背景:以前,与标准RUTF(s-RUTF)相比,新型燕麦即食治疗性食品(o-RUTF)可改善严重急性营养不良(SAM)的恢复情况.o-RUTF含有18%的燕麦,而s-RUTF没有谷物成分。
目的:我们确定了o-RUTF对肠道通透性的影响,通过乳果糖渗透率测量,和SAM患儿的16S核糖体RNA(rRNA)粪便微生物组构型。
方法:这是一个前瞻性的,随机化,双盲,对照临床试验。6-59个月的塞拉利昂儿童与SAM,由一个midupper臂周长<11.5厘米,随机接受o-RUTF或s-RUTF。所有儿童根据指南接受7d阿莫西林治疗。在基线和治疗4周后进行乳果糖通透性测试和粪便16SrRNA测序。乳果糖渗透性的变化是主要结果,而4周时的粪便16SrRNA构型是次要结局。
结果:在129名儿童中,乳果糖渗透率测试在基线时完成100,在第4周完成82。经过4周的治疗性喂养,o-RUTF组和s-RUTF组之间乳果糖渗透率无差异(P=0.84),超过一半的儿童乳果糖渗透性增加(50%s-RUTF与58%o-RUTF相比,平均差=-7.5%;95%CI:-29.2,15.2;P=0.50)。喂食4周后,o-RUTF和s-RUTF组之间的16SrRNA构型没有差异(Permanova,999个排列;P=0.648;伪F=0.581),α或β多样性也没有差异。
结论:尽管o-RUTF和s-RUTF的组成明显不同,在接受这些食物的SAM患儿中,乳果糖通透性或粪便16SrRNA构型没有发现差异.这些结果表明,o-RUTF通过除了降低肠渗透性或改变粪便16S构型之外的机制发挥其有益作用。该试验在clinicaltrials.gov注册为NCT04334538。
Previously, a novel oat ready-to-use therapeutic food (o-RUTF) resulted in improved recovery from severe acute malnutrition (SAM) when compared to a standard RUTF (s-RUTF). The o-RUTF contained 18% oat, while the s-RUTF has no cereal ingredients.
We determined the effects of o-RUTF on intestinal permeability, as measured by lactulose permeability, and the 16S ribosomal RNA (rRNA) fecal microbiome configuration of children with SAM.
This was a prospective, randomized, double-blinded, controlled clinical trial. Sierra Leonean children aged 6-59 mo with SAM, defined by a midupper arm circumference < 11.5 cm, were randomized to receive o-RUTF or s-RUTF. All children received 7 d of amoxicillin per guidelines. Lactulose permeability testing and fecal 16S rRNA sequencing were performed at baseline and after 4 wk of therapy. The change in lactulose permeability was the primary outcome, while the fecal 16S rRNA configuration at 4 wk was a secondary outcome.
Of the 129 children enrolled, lactulose permeability testing was completed by 100 at baseline and 82 at week 4. After 4 wk of therapeutic feeding, there were no differences in lactulose permeability between the o-RUTF and s-RUTF groups (P = 0.84), and over half of children had increased lactulose permeability (50% s-RUTF compared with 58% o-RUTF, mean difference = -7.5%; 95% CI: -29.2, 15.2; P = 0.50). After 4 wk of feeding, there were no differences in the 16S rRNA configurations between the o-RUTF and s-RUTF groups (Permanova, 999 permutations; P = 0.648; pseudo-F = 0.581), nor were there differences in α or β diversity.
Despite remarkably different compositions of o-RUTF and s-RUTF, no differences were identified in lactulose permeability or the fecal 16S rRNA configuration among children with SAM receiving these foods. These results suggest that the o-RUTF exerts its beneficial effects through mechanisms other than reducing intestinal permeability or altering the fecal 16S configuration. This trial was registered at clinicaltrials.gov as NCT04334538.