Child Nutrition, Systemic Inflammation, and Cognitive Development in South Africa

项目摘要 低收入和中等收入国家(LMIC)数以百万计的儿童努力达到他们的发展阶段 潜力。早期生活暴露在高度贫困环境中很常见，包括营养不良和慢性 感染，会导致认知缺陷，这种缺陷会持续到成年。生物途径 营养、炎症和认知发展之间的关系是复杂的，而不是 完全理解，部分原因是在营养不良最严重的地方--LMICs存在测量挑战。 确定这些途径的特征对于设计早期干预措施以促进全球儿童 健康和认知发展。 这项研究将结合南非正在进行的前瞻性队列研究中的一个新数据集 收集新数据以检查全身性炎症与营养不良和认知的关系 发展。将采集全血样本以评估全身炎症的生物标记物 已经为家长研究计划了实验室访问。这项研究有两个目的：1)考察 24个月龄全身炎症的生物标志物(IL-1β、IL-6和C反应蛋白) 营养不良，包括低出生体重和在7个月、15个月和24个月时反复测量发育迟缓 以及2)检查全身炎症的生物标志物与两个月龄婴儿之间的关系 24个月时认知发育的客观测量--脑电伽马功率和眼跳反应时间 年纪大了。 这项研究意义重大，因为我们的结果将加强对影响 像南非这样的低收入国家的认知发展。越来越多的证据表明，消极的 早期逆境的影响可以通过适当的早期生活干预来减轻。但是， 我们目前对LMIC认知发展缺陷的根本原因的理解是一个障碍 制定更有效的干预措施。这项研究产生的新证据将为未来的设计提供参考 更有效的干预措施。

Project Summary Millions of children in low- and middle-income countries (LMICs) struggle to reach their developmental potential. Early life exposures that are common in high-poverty settings, including undernutrition and chronic infection, contribute to cognitive deficits that have persistent effects into adulthood. The biological pathways that underlie the relationships between nutrition, inflammation, and cognitive development are complex and not entirely understood, in part due to measurement challenges in LMICs, where most undernutrition occurs. Characterizing these pathways is critical to inform the design of early interventions to promote global child health and cognitive development. This study will combine a novel dataset from an ongoing prospective cohort study in South Africa with collection of new data to examine the relationship of systemic inflammation with undernutrition and cognitive development. Whole blood samples to assess biomarkers of systemic inflammation will be collected during a lab visit already planned for the parent study. The study has two aims: 1) to examine the association of biomarkers of systemic inflammation (IL-1β, IL-6, and C-reactive protein) at 24 months of age with indicators of undernutrition, including low birthweight and repeated measures of stunting at 7 months, 15 months, and 24 months of age; and 2) to examine the relationship between biomarkers of systemic inflammation and two objective measures of cognitive development—EEG gamma power and saccadic reaction time—at 24 months of age. This study is significant because our results will strengthen understanding of the biological pathways affecting cognitive development in LMICs like South Africa. A growing body of evidence suggests that the negative impact of early adversity can be mitigated through appropriate early-life interventions. However, limitations in our current understanding of the root causes of deficits in cognitive development in LMICs are a barrier to developing more effective interventions. The new evidence this study generates will inform the future design of more effective interventions.