Anthropometry, body composition, early growth and chronic disease risk factors among Zambian adolescents exposed or not to perinatal maternal HIV

Abstract

Early life exposures and growth patterns may affect long-term risk of chronic non-communicable diseases (NCD). We followed up in adolescence two Zambian cohorts (n 322) recruited in infancy to investigate how two early exposures - maternal HIV exposure without HIV infection (HEU) and early growth profile - were associated with later anthropometry, body composition, blood lipids, Hb and HbA1c, blood pressure and grip strength. Although in analyses controlled for age and sex, HEU children were thinner, but not shorter, than HIV-unexposed, uninfected (HUU) children, with further control for socio-demographic factors, these differences were not significant. HEU children had higher HDL-cholesterol than HUU children and marginally lower HbA1c but no other biochemical or clinical differences. We identified three early growth profiles - adequate growth, declining and malnourished - which tracked into adolescence when differences in anthropometry and body fat were still seen. In adolescence, the early malnourished group, compared with the adequate group, had lower blood TAG and higher HDL, lower grip strength (difference: -1·87 kg, 95 % CI -3·47, -0·27; P = 0·02) and higher HbA1c (difference: 0·5 %, 95 % CI 0·2, 0·9; P = 0·005). Lower grip strength and higher HbA1c suggest the early malnourished children could be at increased risk of NCD in later life. Including early growth profile in analyses of HIV exposure reduced the associations between HIV and outcomes. The results suggest that perinatal HIV exposure may have no long-term effects unless accompanied by poor early growth. Reducing the risk of young child malnutrition may lessen children's risk of later NCD.

Keywords: Adolescent; Body composition; Chronic disease risk; Cohort; Growth trajectory; HIV; HbA1c.

Fig. 1.

Conceptual framework linking HIV exposure and early growth trajectory to later risk factors for non-communicable diseases.

Fig. 2.

Flow chart of study participants. BFPH, Breastfeeding and Postpartum Health; CIGNIS, Chilenje Infant Growth, Nutrition and Infection Study; HUU, HIV-unexposed, uninfected; HEU, HIV-exposed, uninfected.

Fig. 3.

Early growth trajectory profiles determined by latent class analysis. () Adequate growth; (), declining; (), malnourished.

Fig. 4.

Anthropometry at follow-up according to early growth trajectory profile. () Adequate growth; (), declining; (), malnourished.