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Elevated acute-phase protein in stunted Nepali children reporting low morbidity : different rural and urban profiles.

Panter-Brick, C. and Lunn, P. G. and Baker, R. and Todd, A. (2001) 'Elevated acute-phase protein in stunted Nepali children reporting low morbidity : different rural and urban profiles.', British journal of nutrition., 85 (1). pp. 125-131.


This study examined the associations between severity of stunting, plasma protein concentrations and morbidity of 104 Nepali boys, aged 10±14 years, living in contrasting environments. Boys from a remote village were compared with three similarly aged urban groups: poor squatters, homeless street children, and middle-class schoolchildren. All but the middle-class group were stunted, particularly village boys whose mean height-for-age z-score (22´97, SD 0´82) indicates severe growth retardation. Stunting was significantly associated with increased plasma levels of the acute-phase protein a1-antichymotrypsin itself inversely related to plasma levels of albumin. Plasma ACT levels of village children (mean 1´52 g/l, SD 0´43) were three to four times higher than those of squatters and homeless street children, and five times higher than those of middle-class boys. Despite being the most severely stunted and having the most abnormal plasma protein values, village children reported the lowest burden of disease, a contradiction which may reflect exposure to sub-clinical infections or habituation to illness and low expectation of treatment. This study draws attention to the strikingly high levels of ACT and of stunting in the rural sample, and cautions on the use of uncorroborated morbidity reports across different epidemiological and socio-ecological environments. Possible mechanisms to explain the impact of illness and inflammation on growth faltering are discussed.

Item Type:Article
Keywords:Child growth, Growth failure, Nutritional status, Acute-phase proteins.
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Publisher statement:© The Nutrition Society 2001
Record Created:23 May 2008
Last Modified:26 Aug 2011 16:52

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