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Correlates of Gut Function in Children Hospitalized for Severe Acute Malnutrition, a Cross-sectional Study in Uganda

Betty Lanyero1,2, Benedikte Grenov1, Nicolette N Barungi1,3

  • 1Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg C, Denmark.

Journal of Pediatric Gastroenterology and Nutrition
|June 7, 2019
PubMed

Insights

Children with severe acute malnutrition (SAM) exhibit impaired gut function, indicated by reduced enterocyte mass and increased inflammation. Biomarkers reveal significant differences in gut health compared to controls, highlighting the need for targeted interventions.

Area of Science:

  • Pediatric Gastroenterology
  • Nutritional Immunology
  • Microbiome Research

Background:

  • Severe acute malnutrition (SAM) in children is linked to intestinal dysfunction, leading to malabsorption, diarrhea, and poor growth.
  • Understanding gut function in SAM is crucial for developing effective treatments and improving child health outcomes.

Purpose of the Study:

  • To evaluate the gut function of children with SAM using fecal and blood biomarkers.
  • To identify correlates of impaired gut function in children with SAM.

Main Methods:

  • A cross-sectional study involving 400 children with complicated SAM and 30 community controls in Uganda.
  • Gut function assessed via plasma citrulline, fecal myeloperoxidase, fecal neopterin, 16S rRNA gene, and Candida-specific ITS fragment in blood.

Main Results:

  • Children with SAM showed lower plasma citrulline, higher fecal myeloperoxidase and neopterin, and increased 16S rRNA gene copies compared to controls.
  • Plasma citrulline was lower in SAM children with edema, diarrhea, dermatosis, and elevated C-reactive protein (CRP).
  • Fecal neopterin correlated positively with fever/cough and negatively with MUAC, WHZ, edema, and dermatosis.

Conclusions:

  • Children with complicated SAM demonstrate impaired gut function, characterized by reduced enterocyte mass.
  • Evidence suggests significant intestinal inflammation and increased bacterial translocation in SAM children.
  • Biomarker profiles offer insights into the pathophysiology of gut dysfunction in severe acute malnutrition.
Abstract

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