Open AccessGlucagon‐like Peptide 2 Concentrations Vary in Zambian Children During Diarrhoea, in Malnutrition and Seasonally
Author(s) -
Besa Ellen C.,
Chandwe Kanta,
Banda Rosemary,
Munalula Likando,
Kalomo Lydia,
Amadi Beatrice,
Kelly Paul
Publication year - 2020
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0000000000002633
Subject(s) - interquartile range , medicine , glucagon like peptide 2 , malnutrition , severe acute malnutrition , diarrhea , gastroenterology , ingestion , physiology , endocrinology , biology , peptide , biochemistry
Objectives: Glucagon‐like peptide 2 (GLP‐2) is a 33 amino acid peptide hormone released from enteroendocrine L‐cells following nutrient ingestion. It has been shown to exert trophic effects on the gut. We set out to measure GLP‐2 concentrations in blood in children with diarrhoea and malnutrition. Methods: GLP‐2 levels were measured in blood samples collected from 5 different groups of children (n = 324) at different time points: those with acute diarrhoea, during illness and 3 weeks after recovery; persistent diarrhoea and severe acute malnutrition; controls contemporaneous for diarrhoea; stunted children from the community; and controls contemporaneous for the stunted children. Stool biomarkers and pathogen analysis were carried out on the children with stunting. Results: GLP‐2 concentrations were higher during acute diarrhoea (median 3.1 ng/mL, interquartile range 2.1, 4.4) than on recovery (median 1.8, interquartile range 1.4, 3.1; P = 0.001), but were not elevated in children with persistent diarrhoea and severe acute malnutrition. In stunted children, there was a progressive decline in GLP‐2 levels from 3.2 ng/mL (1.9, 4.9) to 1.0 (0.0, 2.0; P < 0.001) as the children became more stunted. Measures of seasonality (rainfall, temperature,Food Price Index, and Shiga toxin‐producing Escherichia coli ) were found to be significantly associated with GLP‐2 concentrations in multivariable analysis. We also found a correlation between stool inflammatory biomarkers and GLP‐2. Conclusions: In diarrhoea, GLP‐2 levels increased in acute but not persistent diarrhoea. Malnutrition was associated with reduced concentrations. GLP‐2 displayed seasonal variation consistent with variations in nutrient availability.