title: REG1B as a predictor of childhood stunting in Bangladesh and Peru.
abstract: BACKGROUND
  Undernutrition remains a significant problem worldwide, with environmental enteropathy implicated as a contributing factor. An understanding of the pathogenesis and identification of children at risk are critical to the design of more-effective interventions.
  
  
  OBJECTIVE
  The stool regenerating gene 1β (REG1B) protein, which is a putative measure of intestinal injury and repair, was tested as a noninvasive biomarker of future childhood stunting.
  
  
  METHODS
  A total of 222 children from Bangladesh and 97 children from Peru, who were from impoverished communities, were followed from birth through 24 mo of age with anthropometric measures obtained every 3 mo. Stool REG1B protein concentrations were obtained by using an REG1B polyclonal-polyclonal ELISA at 3 mo of age. We tested for the ability of REG1B to forecast future anthropometric shortfalls, independent of known predictors of undernutrition of family income and baseline height and weight.
  
  
  RESULTS
  In the Bangladesh cohort of 222 children, higher REG1B concentrations at month 3 were significantly and independently associated with a growth shortfall in a linear regression analysis at months 9, 12, 18, 21, and 24 and, in the Peru cohort, at months 12, 15, 18, 21, and 24. With the use of a mixed model for repeated measurements, higher stool REG1B concentrations at 3 mo were also independently predictive of a lower future length-for-age z score through 24 mo of age (Bangladesh P = 0.006; Peru P = 0.058).
  
  
  CONCLUSIONS
  The ability of fecal REG1B to predict growth shortfall in independent cohorts of impoverished children from the developing world offers promise as a malnutrition biomarker and supports a role for environmental enteropathy in the pathogenesis of growth shortfall.
authors.affiliation: University of Virginia Health Systems, Charlottesville, VA 22908, USA.
authors.forename: Kristine M
authors.initials: KM
authors.lastname: Peterson
authors.forename: Janice
authors.initials: J
authors.lastname: Buss
authors.forename: Rebecca
authors.initials: R
authors.lastname: Easley
authors.forename: Zhengyu
authors.initials: Z
authors.lastname: Yang
authors.forename: Poonum S
authors.initials: PS
authors.lastname: Korpe
authors.forename: Feiyang
authors.initials: F
authors.lastname: Niu
authors.forename: Jennie Z
authors.initials: JZ
authors.lastname: Ma
authors.forename: Maribel Paredes
authors.initials: MP
authors.lastname: Olortegui
authors.forename: Rashidul
authors.initials: R
authors.lastname: Haque
authors.forename: Margaret N
authors.initials: MN
authors.lastname: Kosek
authors.forename: William A
authors.initials: WA
authors.lastname: Petri
mesh_terms: D001459:Bangladesh / Q000453:epidemiology; D001827:Body Height; D001835:Body Weight; D002675:Child, Preschool; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006130:Growth Disorders / Q000453:epidemiology* / Q000209:etiology / Q000235:genetics*; D006801:Humans; D016014:Linear Models; D051847:Lithostathine / Q000235:genetics* / Q000378:metabolism; D008297:Male; D044342:Malnutrition / Q000150:complications / Q000453:epidemiology*; D009752:Nutritional Status; D010568:Peru / Q000453:epidemiology; D015995:Prevalence; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012307:Risk Factors; D012959:Socioeconomic Factors
chemical_list: D051847:Lithostathine; C497618:REG1B protein, human; D012333:RNA, Messenger
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