Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda
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Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda. / Lanyero, Betty; Grenov, Benedikte; Barungi, Nicolette Nabukeera; Namusoke, Hanifa; Michaelsen, Kim F.; Mupere, Ezekiel; Mølgaard, Christian; Jiang, Pingping; Frøkiær, Hanne; Wiese, Maria; Muhammed, Musemma Kedir; Pesu, Hannah; Nielsen, Dennis Sandris; Friis, Henrik; Rytter, Maren Johanne Heilskov; Christensen, Vibeke Brix.
In: Journal of Pediatric Gastroenterology and Nutrition, Vol. 69, No. 3, 2019, p. 292-298.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda
AU - Lanyero, Betty
AU - Grenov, Benedikte
AU - Barungi, Nicolette Nabukeera
AU - Namusoke, Hanifa
AU - Michaelsen, Kim F.
AU - Mupere, Ezekiel
AU - Mølgaard, Christian
AU - Jiang, Pingping
AU - Frøkiær, Hanne
AU - Wiese, Maria
AU - Muhammed, Musemma Kedir
AU - Pesu, Hannah
AU - Nielsen, Dennis Sandris
AU - Friis, Henrik
AU - Rytter, Maren Johanne Heilskov
AU - Christensen, Vibeke Brix
N1 - CURIS 2019 NEXS 277
PY - 2019
Y1 - 2019
N2 - Objective: Children with severe acute malnutrition (SAM) may have impaired intestinal function which can result in malabsorption, diarrhoea and poor growth. This study evaluated the gut function of children with SAM using fecal and blood biomarkers and assessed their correlates.Methods: A cross-sectional study, nested in a randomized trial (www.isrctn.com, ISRCTN 16454889), was conducted at Mulago hospital, Uganda among subgroups of 400 children with complicated SAM and 30 community controls. Gut function was evaluated by five biomarkers: plasma citrulline, fecal myeloperoxidase and fecal neopterin, bacterially derived 16S rRNA gene and internal transcribed Spacer region (ITS) specific for Candida spp. in blood.Results: Compared to controls, children with SAM had lower median plasma citrulline (5.14 vs. 27.4 μmol/l, P < 0.001), higher median fecal myeloperoxidase (18083 vs 7482 ng/ml, P = 0.001) and fecal neopterin (541 vs 210 nmol/l, P < 0.001). A higher blood concentration of 16S rRNA gene copy numbers was observed among children with SAM (95 vs 28 copies/μl, P = 0.05), while there was no difference in the blood concentration of Candida-specific ITS fragment. Among those with SAM, plasma citrulline was lower in children with oedema, diarrhoea, dermatosis, and plasma C-reactive protein (CRP) >10 mg/l. Fecal neopterin was positively correlated with symptoms of fever and cough whereas it was negatively correlated with mid-upper arm circumference (MUAC), weight-for-height (WHZ), oedema, and dermatosis Conclusion: Children with complicated SAM seem to have impaired gut function characterized by reduced enterocyte mass, intestinal inflammation, and increased bacterial translocation.
AB - Objective: Children with severe acute malnutrition (SAM) may have impaired intestinal function which can result in malabsorption, diarrhoea and poor growth. This study evaluated the gut function of children with SAM using fecal and blood biomarkers and assessed their correlates.Methods: A cross-sectional study, nested in a randomized trial (www.isrctn.com, ISRCTN 16454889), was conducted at Mulago hospital, Uganda among subgroups of 400 children with complicated SAM and 30 community controls. Gut function was evaluated by five biomarkers: plasma citrulline, fecal myeloperoxidase and fecal neopterin, bacterially derived 16S rRNA gene and internal transcribed Spacer region (ITS) specific for Candida spp. in blood.Results: Compared to controls, children with SAM had lower median plasma citrulline (5.14 vs. 27.4 μmol/l, P < 0.001), higher median fecal myeloperoxidase (18083 vs 7482 ng/ml, P = 0.001) and fecal neopterin (541 vs 210 nmol/l, P < 0.001). A higher blood concentration of 16S rRNA gene copy numbers was observed among children with SAM (95 vs 28 copies/μl, P = 0.05), while there was no difference in the blood concentration of Candida-specific ITS fragment. Among those with SAM, plasma citrulline was lower in children with oedema, diarrhoea, dermatosis, and plasma C-reactive protein (CRP) >10 mg/l. Fecal neopterin was positively correlated with symptoms of fever and cough whereas it was negatively correlated with mid-upper arm circumference (MUAC), weight-for-height (WHZ), oedema, and dermatosis Conclusion: Children with complicated SAM seem to have impaired gut function characterized by reduced enterocyte mass, intestinal inflammation, and increased bacterial translocation.
KW - Faculty of Science
KW - 16S rRNA gene
KW - Citrulline
KW - ITS fragment
KW - Myeloperoxidase
KW - Neopterin
U2 - 10.1097/MPG.0000000000002381
DO - 10.1097/MPG.0000000000002381
M3 - Journal article
C2 - 31169661
VL - 69
SP - 292
EP - 298
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
SN - 0277-2116
IS - 3
ER -
ID: 222093390