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

Hormonal Correlates and Predictors of Nutritional Recovery in Malnourished African Children

Helen M Nabwera  1   2 , Robin M Bernstein  3 , Schadrac C Agbla  1   2 , Sophie E Moore  1   4 , Momodou K Darboe  1 , Mariama Colley  1 , Amadou T Jallow  1 , Richard Bradbury  1 , Jennifer Karafin  3 , Anthony J Fulford  1   2 , Andrew M Prentice  1   2
Affiliations

Hormonal Correlates and Predictors of Nutritional Recovery in Malnourished African Children

Helen M Nabwera et al. J Trop Pediatr. .

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.

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Figures

Fig. 1.
Fig. 1.
Weight-for-age Z-score (WAZ) gain. (A) MAM group. Number of children by WAZ gain. (B) SAM group. Number of children by WAZ gain.
Fig. 2.
Fig. 2.
Changes in hormone and receptor levels over time by nutritional category. (A) Leptin levels in nanograms per millilitre. Dark grey bars = pre-test meal levels, pale grey bars = post-test meal levels. (B) sOBR levels in nanograms per millilitre. Dark grey bars = pre-test meal levels, pale grey bars = post-test meal levels. (C) Molar excess of sOBR/leptin. Dark grey bars = pre-test meal levels, pale grey bars = post-test meal levels. (D) Total ghrelin in nanograms per millilitre. Dark grey bars = pre-test meal levels, pale grey bars = post-test meal levels. (E) IGF-1 in nanograms per millilitre. Dark grey bars = pre-test meal levels, pale grey bars = post-test meal levels. (F) IGFBP3 in nanograms per millilitre. Dark grey bars = pre-test meal levels, pale grey bars = post-test meal levels. (G) Molar excess of IGF-1/IGFBP3. Dark grey bars = pre-test meal levels, pale grey bars = post-test meal levels. (H) Pre-prandial cortisol in micrograms per decilitre.
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