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Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh

BACKGROUND: Current nutritional intervention strategies have not proven effective in improving childhood ponderal and linear growth in underweight and stunted children. Novel markers are needed to classify children who are likely to respond to available interventions and to identify those requiring...

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Autores principales: Arndt, Michael B, Richardson, Barbra A, Mahfuz, Mustafa, Ahmed, Tahmeed, Haque, Rashidul, Gazi, Md Amran, John-Stewart, Grace C, Denno, Donna M, Scarlett, Jarrad M, Walson, Judd L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511337/
https://www.ncbi.nlm.nih.gov/pubmed/31093598
http://dx.doi.org/10.1093/cdn/nzz024
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author Arndt, Michael B
Richardson, Barbra A
Mahfuz, Mustafa
Ahmed, Tahmeed
Haque, Rashidul
Gazi, Md Amran
John-Stewart, Grace C
Denno, Donna M
Scarlett, Jarrad M
Walson, Judd L
author_facet Arndt, Michael B
Richardson, Barbra A
Mahfuz, Mustafa
Ahmed, Tahmeed
Haque, Rashidul
Gazi, Md Amran
John-Stewart, Grace C
Denno, Donna M
Scarlett, Jarrad M
Walson, Judd L
author_sort Arndt, Michael B
collection PubMed
description BACKGROUND: Current nutritional intervention strategies have not proven effective in improving childhood ponderal and linear growth in underweight and stunted children. Novel markers are needed to classify children who are likely to respond to available interventions and to identify those requiring additional interventions. Fibroblast Growth Factor 21 (FGF21), an endocrine hormone that regulates metabolism and growth during periods of reduced protein intake, may be useful in this context. OBJECTIVES: We aimed to determine the associations between plasma FGF21 concentrations and subsequent growth, and the association between change in FGF21 concentrations and concurrent growth, in children receiving nutritional supplementation. METHODS: A total of 120 children between ages 6 and 13 mo with weight-for-age z score (WAZ) between −3 and −2 were enrolled from an urban slum in Dhaka, Bangladesh. Children received 376-kcal feeding supplements daily for 5 mo and were followed for 5 additional mo. FGF21 was measured in plasma collected at enrollment and month 5. FGF21 values that fell above the 90th percentile of baseline concentrations (1056.5 pg/mL) were considered high. Linear regression was used to examine the association between baseline FGF21 status and 5-mo change in WAZ and length-for-age z score (LAZ), and the association between 5-mo change in FGF21 and concurrent WAZ and LAZ change. RESULTS: The median baseline FGF21 concentration was 241.4 pg/mL (IQR: 111.7, 451.3 pg/mL). On average, children with high baseline FGF21 gained 0.58 WAZ (95% CI: 0.28, 0.88) and 0.54 LAZ (95% CI: 0.23, 0.84) more during supplementation than those with low values. Change in FGF21 concentration during supplementation was negatively associated with change in WAZ (−0.48; 95% CI: −0.67, −0.29) and LAZ (−0.31; 95% CI: −0.52, −0.11). CONCLUSIONS: FGF21 may be a useful marker of growth faltering and may allow identification of children who are more or less likely to respond to nutritional supplementation. This trial was registered at clinicaltrials.gov as NCT02441426.
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spelling pubmed-65113372019-05-15 Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh Arndt, Michael B Richardson, Barbra A Mahfuz, Mustafa Ahmed, Tahmeed Haque, Rashidul Gazi, Md Amran John-Stewart, Grace C Denno, Donna M Scarlett, Jarrad M Walson, Judd L Curr Dev Nutr Original Research BACKGROUND: Current nutritional intervention strategies have not proven effective in improving childhood ponderal and linear growth in underweight and stunted children. Novel markers are needed to classify children who are likely to respond to available interventions and to identify those requiring additional interventions. Fibroblast Growth Factor 21 (FGF21), an endocrine hormone that regulates metabolism and growth during periods of reduced protein intake, may be useful in this context. OBJECTIVES: We aimed to determine the associations between plasma FGF21 concentrations and subsequent growth, and the association between change in FGF21 concentrations and concurrent growth, in children receiving nutritional supplementation. METHODS: A total of 120 children between ages 6 and 13 mo with weight-for-age z score (WAZ) between −3 and −2 were enrolled from an urban slum in Dhaka, Bangladesh. Children received 376-kcal feeding supplements daily for 5 mo and were followed for 5 additional mo. FGF21 was measured in plasma collected at enrollment and month 5. FGF21 values that fell above the 90th percentile of baseline concentrations (1056.5 pg/mL) were considered high. Linear regression was used to examine the association between baseline FGF21 status and 5-mo change in WAZ and length-for-age z score (LAZ), and the association between 5-mo change in FGF21 and concurrent WAZ and LAZ change. RESULTS: The median baseline FGF21 concentration was 241.4 pg/mL (IQR: 111.7, 451.3 pg/mL). On average, children with high baseline FGF21 gained 0.58 WAZ (95% CI: 0.28, 0.88) and 0.54 LAZ (95% CI: 0.23, 0.84) more during supplementation than those with low values. Change in FGF21 concentration during supplementation was negatively associated with change in WAZ (−0.48; 95% CI: −0.67, −0.29) and LAZ (−0.31; 95% CI: −0.52, −0.11). CONCLUSIONS: FGF21 may be a useful marker of growth faltering and may allow identification of children who are more or less likely to respond to nutritional supplementation. This trial was registered at clinicaltrials.gov as NCT02441426. Oxford University Press 2019-03-30 /pmc/articles/PMC6511337/ /pubmed/31093598 http://dx.doi.org/10.1093/cdn/nzz024 Text en Copyright © American Society for Nutrition 2019. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Arndt, Michael B
Richardson, Barbra A
Mahfuz, Mustafa
Ahmed, Tahmeed
Haque, Rashidul
Gazi, Md Amran
John-Stewart, Grace C
Denno, Donna M
Scarlett, Jarrad M
Walson, Judd L
Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh
title Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh
title_full Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh
title_fullStr Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh
title_full_unstemmed Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh
title_short Plasma Fibroblast Growth Factor 21 Is Associated with Subsequent Growth in a Cohort of Underweight Children in Bangladesh
title_sort plasma fibroblast growth factor 21 is associated with subsequent growth in a cohort of underweight children in bangladesh
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6511337/
https://www.ncbi.nlm.nih.gov/pubmed/31093598
http://dx.doi.org/10.1093/cdn/nzz024
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