Post-malnutrition growth and its associations with child survival and non-communicable disease risk: a secondary analysis of the Malawi 'ChroSAM' cohort.
Post-malnutrition growth and its associations with child survival and non-communicable disease risk: a secondary analysis of the Malawi 'ChroSAM' cohort.
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麦芽营后的生长及其与儿童生存和非传染性疾病风险的关联：对马拉维“ Chrosam”同伙的次要分析。
DOI：
10.1017/s1368980023000411
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发表时间：
2023-08
影响因子：
3.2
通讯作者：
Kerac, Marko
中科院分区：
文献类型：
--
作者：
Lelijveld, Natasha;Cox, Sioned;Anujuo, Kenneth;Amoah, Abena S.;Opondo, Charles;Cole, Tim J.;Wells, Jonathan C. K.;Thompson, Debbie;McKenzie, Kimberley;Abera, Mubarek;Berhane, Melkamu;Kerac, Marko
关键词：
探讨严重营养不良治疗期间和治疗后的营养不良后生长（PMGr）模式，并描述其与治疗后7年生存率和非传染性疾病（NCD）风险的关系。基于各种时间点、体重、体重年龄z-score和身高年龄z-score (HAZ)，得出PMGr的6个指标。三种分类方法包括无分类、五分位数和潜在类分析（LCA）。分析了与死亡风险和7项非传染性疾病指标的关系。二手数据来自马拉维布兰太尔，2006年至2014年。研究对象为1024名在5-168个月大时因严重营养不良（体重/长度z-score < 70%中位值和/或MUAC（中上臂围）< 110 mm和/或双侧水肿）接受治疗的儿童。治疗期间（g/d）和治疗后（g/kg/天）体重增加较快与较低的死亡风险相关（调整后的OR分别为0.99、95% CI 0.99、1.00；调整后的OR分别为0.91、95% CI 0.87、0.94）。在幸存者（平均年龄9岁）中，它与更大的握力（0.02,95% CI 0.00, 0.03）和更大的HAZ （6.62, 95% CI 1.31, 11.9）相关，这两个指标都是更好的健康状况。然而，更快的体重增加也与腰臀比增加相关（0.02,95% CI 0.01, 0.03），这是晚年非传染性疾病风险的一个指标。当根据治疗期间以g/d为单位的体重增加来定义PMGr并使用LCA方法来描述生长模式时，可以看到最明显的关联模式。入院时体重不足是一个主要的混杂因素。利益和风险的复杂模式与更快的PMGr有关。最初的体重不足和体重增加的速度对未来的健康都有重要的影响。
To explore patterns of post-malnutrition growth (PMGr) during and after treatment for severe malnutrition and describe associations with survival and non-communicable disease (NCD) risk 7 years post-treatment. Six indicators of PMGr were derived based on a variety of timepoints, weight, weight-for-age z-score and height-for-age z-score (HAZ). Three categorisation methods included no categorisation, quintiles and latent class analysis (LCA). Associations with mortality risk and seven NCD indicators were analysed. Secondary data from Blantyre, Malawi between 2006 and 2014. A cohort of 1024 children treated for severe malnutrition (weight-for-length z-score < 70 % median and/or MUAC (mid-upper arm circumference) < 110 mm and/or bilateral oedema) at ages 5–168 months. Faster weight gain during treatment (g/d) and after treatment (g/kg/day) was associated with lower risk of death (adjusted OR 0·99, 95 % CI 0·99, 1·00; and adjusted OR 0·91, 95 % CI 0·87, 0·94, respectively). In survivors (mean age 9 years), it was associated with greater hand grip strength (0·02, 95 % CI 0·00, 0·03) and larger HAZ (6·62, 95 % CI 1·31, 11·9), both indicators of better health. However, faster weight gain was also associated with increased waist:hip ratio (0·02, 95 % CI 0·01, 0·03), an indicator of later-life NCD risk. The clearest patterns of association were seen when defining PMGr based on weight gain in g/d during treatment and using the LCA method to describe growth patterns. Weight deficit at admission was a major confounder. A complex pattern of benefits and risks is associated with faster PMGr. Both initial weight deficit and rate of weight gain have important implications for future health.
DOI：
10.1183/13993003.01301-2016
发表时间：
2017-04
期刊：
The European respiratory journal
影响因子：
--
作者：
Lelijveld N;Kerac M;Seal A;Chimwezi E;Wells JC;Heyderman RS;Nyirenda MJ;Stocks J;Kirkby J
通讯作者：
Kirkby J
影响因子：
2
作者：
Kamugisha JGK;Lanyero B;Nabukeera-Barungi N;Nambuya-Lakor H;Ritz C;Mølgaard C;Michaelsen KF;Briend A;Mupere E;Friis H;Grenov B
通讯作者：
Grenov B
影响因子：
8.1
作者：
Greiner R;Nyrienda M;Rodgers L;Asiki G;Banda L;Shields B;Hattersley A;Crampin A;Newton R;Jones A
通讯作者：
Jones A