Fecal Markers of Environmental Enteric Dysfunction and their Relation to Faltering Growth in a Sample of Egyptian Children

Maged A.  El Wakeel; Ghada M. El-Kassas; Gihan Fouad Ahmed; Walaa H. Ali; Eman Mohamed Elsheikh; Salwa Refat El-Zayat; Nevein N. Fadl; Iman H. Kamel; Thanaa M. Rabah

doi:10.3889/oamjms.2021.7029

Authors

Maged A. El Wakeel Department of Child Health, National Research Centre, Giza, Egypt
Ghada M. El-Kassas Department of Child Health, National Research Centre, Giza, Egypt
Gihan Fouad Ahmed Department of Pediatrics, National Nutrition Institute, Cairo, Egypt
Walaa H. Ali Department of Child Health, National Research Centre, Giza, Egypt
Eman Mohamed Elsheikh Department of Child Health, National Research Centre, Giza, Egypt
Salwa Refat El-Zayat Department of Medical Physiology, National Research Centre, Giza, Egypt
Nevein N. Fadl Department of Medical Physiology, National Research Centre, Giza, Egypt
Iman H. Kamel Department of Child Health
Thanaa M. Rabah Department of Community Medicine Research, National Research Centre, Giza, Egypt

DOI:

https://doi.org/10.3889/oamjms.2021.7029

Keywords:

Environmental enteric dysfunction, Undernutrition, Fecal markers, Micronutrients, Children

Abstract

BACKGROUND: Chronic malnutrition is a long-term health condition that has threatening effects on children’s health. Environmental enteric dysfunction (EED) is a subclinical disorder affecting the small intestine that may occur due to exposure to environmental pathogens and toxins.

AIM: The present research was intended to detect the value of fecal biomarkers of intestinal epithelial damage alpha-1anti-trypsin (AAT) and intestinal inflammation Myeloperoxidase (MPO) and Neopetrin (NEO), also to quantify their association with faltering growth in stunted and underweight children.

PATIENTS AND METHODS: This case–control study included 105 children with moderate malnutrition as a case group and 100 children of normal body weight and height as a control group. Quantification of fecal markers levels of intestinal permeability AAT and intestinal inflammation (NEO and MPO) along with serum micronutrients levels (iron and zinc) in children with malnutrition in comparison to controls.

RESULTS: Fecal markers of intestinal permeability AAT and intestinal inflammation NEO had statistically significant higher levels in children with malnutrition, while serum micronutrients (iron and zinc) had statistically significant lower levels in children with malnutrition.

CONCLUSION: Faltering growth is associated with elevated fecal markers of intestinal permeability AAT and intestinal inflammation NEO. EED may be a cause for faltering growth.

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