Editors' ChoiceMalnutrition

REG1B: A Marker of Childhood Stunting

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Science Translational Medicine  07 Aug 2013:
Vol. 5, Issue 197, pp. 197ec130
DOI: 10.1126/scitranslmed.3007132

Various indicators of global health have improved over the years, but childhood malnutrition and, particularly, stunting (decreased linear growth) remain a widespread problem. Intestinal disease, also known as gut enteropathy, is thought to be a major contributing factor for childhood stunting. The development of noninvasive biomarkers of gut enteropathy would help identify children who are at risk of stunting and prevent this problem by allowing nutritional interventions early in life.

Peterson et al. conducted a study to determine whether higher concentrations of regenerating gene 1 (REG1) protein in stool early in life correlate with later growth deficits. REG1 proteins were previously observed to be involved in cell growth, tissue repair, and regeneration. The authors of the current study hypothesized that higher concentrations of REG1 protein in stool early in life may predict future stunting. The authors evaluated this hypothesis by using a stool enzyme-linked immunosorbent assay (ELISA) to test for REG1B among birth cohorts in two countries, Bangladesh and Peru. Two hundred twenty-two children from Bangladesh and 97 children from Peru were followed from birth up to the age of 24 months, and anthropometric measures were carried out every 3 months. Stool REG1B protein concentrations were measured with a REG1B polyclonal-polyclonal ELISA at 3 months to evaluate for associations between stool REG1B and future reduced growth.

In the Bangladeshi cohort, higher REG1B concentrations at 3 months were independently associated with stunting at 9 through 24 months in a linear regression model. For the Peruvian children, the association was significant at months 12 through 18. Using a mixed model based on repeated measurements, higher stool REG1B concentrations at 3 months were found to be an independent predictor of future stunting at the age of 12 months for both Bangladeshi and Peruvian children.

The emergence of stool REG1B concentration as a significant predictor of stunting may be useful for providing early interventions to prevent stunting in at-risk children. The involvement of REG1B is also consistent with a role for gut enteropathy in the stunting phenomenon. It is, however, possible that the antibody to REG1B may cross-react with REG1A protein, or that a confounding effect may be present in the analysis. Thus, additional work will be necessary to confirm these findings and implement them in clinical care.

K. M. Peterson et al., REG1B as a predictor of childhood stunting in Bangladesh and Peru. Am. J. Clin. Nutr. 97, 1129–1133 (2013). [Abstract]

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