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Glucagon-like Peptide 2 Concentrations Vary in Zambian Children During Diarrhoea, in Malnutrition and Seasonally.

Authors
  • Besa, Ellen C1
  • Chandwe, Kanta1, 2
  • Banda, Rosemary1
  • Munalula, Likando1
  • Kalomo, Lydia1
  • Amadi, Beatrice1, 2
  • Kelly, Paul1, 3, 4
  • 1 Tropical Gastroenterology and Nutrition group, University of Zambia School of Medicine. , (Zambia)
  • 2 Children's Hospital, University Teaching Hospitals, Lusaka, Zambia. , (Zambia)
  • 3 Blizzard Institute, Queen Mary University of London.
  • 4 London School of Hygiene and Tropical Medicine, London, UK.
Type
Published Article
Journal
Journal of pediatric gastroenterology and nutrition
Publication Date
Apr 01, 2020
Volume
70
Issue
4
Pages
513–520
Identifiers
DOI: 10.1097/MPG.0000000000002633
PMID: 32044830
Source
Medline
Language
English
License
Unknown

Abstract

Glucagon-like peptide 2 (GLP-2) is a 33 amino acid peptide hormone released from enteroendocrine L-cells following nutrient ingestion. It has been shown to exert trophic effects on the gut. We set out to measure GLP-2 concentrations in blood in children with diarrhoea and malnutrition. GLP-2 levels were measured in blood samples collected from 5 different groups of children (n = 324) at different time points: those with acute diarrhoea, during illness and 3 weeks after recovery; persistent diarrhoea and severe acute malnutrition; controls contemporaneous for diarrhoea; stunted children from the community; and controls contemporaneous for the stunted children. Stool biomarkers and pathogen analysis were carried out on the children with stunting. GLP-2 concentrations were higher during acute diarrhoea (median 3.1 ng/mL, interquartile range 2.1, 4.4) than on recovery (median 1.8, interquartile range 1.4, 3.1; P = 0.001), but were not elevated in children with persistent diarrhoea and severe acute malnutrition. In stunted children, there was a progressive decline in GLP-2 levels from 3.2 ng/mL (1.9, 4.9) to 1.0 (0.0, 2.0; P < 0.001) as the children became more stunted. Measures of seasonality (rainfall, temperature,Food Price Index, and Shiga toxin-producing Escherichia coli) were found to be significantly associated with GLP-2 concentrations in multivariable analysis. We also found a correlation between stool inflammatory biomarkers and GLP-2. In diarrhoea, GLP-2 levels increased in acute but not persistent diarrhoea. Malnutrition was associated with reduced concentrations. GLP-2 displayed seasonal variation consistent with variations in nutrient availability.

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