Abstract
ABSTRACTBackgroundMalnourished children show variable growth responses to nutritional rehabilitation. We aimed to investigate whether these differences could be explained by variations in growth and energy-regulating hormones.MethodsQuasi-experimental study: Children aged 6–24 months in rural Gambia were recruited to controls if weight-for-height z-score (WHZ) > −2 (n = 22), moderate acute malnutrition if WHZ < −2 and > −3 (n = 18) or severe acute malnutrition if WHZ < −3 (n = 20). Plasma hormone and salivary CRP levels were determined by ELISA.ResultsIn univariable analyses, increases in weight-for-age z-score (WAZ) in malnourished children were positively correlated with insulin (F-ratio 7.8, p = 0.006), C-peptide (F-ratio 12.2, p < 0.001) and cortisol (F-ratio 5.0, p = 0.03). In multivariable analysis, only baseline C-peptide (F-ratio 7.6, p = 0.009) predicted the changes in WAZ over 28 days of interventions.ConclusionIn rural Gambian, malnourished children, although it cannot be used in isolation, baseline C-peptide was a predictor of future response to rehabilitation.
Highlights
Malnourished children show variable growth responses to nutritional rehabilitation
This variability in weight-for-age z-score (WAZ) recovery was not predicted by baseline age, anthropometry, breastfeeding status, salivary C-reactive protein (CRP), amount consumed at the test meal, presence of diarrhoea or a urinary tract infection
From Days 0 to 14, significant increases in the geometric mean ratios in both moderate acute malnutrition (MAM) and severe acute malnutrition (SAM) were found for the following: total leptin [1.6, p 1⁄4 0.002 and 1.8, p < 0.001]; Insulin-like growth factor 1 (IGF-1) [1.6, p < 0.001 and 2.1, p < 0.001]; IGF-binding protein 3 (IGFBP3) [1.3, p 1⁄4 0.002 and 1.7, p < 0.001], respectively
Summary
Malnourished children show variable growth responses to nutritional rehabilitation. Results: In univariable analyses, increases in weight-for-age z-score (WAZ) in malnourished children were positively correlated with insulin (F-ratio 7.8, p 1⁄4 0.006), C-peptide (F-ratio 12.2, p < 0.001) and cortisol (F-ratio 5.0, p 1⁄4 0.03). Conclusion: In rural Gambian, malnourished children, it cannot be used in isolation, baseline C-peptide was a predictor of future response to rehabilitation. The causes of the wide variability in the response of children suffering from SAM to nutritional rehabilitation are unknown [2], (except for HIV infection) even when rigorously implemented according to latest international guidelines [2, 3].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
