Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda

Betty Lanyero; Benedikte Grenov; Nicolette Nabukeera Barungi; Hanifa Namusoke; Kim F. Michaelsen; Ezekiel Mupere; Christian Mølgaard; Pingping Jiang; Hanne Frøkiær; Maria Wiese; Musemma Kedir Muhammed; Hannah Pesu; Dennis Sandris Nielsen; Henrik Friis; Maren Johanne Heilskov Rytter; Vibeke Brix Christensen

doi:10.1097/MPG.0000000000002381

Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda

Betty Lanyero^*, Benedikte Grenov, Nicolette Nabukeera Barungi, Hanifa Namusoke, Kim F. Michaelsen, Ezekiel Mupere, Christian Mølgaard, Pingping Jiang, Hanne Frøkiær, Maria Wiese, Musemma Kedir Muhammed, Hannah Pesu, Dennis Sandris Nielsen, Henrik Friis, Maren Johanne Heilskov Rytter, Vibeke Brix Christensen

^*Corresponding author af dette arbejde

Abstract

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 5 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 with 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), whereas there was no difference in the blood concentration of Candida-specific ITS fragment.Among those with SAM, plasma citrulline was lower in children with edema, 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 z score (WHZ), edema, and dermatosis.Conclusions:Children with complicated SAM seem to have impaired gut function characterized by reduced enterocyte mass, intestinal inflammation, and increased bacterial translocation.

Originalsprog	Engelsk
Tidsskrift	Journal of Pediatric Gastroenterology and Nutrition
Vol/bind	69
Udgave nummer	3
Sider (fra-til)	292-298
Antal sider	6
ISSN	0277-2116
DOI	https://doi.org/10.1097/MPG.0000000000002381
Status	Udgivet - 1 sep. 2019

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Det Natur- og Biovidenskabelige Fakultet

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10.1097/MPG.0000000000002381

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Lanyero, B., Grenov, B., Barungi, N. N., Namusoke, H., Michaelsen, K. F., Mupere, E., Mølgaard, C., Jiang, P., Frøkiær, H., Wiese, M., Muhammed, M. K., Pesu, H., Nielsen, D. S., Friis, H., Rytter, M. J. H., & Christensen, V. B. (2019). Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda. Journal of Pediatric Gastroenterology and Nutrition, 69(3), 292-298. https://doi.org/10.1097/MPG.0000000000002381

Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda. / Lanyero, Betty; Grenov, Benedikte; Barungi, Nicolette Nabukeera et al.

I: Journal of Pediatric Gastroenterology and Nutrition, Bind 69, Nr. 3, 01.09.2019, s. 292-298.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Lanyero, B, Grenov, B, Barungi, NN, Namusoke, H, Michaelsen, KF, Mupere, E, Mølgaard, C , Jiang, P , Frøkiær, H, Wiese, M, Muhammed, MK , Pesu, H , Nielsen, DS , Friis, H , Rytter, MJH & Christensen, VB 2019, 'Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda', Journal of Pediatric Gastroenterology and Nutrition, bind 69, nr. 3, s. 292-298. https://doi.org/10.1097/MPG.0000000000002381

@article{9e13367c2fb84a0faafaaba75f1e457c,

title = "Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda",

abstract = "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 5 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 with 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), whereas there was no difference in the blood concentration of Candida-specific ITS fragment.Among those with SAM, plasma citrulline was lower in children with edema, 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 z score (WHZ), edema, and dermatosis.Conclusions:Children with complicated SAM seem to have impaired gut function characterized by reduced enterocyte mass, intestinal inflammation, and increased bacterial translocation.",

keywords = "Faculty of Science, 16S rRNA gene, Citrulline, ITS fragment, Myeloperoxidase, Neopterin",

author = "Betty Lanyero and Benedikte Grenov and Barungi, {Nicolette Nabukeera} and Hanifa Namusoke and Michaelsen, {Kim F.} and Ezekiel Mupere and Christian M{\o}lgaard and Pingping Jiang and Hanne Fr{\o}ki{\ae}r and Maria Wiese and Muhammed, {Musemma Kedir} and Hannah Pesu and Nielsen, {Dennis Sandris} and Henrik Friis and Rytter, {Maren Johanne Heilskov} and Christensen, {Vibeke Brix}",

note = "CURIS 2019 NEXS 277",

year = "2019",

month = sep,

day = "1",

doi = "10.1097/MPG.0000000000002381",

language = "English",

volume = "69",

pages = "292--298",

journal = "Journal of Pediatric Gastroenterology and Nutrition",

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publisher = "Lippincott Williams & Wilkins",

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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 - 2019/9/1

Y1 - 2019/9/1

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 5 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 with 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), whereas there was no difference in the blood concentration of Candida-specific ITS fragment.Among those with SAM, plasma citrulline was lower in children with edema, 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 z score (WHZ), edema, and dermatosis.Conclusions: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 5 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 with 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), whereas there was no difference in the blood concentration of Candida-specific ITS fragment.Among those with SAM, plasma citrulline was lower in children with edema, 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 z score (WHZ), edema, and dermatosis.Conclusions: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

SN - 0277-2116

VL - 69

SP - 292

EP - 298

JO - Journal of Pediatric Gastroenterology and Nutrition

JF - Journal of Pediatric Gastroenterology and Nutrition

IS - 3

ER -

Correlates of gut function in children hospitalized for severe acute malnutrition, a cross-sectional study in Uganda

Abstract

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