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Environmental enteropathy is associated with cardiometabolic risk factors in Peruvian children

Published online by Cambridge University Press:  07 March 2017

G. O. Lee Open the ORCID record for G. O. Lee [Opens in a new window] ,
M. Paredes Olortegui ,
M. Siguas Salas ,
P. Peñataro Yori ,
D. Rengifo Trigoso ,
P. Kosek ,
M. L. Mispireta ,
R. Oberhelman ,
L. E. Caulfield  and
M. N. Kosek
G. O. Lee*
Affiliation:
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
M. Paredes Olortegui
Affiliation:
Asociación Benéfica PRISMA, Iquitos, Peru
M. Siguas Salas
Affiliation:
Asociación Benéfica PRISMA, Iquitos, Peru
P. Peñataro Yori
Affiliation:
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
D. Rengifo Trigoso
Affiliation:
Asociación Benéfica PRISMA, Iquitos, Peru
P. Kosek
Affiliation:
Oregon Analytics, Eugene, OR, USA
M. L. Mispireta
Affiliation:
School of Nursing, Division of Health Sciences, Idaho State University, Pocatello, ID, USA
R. Oberhelman
Affiliation:
Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
L. E. Caulfield
Affiliation:
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
M. N. Kosek
Affiliation:
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
*
*Address for correspondence: G. O. Lee, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA. (Email golee@umich.edu)
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Abstract

Environmental enteropathy (EE) is a syndrome of altered small intestine structure and function hypothesized to be common among individuals lacking access to improved water and sanitation. There are plausible biological mechanisms, both inflammatory and non-inflammatory, by which EE may alter the cardiometabolic profile. Here, we test the hypothesis that EE is associated with the cardiometabolic profile among young children living in an environment of intense enteropathogen exposure. In total, 156 children participating in the Peruvian cohort of a multicenter study on childhood infectious diseases, growth and development were contacted at 3–5 years of age. The urinary lactulose:mannitol ratio, and plasma antibody to endotoxin core were determined in order to assess intestinal permeability and bacterial translocation. Blood pressure, anthropometry, fasting plasma glucose, insulin, and cholesterol and apolipoprotein profiles were also assessed. Extant cohort data were also used to relate biomarkers of EE during the first 18 months of life to early child cardiometabolic profile. Lower intestinal surface area, as assessed by percent mannitol excretion, was associated with lower apolipoprotein-AI and lower high-density lipoprotein concentrations. Lower intestinal surface area was also associated with greater blood pressure. Inflammation at 7 months of age was associated with higher blood pressure in later childhood. This study supports the potential for a relationship between EE and the cardiometabolic profile.

Keywords

cardiovascular riskenvironmental enteropathyPeru
Type
Original Article
Information
Journal of Developmental Origins of Health and Disease , Volume 8 , Issue 3 , June 2017 , pp. 337 - 348
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© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2017 

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