiome: a randomised controlled study in Kenyan infants
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DOI：
10.1136/gutjnl-2017-314418
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发表时间：
2017-11-01
期刊：
影响因子：
24.5
通讯作者：
Zimmermann, Michael B.
中科院分区：
文献类型：
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作者：
Paganini, Daniela;Uyoga, Mary A.;Zimmermann, Michael B.
目的含铁微量营养素粉(MNPs)可减少非洲婴儿的贫血，但目前的高铁剂量(12.5 mg/d)可能会减少肠道双歧杆菌科和乳杆菌科细菌的数量，增加肠道病原体、腹泻和呼吸道感染(RTI)的发生率。我们评估了一种新的含有益生素低聚半乳糖(GOS)和低剂量(5 mg/d)高生物可利用铁的MNP配方的有效性和安全性。设计在一项为期4个月的对照双盲试验中，我们随机选择了年龄在6.5-9.5个月的肯尼亚婴儿(n=155)，每天服用(1)不含铁的MNP(对照组)；(2)相同的MNP加5 mg铁(2.5 mg为乙二胺四乙酸铁钠，2.5 mg为富马酸亚铁)(Fe组)；结果FeGOS组和FeGOS组的贫血发生率约为50%(P<0.001)。与对照组或FeGOS组相比，FeGOS组大鼠肠道双歧杆菌和乳杆菌数量减少，梭状杆菌数量增加(p<；0.01)；致病菌毒力和毒素基因(VTGs)含量增加(p<；0.01)；血浆肠道脂肪酸结合蛋白(肠道细胞损伤的生物标志物)升高(p<；0.05)；(4)治疗后RTIs发生率增加(p<；0.05)。与对照组和FeGOS组相比，除FeGOS组所有病原体的VTGs丰度显著低于对照组和铁组外，其他指标均无显著差异(p<；0.01)。结论低剂量高生物有效铁的MNP可减少贫血，GOS的加入减轻了铁对非洲婴儿肠道微生物群和发病率的大部分不利影响。
Objective Iron-containing micronutrient powders (MNPs) reduce anaemia in African infants, but the current high iron dose (12.5 mg/day) may decrease gut Bifidobacteriaceae and Lactobacillaceae, and increase enteropathogens, diarrhoea and respiratory tract infections (RTIs). We evaluated the efficacy and safety of a new MNP formula with prebiotic galacto-oligosaccharides (GOS) combined with a low dose (5 mg/day) of highly bioavailable iron.Design In a 4-month, controlled, double-blind trial, we randomised Kenyan infants aged 6.5-9.5 months (n = 155) to receive daily (1) a MNP without iron (control); (2) the identical MNP but with 5 mg iron (2.5 mg as sodium iron ethylenediaminetetraacetate and 2.5 mg as ferrous fumarate) (Fe group); or (3) the identical MNP as the Fe group but with 7.5 g GOS (FeGOS group).Results Anaemia decreased by approximate to 50% in the Fe and FeGOS groups (p < 0.001). Compared with the control or FeGOS group, in the Fe group there were (1) lower abundances of Bifidobacterium and Lactobacillus and higher abundances of Clostridiales (p < 0.01); (2) higher abundances of virulence and toxin genes (VTGs) of pathogens (p < 0.01); (3) higher plasma intestinal fatty acid-binding protein (a biomarker of enterocyte damage) (p < 0.05); and (4) a higher incidence of treated RTIs (p < 0.05). In contrast, there were no significant differences in these variables comparing the control and FeGOS groups, with the exception that the abundance of VTGs of all pathogens was significantly lower in the FeGOS group compared with the control and Fe groups (p < 0.01).Conclusion A MNP containing a low dose of highly bioavailable iron reduces anaemia, and the addition of GOS mitigates most of the adverse effects of iron on the gut microbiome and morbidity in African infants.