Hormonal Correlates and Predictors of Nutritional Recovery in Malnourished African Children
Helen M Nabwera1,2, Robin M Bernstein3, Schadrac C Agbla1,2
1MRC Unit The Gambia, Banjul, The Gambia.
Insights
Growth hormone levels vary in malnourished children undergoing nutritional rehabilitation. Baseline C-peptide levels predict weight gain in these children, aiding in personalized rehabilitation strategies.
Area of Science:
- Pediatric Nutrition
- Endocrinology
- Growth Monitoring
Background:
- Children exhibit varied growth responses to nutritional rehabilitation.
- Investigating hormonal factors influencing these growth differences is crucial.
Purpose of the Study:
- To explore the relationship between growth and energy-regulating hormones in malnourished children.
- To identify hormonal predictors of growth response to nutritional rehabilitation.
Main Methods:
- A quasi-experimental study involving 6-24 month old children in rural Gambia.
- Children were categorized into control, moderate acute malnutrition, and severe acute malnutrition groups based on weight-for-height z-score (WHZ).
- Plasma hormone and salivary C-reactive protein (CRP) levels were measured using ELISA.
Main Results:
- Increases in weight-for-age z-score (WAZ) were positively correlated with insulin, C-peptide, and cortisol in univariable analyses.
- Multivariable analysis revealed that baseline C-peptide was the sole significant predictor of WAZ changes over 28 days.
- Baseline C-peptide demonstrated a significant positive correlation with WAZ changes (F-ratio 7.6, p=0.009).
Conclusions:
- Baseline C-peptide levels are a significant predictor of nutritional rehabilitation response in Gambian children.
- While not solely diagnostic, C-peptide can inform individualized rehabilitation approaches.
- Hormonal profiling may enhance the effectiveness of interventions for childhood malnutrition.
Background:
Malnourished children show variable growth responses to nutritional rehabilitation. We aimed to investigate whether these differences could be explained by variations in growth and energy-regulating hormones.
Methods:
Quasi-experimental study: Children aged 6-24 months in rural Gambia were recruited to controls if weight-for-height z-score (WHZ) > -2 (n = 22), moderate acute malnutrition if WHZ < -2 and > -3 (n = 18) or severe acute malnutrition if WHZ < -3 (n = 20). Plasma hormone and salivary CRP levels were determined by ELISA.
Results:
In univariable analyses, increases in weight-for-age z-score (WAZ) in malnourished children were positively correlated with insulin (F-ratio 7.8, p = 0.006), C-peptide (F-ratio 12.2, p < 0.001) and cortisol (F-ratio 5.0, p = 0.03). In multivariable analysis, only baseline C-peptide (F-ratio 7.6, p = 0.009) predicted the changes in WAZ over 28 days of interventions.
Conclusion:
In rural Gambian, malnourished children, although it cannot be used in isolation, baseline C-peptide was a predictor of future response to rehabilitation.
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