TY - JOUR
T1 - Environmental enteric dysfunction is associated with altered bile acid metabolism
AU - Semba, Richard D.
AU - Gonzalez-Freire, Marta
AU - Moaddel, Ruin
AU - Trehan, Indi
AU - Maleta, Kenneth M.
AU - Khadeer, Mohammed
AU - Ordiz, Maria Isabel
AU - Ferrucci, Luigi
AU - Manary, Mark J.
N1 - Publisher Copyright:
© Copyright 2017 by ESPGHAN and NASPGHAN.
PY - 2017/4/1
Y1 - 2017/4/1
N2 - Objectives: Environmental enteric dysfunction (EED), a clinically asymptomatic condition characterized by inflammation of the small bowel mucosa, villous atrophy, and increased gut permeability, is common among children in developing countries. Because of abnormal gut mucosa and altered gut microbiome, EED could potentially affect the metabolism and enterohepatic circulation of bile acids. Methods: In 313 children, aged 12 to 59 months, EED was assessed by the dual sugar absorption test. Serum bile acids were measured using stable-isotope liquid chromatography-tandem mass spectrometry. Results: In the overall study population, serum cholic acid and chenodeoxycholic acid were lower, whereas glycocholic acid, taurodeoxycholic acid, glycodeoxycholic acid, glycolithocholic acid, and glycoursodeoxycholic acid were significantly higher at older ages. Independent of age, serum taurochenodeoxycholic acid, tauromuricholic acid, and glycoursodeoxycholic acid were significantly different between 244 children with EED and 69 children without EED. Total serum bile acids (median, interquartile range) were 4.51 (2.45, 7.51) and 5.10 (3.32, 9.01) μmol/L in children with and without EED, respectively (age-adjusted, P=0.0009). The proportion of bile acids conjugated with taurine instead of glycine was higher in children with EED (P<0.0001). Conclusions: EED is associated with altered bile acid metabolism in young children in rural Malawi. Further work is needed to determine the generalizability of these findings in other study populations.
AB - Objectives: Environmental enteric dysfunction (EED), a clinically asymptomatic condition characterized by inflammation of the small bowel mucosa, villous atrophy, and increased gut permeability, is common among children in developing countries. Because of abnormal gut mucosa and altered gut microbiome, EED could potentially affect the metabolism and enterohepatic circulation of bile acids. Methods: In 313 children, aged 12 to 59 months, EED was assessed by the dual sugar absorption test. Serum bile acids were measured using stable-isotope liquid chromatography-tandem mass spectrometry. Results: In the overall study population, serum cholic acid and chenodeoxycholic acid were lower, whereas glycocholic acid, taurodeoxycholic acid, glycodeoxycholic acid, glycolithocholic acid, and glycoursodeoxycholic acid were significantly higher at older ages. Independent of age, serum taurochenodeoxycholic acid, tauromuricholic acid, and glycoursodeoxycholic acid were significantly different between 244 children with EED and 69 children without EED. Total serum bile acids (median, interquartile range) were 4.51 (2.45, 7.51) and 5.10 (3.32, 9.01) μmol/L in children with and without EED, respectively (age-adjusted, P=0.0009). The proportion of bile acids conjugated with taurine instead of glycine was higher in children with EED (P<0.0001). Conclusions: EED is associated with altered bile acid metabolism in young children in rural Malawi. Further work is needed to determine the generalizability of these findings in other study populations.
KW - Africa
KW - children
KW - malabsorption
KW - malnutrition
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U2 - 10.1097/MPG.0000000000001313
DO - 10.1097/MPG.0000000000001313
M3 - Article
C2 - 27322559
AN - SCOPUS:84975469625
SN - 0277-2116
VL - 64
SP - 536
EP - 540
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 4
ER -