Hormonal Correlates and Predictors of Nutritional Recovery in Malnourished African Children

BACKGROUND: Malnourished children show variable growth responses to nutritional rehabilitation. We aimed to investigate whether these differences could be explained by variations in growth and energy-regulating hormones. METHODS: Quasi-experimental study: Children aged 6–24 months in rural Gambia were recruited to controls if weight-for-height z-score (WHZ) > −2 (n = 22), moderate acute malnutrition if WHZ < −2 and > −3 (n = 18) or severe acute malnutrition if WHZ < −3 (n = 20). Plasma hormone and salivary CRP levels were determined by ELISA. RESULTS: In univariable analyses, increases in weight-for-age z-score (WAZ) in malnourished children were positively correlated with insulin (F-ratio 7.8, p = 0.006), C-peptide (F-ratio 12.2, p < 0.001) and cortisol (F-ratio 5.0, p = 0.03). In multivariable analysis, only baseline C-peptide (F-ratio 7.6, p = 0.009) predicted the changes in WAZ over 28 days of interventions. CONCLUSION: In rural Gambian, malnourished children, although it cannot be used in isolation, baseline C-peptide was a predictor of future response to rehabilitation.