背景:发育迟缓的儿童身体成分(BC)的发育可能会受到干扰。这种破坏可能会影响后期过度肥胖和代谢健康的风险。然而,很少有研究调查与发育迟缓儿童BC的相关性。
目的:我们旨在调查营养状况,感染和炎症,母乳喂养行为和其他因素与发育迟缓儿童BC的相关性。
方法:在身高年龄z得分<-2的乌干达儿童中,使用生物电阻抗分析估算BC,并与英国参考文献进行比较。我们使用多元线性回归分析来确定脂肪量(FM)的相关性,无脂质量(FFM),FM指数(FMI),以及FFM指数(FFMI)和高度,调整性别和年龄。
结果:在750名1-5岁的儿童中,FMI为0.46[95CI:0.38,0.54],FFMI为0.18[95CI:0.1,0.26],z评分低于英国参考文献。血清α1-酸性糖蛋白升高与身高降低1.14[0.76,1.52]cm相关,减少0.50[0.35,0.65]kg/m2FFMI,和0.48[0.31,0.66]kg/m2以上的FMI。类似,较弱,检测到血清C反应蛋白升高的相关性.疟疾快速检测阳性与身高0.64[0.25,1.02]厘米相关,但FMI更大0.36[0.18,0.54]kg/m2。贫血(根据血红蛋白)与FFM减少0.20[0.07,0.33]kg和较短的身高成比例相关。较长的母乳喂养时间与每月增加0.03[0.02,0.04]kg的FFM相关,与更高的高度成比例。
结论:这些儿童在FM和FFM中表现出缺陷,与他们发育不良的身高成比例,与英国参考相比。系统性炎症与线性生长和无脂肪成反比,但与肥胖呈正相关,使其成为需要无脂肪组织积聚的干预的可能目标。更长的母乳喂养可能为瘦线性生长提供保护,但微量营养素的发现尚不清楚。纵向研究有必要支持这些发现。该研究已在www上注册。isrctn.com(参考ISRCTN13093195)。
BACKGROUND: Development of body composition (BC) may be disrupted in children with stunting. Such disruption may affect the later risk of excess adiposity and metabolic health, yet few studies have investigated correlates of BC in children with stunting.
OBJECTIVE: We aimed to investigate nutritional status, infection and inflammation, breastfeeding behaviors, and other factors as correlates of BC in children with stunting.
METHODS: Among Ugandan children with a height-for-age z-score <-2, BC was estimated using bioelectrical impedance analysis and compared with United Kingdom references. We used multiple linear regression analysis to identify correlates of fat mass (FM), fat-free mass (FFM), FM-index (FMI), and FFM index (FFMI) and height, adjusting for gender and age.
RESULTS: In 750 children aged 1-5 y, FMI was 0.46 (95% confidence interval [CI]: 0.38, 0.54] and FFMI 0.18 [95% CI: 0.11, 0.26) z-scores lower than United Kingdom references. Elevated serum α1-acid glycoprotein was associated with 1.14 [0.76, 1.52] cm lower height, 0.50 [0.35, 0.65] kg/m2 less FFMI, and 0.48 [0.31, 0.66] kg/m2 greater FMI. Similar, weaker, associations for elevated serum C-reactive protein were detected. A positive malaria rapid test was associated with 0.64 [0.25, 1.02] cm shorter height, but 0.36 [0.18, 0.54] kg/m2 greater FMI. Anemia (according to hemoglobin) was associated with 0.20 [0.07, 0.33] kg less FFM in proportion to shorter height. Longer breastfeeding duration was associated with 0.03 [0.02, 0.04] kg greater FFM per month, in proportion to greater height.
CONCLUSIONS: These children exhibited deficits in FM and FFM, proportionally to their stunted height, compared with United Kingdom references. Systemic inflammation correlated inversely with linear growth and FFM but positively with fatness, making it a possible target for intervention where fat-free tissue accretion is desirable. Longer breastfeeding may offer protection to lean linear growth, but findings for micronutrients were less clear. Longitudinal studies are warranted to support these findings. The study was registered at www.isrctn.com (Ref. ISRCTN13093195).