Hormonal Correlates and Predictors of Nutritional Recovery in Malnourished African Children

J Trop Pediatr. 2018 Oct 1;64(5):364-372. doi: 10.1093/tropej/fmx075.

Abstract

Background: Malnourished 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.

Methods: Quasi-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.

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 = 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.

Conclusion: In rural Gambian, malnourished children, although it cannot be used in isolation, baseline C-peptide was a predictor of future response to rehabilitation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anthropometry
  • Arm / anatomy & histology*
  • Biomarkers / blood*
  • C-Reactive Protein / metabolism
  • Case-Control Studies
  • Child Nutrition Disorders
  • Child, Preschool
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Gambia / epidemiology
  • Hormones / blood
  • Humans
  • Infant
  • Male
  • Malnutrition / blood
  • Malnutrition / diet therapy*
  • Malnutrition / epidemiology
  • Nutrition Therapy / methods*
  • Protein-Energy Malnutrition / blood
  • Protein-Energy Malnutrition / diet therapy
  • Rural Population*
  • Saliva / metabolism
  • Treatment Outcome

Substances

  • Biomarkers
  • Hormones
  • C-Reactive Protein