Biomarkers of environmental enteric dysfunction are not consistently associated with linear growth velocity in rural Zimbabwean infants
Biomarkers of environmental enteric dysfunction are not consistently associated with linear growth velocity in rural Zimbabwean infants
Background: child stunting remains a poorly understood, prevalent public health problem. Environmental enteric dysfunction (EED) is hypothesized to be an important underlying cause.
Objectives: within a subgroup of 1169 children enrolled in the SHINE (Sanitation Hygiene Infant Nutrition Efficacy) trial in rural Zimbabwe, followed longitudinally from birth to 18 mo of age, we evaluated associations between the concentration of 11 EED biomarkers and linear growth velocity.
Methods: at infant ages 1, 3, 6, 12, and 18 mo, nurses measured child length and collected stool and blood; the lactulose-mannitol urine test was also conducted at all visits except at 1 mo. Stool neopterin, α-1 antitrypsin, myeloperoxidase, and regenerating gene 1β protein; urinary lactulose and mannitol; and plasma kynurenine, tryptophan, C-reactive protein, insulin-like growth factor-1 (IGF-1), soluble CD14, intestinal fatty acid binding protein, and citrulline were measured. We analyzed the change in relative [∆ length-for-age z score (LAZ)/mo] and absolute (∆ length/mo) growth velocity during 4 age intervals (1-3 mo; 3-6 mo; 6-12 mo; and 12-18 mo) per SD increase in biomarker concentration at the start of each age interval.
Results: in fully adjusted models, we observed only 3 small, statistically significant associations: kynurenine:tryptophan ratio at 12 mo was associated with decreased mean LAZ velocity during the 12-18 mo interval (-0.015 LAZ/mo; 95% CI: -0.029, -0.001 LAZ/mo); mannitol excretion at 6 mo was associated with increased LAZ velocity during the 6-12 mo interval (0.013 LAZ/mo; 95% CI: 0.001, 0.025 LAZ/mo), and plasma IGF-1 at 1 mo was associated with increased LAZ velocity during the 1-3 mo interval (0.118 LAZ/mo; 95% CI: 0.024, 0.211 LAZ/mo). Results for absolute growth velocity were similar, except IGF-1 was also associated with growth during the 12-18 mo interval. We found no other associations between any EED biomarker and linear growth velocity.
Conclusions: none of 11 biomarkers of EED were consistently associated with linear growth among Zimbabwean children.This trial was registered at clinicaltrials.gov as NCT01824940.
Zimbabwe, biomarkers, child growth, environmental enteric dysfunction, stunting
1185-1198
Mutasa, Kuda
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Ntozini, Robert
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Mbuya, Mduduzi N N
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Rukobo, Sandra
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Govha, Margaret
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Majo, Florence D
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Tavengwa, Naume
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Smith, Laura E
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Caulfield, Laura
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Swann, Jonathan R
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Stoltzfus, Rebecca J
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Moulton, Lawrence H
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Humphrey, Jean H
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Gough, Ethan K
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Prendergast, Andrew J
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8 May 2021
Mutasa, Kuda
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Ntozini, Robert
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Mbuya, Mduduzi N N
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Rukobo, Sandra
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Govha, Margaret
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Majo, Florence D
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Tavengwa, Naume
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Smith, Laura E
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Caulfield, Laura
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Swann, Jonathan R
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Stoltzfus, Rebecca J
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Moulton, Lawrence H
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Humphrey, Jean H
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Gough, Ethan K
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Prendergast, Andrew J
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Mutasa, Kuda, Ntozini, Robert, Mbuya, Mduduzi N N, Rukobo, Sandra, Govha, Margaret, Majo, Florence D, Tavengwa, Naume, Smith, Laura E, Caulfield, Laura, Swann, Jonathan R, Stoltzfus, Rebecca J, Moulton, Lawrence H, Humphrey, Jean H, Gough, Ethan K and Prendergast, Andrew J
(2021)
Biomarkers of environmental enteric dysfunction are not consistently associated with linear growth velocity in rural Zimbabwean infants.
The American Journal of Clinical Nutrition, 113 (5), .
(doi:10.1093/ajcn/nqaa416).
Abstract
Background: child stunting remains a poorly understood, prevalent public health problem. Environmental enteric dysfunction (EED) is hypothesized to be an important underlying cause.
Objectives: within a subgroup of 1169 children enrolled in the SHINE (Sanitation Hygiene Infant Nutrition Efficacy) trial in rural Zimbabwe, followed longitudinally from birth to 18 mo of age, we evaluated associations between the concentration of 11 EED biomarkers and linear growth velocity.
Methods: at infant ages 1, 3, 6, 12, and 18 mo, nurses measured child length and collected stool and blood; the lactulose-mannitol urine test was also conducted at all visits except at 1 mo. Stool neopterin, α-1 antitrypsin, myeloperoxidase, and regenerating gene 1β protein; urinary lactulose and mannitol; and plasma kynurenine, tryptophan, C-reactive protein, insulin-like growth factor-1 (IGF-1), soluble CD14, intestinal fatty acid binding protein, and citrulline were measured. We analyzed the change in relative [∆ length-for-age z score (LAZ)/mo] and absolute (∆ length/mo) growth velocity during 4 age intervals (1-3 mo; 3-6 mo; 6-12 mo; and 12-18 mo) per SD increase in biomarker concentration at the start of each age interval.
Results: in fully adjusted models, we observed only 3 small, statistically significant associations: kynurenine:tryptophan ratio at 12 mo was associated with decreased mean LAZ velocity during the 12-18 mo interval (-0.015 LAZ/mo; 95% CI: -0.029, -0.001 LAZ/mo); mannitol excretion at 6 mo was associated with increased LAZ velocity during the 6-12 mo interval (0.013 LAZ/mo; 95% CI: 0.001, 0.025 LAZ/mo), and plasma IGF-1 at 1 mo was associated with increased LAZ velocity during the 1-3 mo interval (0.118 LAZ/mo; 95% CI: 0.024, 0.211 LAZ/mo). Results for absolute growth velocity were similar, except IGF-1 was also associated with growth during the 12-18 mo interval. We found no other associations between any EED biomarker and linear growth velocity.
Conclusions: none of 11 biomarkers of EED were consistently associated with linear growth among Zimbabwean children.This trial was registered at clinicaltrials.gov as NCT01824940.
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Biomarkers of environmental enteric dysfunction
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e-pub ahead of print date: 19 March 2021
Published date: 8 May 2021
Keywords:
Zimbabwe, biomarkers, child growth, environmental enteric dysfunction, stunting
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Local EPrints ID: 448329
URI: http://eprints.soton.ac.uk/id/eprint/448329
ISSN: 0002-9165
PURE UUID: a37067a0-9e61-4a4e-b190-b91bbadfd8c5
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Date deposited: 20 Apr 2021 16:33
Last modified: 12 Jul 2024 02:06
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Contributors
Author:
Kuda Mutasa
Author:
Robert Ntozini
Author:
Mduduzi N N Mbuya
Author:
Sandra Rukobo
Author:
Margaret Govha
Author:
Florence D Majo
Author:
Naume Tavengwa
Author:
Laura E Smith
Author:
Laura Caulfield
Author:
Rebecca J Stoltzfus
Author:
Lawrence H Moulton
Author:
Jean H Humphrey
Author:
Ethan K Gough
Author:
Andrew J Prendergast
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