Overnutrition in Infants Is Associated With High Level of Leptin, Viral Coinfection and Increased Severity of Respiratory Infections: A Cross-Sectional Study

Frontiers in Pediatrics

article

Guisselle Arias-Bravo¹  Gustavo Valderrama³  Jaime Inostroza⁴  Marjorie Reyes-Farías¹  Diego F. Garcia-Diaz⁵  Francisco Zorondo-Rodríguez⁶  Loreto F. Fuenzalida¹ 

[1] Instituto de Ciencias Biomédicas, Universidad Autónoma de Chile;Instituto de Ciencias de la Salud, Universidad de O'Higgins;Urgencia Materno-Infantil;Jeffrey Modell Centre for Diagnosis and Research in Primary Immunodeficiencies, Universidad de La Frontera;Laboratorio de Nutrigenomica, Departamento de Nutricion, Universidad de Chile;Departamento de Gestión Agraria, Universidad de Santiago de Chile

关键词: overnutrition;    children;    viral respiratory infection;    severity;    viral coinfection;    leptin;   

DOI  :  10.3389/fped.2020.00044

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Objective: To investigate the relationship of overnutrition (obese and overweight) with severity of illness in children hospitalized with acute lower respiratory infections (ALRIs), frequency of viral coinfections and leptin levels. Methods: We studied 124 children <2 years old that were hospitalized for ALRI. Nutritional status was calculated by z-scores according to weight-for-age z-scores, length or height-for-age z-scores, and weight-for-height z-scores. Nasopharyngeal aspirates (NPAs) were obtained and viral respiratory pathogens were identified using reverse transcription polymerase chain reactions (RT-PCR). Respiratory syncytial virus (RSV) load was assessed using quantitative RT-PCR. NPA and plasma leptin level were measured. Clinical data and nutritional status were recorded, and patients were followed up until hospital discharge. Viral coinfection was defined as the presence of two or more viruses detected in the same respiratory sample. Severity of illness was determined by length of hospitalization and duration of oxygen therapy. Results: Children with overnutrition showed a greater frequency of viral coinfection than those with normal weight (71% obese vs. 37% normal weight p = 0.013; 68% overweight vs. 37% normal weight p = 0.004). A lower RSV load was found in obese (5.91 log 10 copies/mL) and overweight children (6.49 log 10 copies/mL) compared to normal weight children (8.06 log 10 copies/mL; p = 0.021 in both cases). In multivariate analysis, obese, and overweight infants <6 months old were associated with longer hospital stays (RR = 1.68; CI: 1.30–2.15 and obese: RR = 1.68; CI: 1.01–2.71, respectively) as well as a greater duration of oxygen therapy (RR = 1.80; IC: 1.41–2.29 and obese: RR = 1.91; CI: 1.15–3.15, respectively). Obese children <6 months showed higher plasma leptin level than normal weight children (7.58 vs. 5.12 ng/μl; p <0.046). Conclusions: In infants younger than 6 months, overnutrition condition was related to increased severity of infections and high plasma leptin level. Also, children with overnutrition showed a greater frequency of viral coinfection and low RSV viral load compared to normal weights children. These findings further contribute to the already existent evidence supporting the importance of overnutrition prevention in pediatric populations.

【 授权许可】

CC BY