title: Predictors of Inflammation in a Cohort of Bolivian Infants and Toddlers.
abstract: Inflammation has been associated with cardiovascular disease and other health outcomes in children and adults, yet few longitudinal data are available on prevalence and predictors of inflammation in infants. We aimed to identify the prevalence of inflammation in a cohort of Bolivian infants and estimate its association with acute (recent illnesses) and chronic (overweight, stunting) morbidities and potential pathogen exposure (represented by water, sanitation, and hygiene [WASH] resources). We measured plasma concentrations of two acute phase proteins (C-reactive protein [CRP], marking acute inflammation, and alpha(1)-acid-glycoprotein [AGP], marking chronic inflammation) at three time points (target 2, 6-8, and 12-18 months). Of 451 singleton infants enrolled in the parent study, 272 had the first blood draw and complete data. Anthropometry and sociodemographic and recent illness data (2-week recall of cough, diarrhea, and fever) were collected at each visit. Inflammation was defined as CRP > 5 mg/L or AGP > 1 g/L. The prevalence of inflammation increased from early infancy (3% at first blood draw) to later infancy (15-22% at later blood draws). Recent cough, recent fever, and age in months were significantly associated with relative increases in CRP (7-44%) and AGP (5-23%), whereas recent diarrhea was only significantly associated with an increase in CRP (48%). Neither anthropometry nor WASH was significantly associated with inflammation. Results confirm the role of recent acute illness in inflammation in infants, and indicate that adiposity and WASH are not as important to inflammation in this age category.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia. rachel.m.burke@gmail.com.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Burke
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia. Emory School of Medicine, Atlanta, Georgia. Nutrition Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Parminder S
authors.initials: PS
authors.lastname: Suchdev
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia. Emory School of Medicine, Atlanta, Georgia.
authors.forename: Paulina A
authors.initials: PA
authors.lastname: Rebolledo
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Anna M Fabiszewski
authors.initials: AM
authors.lastname: de Aceituno
authors.affiliation: Servicio Departamental de Salud, La Paz, Bolivia.
authors.forename: Rita
authors.initials: R
authors.lastname: Revollo
authors.affiliation: Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés, La Paz, Bolivia.
authors.forename: Volga
authors.initials: V
authors.lastname: Iñiguez
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Mitchel
authors.initials: M
authors.lastname: Klein
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Drews-Botsch
authors.affiliation: Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Juan S
authors.initials: JS
authors.lastname: Leon
mesh_terms: D000208:Acute Disease; D000886:Anthropometry; D001838:Bolivia / Q000453:epidemiology; D002097:C-Reactive Protein / Q000276:immunology*; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D003371:Cough / Q000453:epidemiology*; D003967:Diarrhea / Q000453:epidemiology*; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006130:Growth Disorders / Q000453:epidemiology*; D006801:Humans; D006920:Hygiene; D007223:Infant; D007249:Inflammation / Q000453:epidemiology* / Q000276:immunology; D008137:Longitudinal Studies; D008297:Male; D009961:Orosomucoid / Q000276:immunology*; D050177:Overweight / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012499:Sanitation; D014871:Water Microbiology
chemical_list: D009961:Orosomucoid; D002097:C-Reactive Protein