Stunting is characterized by chronic inflammation in zimbabwean infants

AJ, Prendergast; S, Rukobo; B, Chasekwa; K, Mutasa; R, Ntozini; MN, Mbuya; A, Jones; LH, Moulton; RJ, Stoltzfus; JH, Humphrey
Background Stunting affects one-third of children in developing countries, but the causes remain unclear. We hypothesized that enteropathy leads to low-grade inflammation, which suppresses the growth hormone-IGF axis and mediates stunting. Methods We conducted a case-control study of 202 HIV-unexposed Zimbabwean infants who were stunted (height-for-age Z-score (HAZ) −0.5; controls) at 18 months. We measured biomarkers of intestinal damage (I-FABP), inflammation (CRP, AGP, IL-6) and growth hormone-IGF axis (IGF-1, IGFBP3) in infant plasma at 6 weeks and 3, 6, 12 and 18 months, and in paired maternal-infant plasma at birth. Adjusted mean differences between biomarkers were estimated using regression models. Multivariate odds ratios of stunting were estimated by logistic regression. Results At birth, cases were shorter (median (IQR) HAZ −1.00 (−1.53, −0.08) vs 0.03 (−0.57, 0.62,); P6 (95%CI 1.34, 6.99); P = 0.008) and AGP (aOR 7.87 (95%CI 0.74, 83.74); P = 0.087) during infancy were associated with stunting. There were no associations between levels of I-FABP, IL-6, sCD14 or EndoCAb and stunting. Conclusions Stunting began in utero and was associated with low maternal IGF-1 levels at birth. Inflammatory markers were higher in cases than controls from 6 weeks of age and were associated with lower levels of IGF-1 throughout infancy. Higher levels of CRP and AGP during infancy were associated with stunting. These findings suggest that an extensive enteropathy occurs during infancy and that low-grade chronic inflammation may impair infant growth.
Research areas:
Year:
2014
Type of Publication:
Article
Journal:
PloS One
Volume:
9
Number:
e86928
Month:
February
DOI:
10.1371/journal.pone.0086928
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The Zvitambo Institute for Maternal and Child Health Research is a multidisciplinary Zimbabwean organization that has developed and attracted expertise in various areas of biomedical and applied research and programming in the areas of maternal health, child health and growth, immunology, HIV/AIDS, nutrition, food security and livelihoods, WASH and counseling

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