Infant Nutritional Status and Markers of Environmental Enteric Dysfunction are Associated with Midchildhood Anthropometry and Blood Pressure in Tanzania.
Infant Nutritional Status and Markers of Environmental Enteric Dysfunction are Associated with Midchildhood Anthropometry and Blood Pressure in Tanzania.
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DOI：
10.1016/j.jpeds.2017.04.005
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发表时间：
2017-08
期刊：
影响因子：
--
通讯作者：
Duggan CP
中科院分区：
文献类型：
--
作者：
Locks LM;Mwiru RS;Mtisi E;Manji KP;McDonald CM;Liu E;Kupka R;Kisenge R;Aboud S;Gosselin K;Gillman M;Gewirtz AT;Fawzi WW;Duggan CP
评估坦桑尼亚婴儿期环境肠功能障碍的生长和生物标志物是否与儿童中期的健康结果相关。在婴儿期参加了两项微量营养素补充随机试验的儿童在儿童中期（4.6-9.8岁）进行了随访。两项试验均在6周龄和52周龄时测量了人体测量，并在1项试验中采集了6周龄和6个月龄儿童的血液样本。身高年龄z-score、体重年龄z-score、体重年龄z-score和血压分析均采用线性回归；使用对数二项模型来估计儿童中期超重、肥胖和发育迟缓的风险。对113名儿童进行了随访。6周长龄z分数和6 - 52周长龄z分数与身高龄z分数呈独立正相关，与儿童中期发育迟缓呈负相关。Delta体重-长度和体重-年龄z-score也与儿童中期身高-年龄z-score呈正相关。6周和delta体重-长度z分数与儿童中期体重指数-年龄z分数和超重独立且正相关，6周和delta体重-年龄z分数也是如此。Delta长度-年龄z-score也与儿童中期超重的风险增加有关。儿童中期年龄体重指数z-score与收缩压呈正相关。6周时血清抗鞭毛蛋白IgA浓度也与儿童中期血压升高有关。6周的人体测量和婴儿期的生长独立预测了儿童中期的体型，而婴儿早期的抗鞭毛蛋白IgA（一种环境肠功能障碍的生物标志物）与儿童中期的血压升高有关。生命早期的干预应侧重于优化线性生长，同时尽量减少体重增加和环境肠功能障碍。ClinicalTrials.gov: NCT00197730和NCT00421668。
To assess whether growth and biomarkers of environmental enteric dysfunction in infancy are related to health outcomes in midchildhood in Tanzania. Children who participated in 2 randomized trials of micronutrient supplements in infancy were followed up in midchildhood (4.6-9.8 years of age). Anthropometry was measured at age 6 and 52 weeks in both trials, and blood samples were available from children at 6 weeks and 6 months from 1 trial. Linear regression was used for height-for-age z-score, body mass index-for-age z-score, and weight for age z-score, and blood pressure analyses; log-binomial models were used to estimate risk of overweight, obesity, and stunting in midchildhood. One hundred thirteen children were followed-up. Length-for-age z-score at 6 weeks and delta length-for-age z-score from 6 to 52 weeks were associated independently and positively with height-for-age z-score and inversely associated with stunting in midchildhood. Delta weight-for-length and weight-for-age z-score were also positively associated with midchildhood height-for-age z-score. The 6-week and delta weight-for-length z-scores were associated independently and positively with midchildhood body mass index-for-age z-score and overweight, as was the 6-week and delta weight-for-age z-score. Delta length-for-age z-score was also associated with an increased risk of overweight in midchildhood. Body mass index-for-age z-score in midchildhood was associated positively with systolic blood pressure. Serum anti-flagellin IgA concentration at 6 weeks was also associated with increased blood pressure in midchildhood. Anthropometry at 6 weeks and growth in infancy independently predict size in midchildhood, while anti-flagellin IgA, a biomarker of environmental enteric dysfunction, in early infancy is associated with increased blood pressure in midchildhood. Interventions in early life should focus on optimizing linear growth while minimizing excess weight gain and environmental enteric dysfunction. ClinicalTrials.gov: NCT00197730 and NCT00421668.
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