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

Long-term effects of severe acute malnutrition on lung function in Malawian children: a cohort study.
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Lelijveld N, Kerac M, Seal A, Chimwezi E, Wells JC, Heyderman RS, Nyirenda MJ, Stocks J, Kirkby J,


Lelijveld N, Kerac M, Seal A, Chimwezi E, Wells JC, Heyderman RS, Nyirenda MJ, Stocks J, Kirkby J, (click to view)

Lelijveld N, Kerac M, Seal A, Chimwezi E, Wells JC, Heyderman RS, Nyirenda MJ, Stocks J, Kirkby J,

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The European respiratory journal 2017 04 0549(4) pii 10.1183/13993003.01301-2016

Abstract

Early nutritional insults may increase risk of adult lung disease. We aimed to quantify the impact of severe acute malnutrition (SAM) on spirometric outcomes 7 years post-treatment and explore predictors of impaired lung function.Spirometry and pulse oximetry were assessed in 237 Malawian children (median age: 9.3 years) 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 African-American population.Forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) were low in all groups (mean FEV1 z-score: -0.47 for cases, -0.48 for siblings, -0.34 for community controls; mean FVC z-score: -0.32, -0.38, and -0.15 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 "thrifty" or "lung-sparing" growth. Female sex and HIV positive status were identified as potentially high-risk groups.

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