title: Environmental enteropathy is associated with cardiometabolic risk factors in Peruvian children.
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.
authors.affiliation: 1Department of Epidemiology,University of Michigan School of Public Health,Ann Arbor,MI,USA.
authors.forename: G O
authors.identifier: http://orcid.org/0000-0002-7889-3852
authors.initials: GO
authors.lastname: Lee
authors.affiliation: 2Asociación Benéfica PRISMA,Iquitos,Peru.
authors.forename: M Paredes
authors.initials: MP
authors.lastname: Olortegui
authors.affiliation: 2Asociación Benéfica PRISMA,Iquitos,Peru.
authors.forename: M Siguas
authors.initials: MS
authors.lastname: Salas
authors.affiliation: 3Department of International Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
authors.forename: P Peñataro
authors.initials: PP
authors.lastname: Yori
authors.affiliation: 2Asociación Benéfica PRISMA,Iquitos,Peru.
authors.forename: D Rengifo
authors.initials: DR
authors.lastname: Trigoso
authors.affiliation: 4Oregon Analytics,Eugene,OR,USA.
authors.forename: P
authors.initials: P
authors.lastname: Kosek
authors.affiliation: 5School of Nursing,Division of Health Sciences,Idaho State University,Pocatello,ID,USA.
authors.forename: M L
authors.initials: ML
authors.lastname: Mispireta
authors.affiliation: 6Department of Global Community Health and Behavioral Sciences,Tulane School of Public Health and Tropical Medicine,New Orleans,LA,USA.
authors.forename: R
authors.initials: R
authors.lastname: Oberhelman
authors.affiliation: 3Department of International Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
authors.forename: L E
authors.initials: LE
authors.lastname: Caulfield
authors.affiliation: 3Department of International Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
authors.forename: M N
authors.initials: MN
authors.lastname: Kosek
mesh_terms: D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D002675:Child, Preschool; D015331:Cohort Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D007421:Intestine, Small / Q000378:metabolism / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008659:Metabolic Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D010568:Peru / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors
keywords: Peru; cardiovascular risk; environmental enteropathy