Status: Funded - Closed
An evaluation of environmental enteropathy in childhood as a risk factor for later chronic disease
Gwenyth Lee, Ph.D.
BACKGROUND: Environmental enteropathy (EE) is a condition of partial villous atrophy, crypt hyperplasia, intestinal inflammation, and increased intestinal permeability associated with growth faltering among children living in unsanitary conditions with high rates of exposure to enteropathogens.
GAP: EE throughout the life course may be a risk factor for chronic disease, as chronic bacterial translocation, inflammation, and frequent childhood illness have all been associated with dyslipidemia and adult cardiovascular disease.
HYPOTHESIS: The hypothesis of this study is that environmental enteropathy in infancy and childhood is associated with changes in the cardiometabolic profile that are consistent with increased risk of adverse cardiovascular outcomes among children living in the developing world.
METHODS: This study will be a cross-sectional follow-up of approximately 200 Peruvian children who previously participated in the “Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED)” longitudinal birth cohort, a study that collected very detailed assessments of enteric and nutritional exposures over the first 24 months of life.
IMPACT: This will be the first study to investigate whether the chronic alterations to the gut that are already known to impact infant growth and oral vaccine response, are also associated with an increased risk of chronic disease in adulthood. If our hypothesis is supported, it would strongly suggest that EE in infancy and early childhood has economic and health ramifications over the lifespan in developing countries, where the rates of chronic cardiovascular diseases in adulthood have rapidly increased, and serve as an argument for the prioritization of strategies and interventions for the prevention of EE.
Johns Hopkins Bloomberg School of Public Health