Long-term effects of severe acute malnutrition on lung function in Malawian children: a cohort study

[摘要] Early nutritional insults may increase risk of adult lung disease. We aimed to quantify the impact of severe acute malnutrition (SAM) on spirometric outcomes 7xe2x80x85years post-treatment and explore predictors of impaired lung function.Spirometry and pulse oximetry were assessed in 237 Malawian children (median age: 9.3xe2x80x85years) who had been treated for SAM and compared with sibling and age/sex-matched community controls. Spirometry results were expressed as z-scores based on Global Lung Function Initiative reference data for the Africanxe2x80x93American population.Forced expiratory volume in 1xe2x80x85s (FEV1) and forced vital capacity (FVC) were low in all groups (mean FEV1 z-score: xe2x88x920.47 for cases; xe2x88x920.48 for siblings; xe2x88x920.34 for community controls; mean FVC z-score: xe2x88x920.32; xe2x88x920.38; and xe2x88x920.15 respectively). There were no differences in spirometric or oximetry outcomes between SAM survivors and controls. Leg length was shorter in SAM survivors but inter-group sitting heights were similar. HIV positive status or female sex was associated with poorer FEV1; by 0.55 and 0.31 z-scores; respectively.SAM in early childhood was not associated with subsequent reduced lung function compared to local controls. Preservation of sitting height and compromised leg length suggest xe2x80x9cthriftyxe2x80x9d or xe2x80x9clung-sparingxe2x80x9d growth. Female sex and HIV positive status were identified as potentially high-risk groups.

[学科分类] 呼吸医学