Essential Fatty Acid Deficiency Associates with Growth Faltering and Environmental Enteric Dysfunction in Children

• Published in: Metabolites Vol. 13; no. 4; p. 489
• Main Authors: Narvaez-Rivas, Monica, Setchell, Kenneth D R, Galandi, Stephanie L, Zhao, Xueheng, Iqbal, Najeeha Talat, Ahmed, Sheraz, Iqbal, Junaid, Syed, Sana, Ali, Syed Asad, Moore, Sean R
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 29.03.2023; MDPI
• Subjects: Age; Bacterial infections; Bile; Bile acids; Biomarkers; Care and treatment; Causes of; Chemokines; Children; Children & youth; Cytokines; Desaturase; Diagnosis; Digestive system; Digestive tract; Diseases; Enrollments; environmental enteric dysfunction (EED); Fatty acids; Health aspects; Linoleic acid; Lipids; Liver diseases; Malabsorption; Malnutrition; Malnutrition in children; Monounsaturated fatty acids; non-esterified fatty acids (NEFA); Oleic acid; Polyunsaturated fatty acids; Sensors; stunting; Undernutrition; Pakistan; United States > US; environmental enteric dysfunction (EED); non-esterified fatty acids (NEFA); stunting; biomarkers; undernutrition
• ISSN: 2218-1989; 2218-1989
• DOI: 10.3390/metabo13040489

Environmental enteric dysfunction (EED) is characterized by intestinal inflammation, malabsorption and growth-faltering in children with heightened exposure to gut pathogens. The aim of this study was to characterize serum non-esterified fatty acids (NEFA), in association with childhood undernutrition and EED, as potential biomarkers to predict growth outcomes. The study comprised a cohort of undernourished rural Pakistani infants ( = 365) and age-matched controls followed prospectively up to 24 months of age. Serum NEFA were quantified at ages 3-6 and 9 months and correlated with growth outcomes, serum bile acids and EED histopathological biomarkers. Serum NEFA correlated with linear growth-faltering and systemic and gut biomarkers of EED. Undernourished children exhibited essential fatty acid deficiency (EFAD), with low levels of linoleic acid and total n-6 polyunsaturated fatty acids, compensated by increased levels of oleic acid and increased elongase and desaturase activities. EFAD correlated with reduced anthropometric Z scores at 3-6 and 9 months of age. Serum NEFA also correlated with elevated BA and liver dysfunction. Essential fatty acid depletion and altered NEFA metabolism were highly prevalent and associated with acute and chronic growth-faltering in EED. The finding suggests that targeting early interventions to correct EFAD and promote FA absorption in children with EED may facilitate childhood growth in high-risk settings.