Pediatric Gastroenterology, Hepatology & Nutrition

  • 제26권6호
  • /
  • Pages.355-369
  • /
  • 2023
  • /
  • 2234-8646(pISSN)
  • /
  • 2234-8840(eISSN)
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)
권호 표지
DOI QR코드

DOI QR Code

Growth and Nutritional Biomarkers in Brazilian Infants with Cow's Milk Allergy at Diagnosis and 18-Month Follow-Up: A Prospective Cohort Study

  • 투고 : 2022.12.08
  • 심사 : 2023.08.03
  • 발행 : 2023.11.15
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Purpose: This study aimed to describe the growth, body protein status, and micronutrient biomarkers of Brazilian infants with cow's milk allergy (CMPA) at baseline and at 18 months of follow-up in comparison with their healthy peers. Methods: Thirty infants with CMPA younger than six months of age were included in this longitudinal study, and their nutritional status was compared with that of 24 non-allergic age-matched children. Anthropometric measurements were used to assess growth, and blood and urine samples were analyzed for protein and micronutrient status. Mixed linear models adjusted for birth weight, socioeconomic status, infant feeding at baseline, weight-for-age, C-reactive protein, serum albumin, micronutrient dietary supplementation, and salt consumption were employed to evaluate the evolution of nutritional parameters throughout the follow-up period. Results: Overall, the mean age of the children at enrolment was 2.9 (standard deviation 1.7) months, and 29 children (53.7%) were male. Infants with CMPA showed a higher prevalence of functional iron depletion (transferrin saturation <20) (p=0.027), lower serum ferritin (p=0.009), and lower urinary iodine (p=0.034) levels than non-allergic children at baseline. Patients with CMPA showed a higher increment in weight-for-age and length-for-age over time than those in the control group (p<0.01). Mixed linear analyses showed a significantly lower increase in serum vitamin B12 (s-B12) (p=0.001) and urinary iodine (p<0.001) concentrations over time compared to the control group. Conclusion: Infants with CMPA on a cow's milk elimination diet had a higher weight and length at 18 months of follow-up but showed signs of inadequate iron, iodine, and B-12 vitamin status.

키워드

과제정보

Financial support was received from Programa Pesquisa para o SUS (PPSUS)/ Fundacao de Apoio a Pesquisa e a Inovacao Tecnologica do Estado de Sergipe (FAPITEC/SE, Brazil).

참고문헌

  1. Flom JD, Sicherer SH. Epidemiology of cow's milk allergy. Nutrients 2019;11:1051.
  2. Goncalves LCP, Guimaraes TCP, Silva RM, Cheik MFA, de Ramos Napolis AC, Barbosa ESG, et al. Prevalence of food allergy in infants and pre-schoolers in Brazil. Allergol Immunopathol (Madr) 2016;44:497-503. https://doi.org/10.1016/j.aller.2016.04.009
  3. Meyer R. Nutritional disorders resulting from food allergy in children. Pediatr Allergy Immunol 2018;29:689-704. https://doi.org/10.1111/pai.12960
  4. Boaventura RM, Mendonca RB, Fonseca FA, Mallozi M, Souza FS, Sarni ROS. Nutritional status and food intake of children with cow's milk allergy. Allergol Immunopathol (Madr) 2019;47:544-50. https://doi.org/10.1016/j.aller.2019.03.003
  5. Medeiros LC, Speridiao PG, Sdepanian VL, Fagundes-Neto U, Morais MB. [Nutrient intake and nutritional status of children following a diet free from cow's milk and cow's milk by-products]. J Pediatr (Rio J) 2004;80:363-70. Portuguese. https://doi.org/10.2223/1220
  6. Vieira MC, Morais MB, Spolidoro JVN, Toporovski MS, Cardoso AL, Araujo GTB, et al. A survey on clinical presentation and nutritional status of infants with suspected cow' milk allergy. BMC Pediatr 2010;10:25.
  7. Meyer R, De Koker C, Dziubak R, Venter C, Dominguez-Ortega G, Cutts R, et al. Malnutrition in children with food allergies in the UK. J Hum Nutr Diet 2014;27:227-35. https://doi.org/10.1111/jhn.12149
  8. Berni Canani R, Leone L, D'Auria E, Riva E, Nocerino R, Ruotolo S, et al. The effects of dietary counseling on children with food allergy: a prospective, multicenter intervention study. J Acad Nutr Diet 2014;114:1432-9. https://doi.org/10.1016/j.jand.2014.03.018
  9. Dong P, Feng JJ, Yan DY, Lyu YJ, Xu X. Children with cow's milk allergy following an elimination diet had normal growth but relatively low plasma leptin at age two. Acta Paediatr 2018;107:1247-52. https://doi.org/10.1111/apa.14283
  10. Paganus A, Juntunen-Backman K, Savilahti E. Follow-up of nutritional status and dietary survey in children with cow's milk allergy. Acta Paediatr 1992;81:518-21. https://doi.org/10.1111/j.1651-2227.1992.tb12286.x
  11. Vandenplas Y, Dupont C, Eigenmann P, Heine RG, Host A, Jarvi A, et al. Growth in infants with cow's milk protein allergy fed an amino acid-based formula. Pediatr Gastroenterol Hepatol Nutr 2021;24:392-402. https://doi.org/10.5223/pghn.2021.24.4.392
  12. Setiabudiawan B, Sitaresmi MN, Sapartini G, Sumadiono , Citraresmi E, Sekartini R, et al. Growth patterns of indonesian infants with cow's milk allergy and fed with soy-based infant formula. Pediatr Gastroenterol Hepatol Nutr 2021;24:316-24. https://doi.org/10.5223/pghn.2021.24.3.316
  13. Kvammen JA, Thomassen RA, Eskerud MB, Rugtveit J, Henriksen C. Micronutrient status and nutritional intake in 0- to 2-year-old children consuming a cows' milk exclusion diet. J Pediatr Gastroenterol Nutr 2018;66:831-7. https://doi.org/10.1097/MPG.0000000000001942
  14. Thomassen RA, Kvammen JA, Eskerud MB, Juliusson PB, Henriksen C, Rugtveit J. Iodine status and growth in 0-2-year-old infants with cow's milk protein allergy. J Pediatr Gastroenterol Nutr 2017;64:806-11. https://doi.org/10.1097/MPG.0000000000001434
  15. Luyt D, Ball H, Makwana N, Green MR, Bravin K, Nasser SM, et al. BSACI guideline for the diagnosis and management of cow's milk allergy. Clin Exp Allergy 2014;44:642-72. https://doi.org/10.1111/cea.12302
  16. Venter C, Brown T, Meyer R, Walsh J, Shah N, Nowak-Wegrzyn A, et al. Better recognition, diagnosis and management of non-IgE-mediated cow's milk allergy in infancy: iMAP-an international interpretation of the MAP (Milk Allergy in Primary Care) guideline. Clin Transl Allergy 2017;7:26.
  17. Sampson HA, Gerth van Wijk R, Bindslev-Jensen C, Sicherer S, Teuber SS, Burks AW, et al. Standardizing double-blind, placebo-controlled oral food challenges: American Academy of Allergy, Asthma & Immunology-European Academy of Allergy and Clinical Immunology PRACTALL consensus report. J Allergy Clin Immunol 2012;130:1260-74. https://doi.org/10.1016/j.jaci.2012.10.017
  18. Franco JM, Pinheiro A, Vieira SCF, Barreto IDC, Gurgel RQ, Cocco RR, et al. Accuracy of serum IgE concentrations and papule diameter in the diagnosis of cow's milk allergy. J Pediatr (Rio J) 2018;94:279-85. https://doi.org/10.1016/j.jped.2017.06.022
  19. Pilli L, Ambrosio B, Suzzara B, Pontes L, Reis M, Yamakawa P, et al. Criterio de classificacao economica Brasil [Internet]. Associacao Brasileira de Empresas de Pesquisa; 2023 [cited 2023 Mar]. Available from: https://d1wqtxts1xzle7.cloudfront.net/48356646/CCE-libre.pdf ?1472304094=&response-content-disposition=inline%3B+filename%3DABEP_Associacao_Brasileira.pdf&Expires=1696929221&Signature=gHif2~KsE7QYK1cNoU0Udt-r7g1KOCrBmN~Ji7a9khD3NwWKBL0cFtrADURnKyvBNM1J3273aAHg07NyA3NLhGNdGfey-nggmMcFCfycjQFFOYcAyclRxQKP8bcuyAWVQU4VNFs41QIbE6FNeUs1yFV96IpScul1fOK9ROCOqi1HU4CcrHAEWKO~8~R3tXyPRXb1dmdQe56~K5Kwy5-D-IEflpSk9iLOHAht5zXUX~aHCWo9BJQhWBCNMir3sX0JjYDxfEQ70qvUkn5uu~IdtYhxUTyQq1sxkNJokpRqM44DB74KM~WP7ZHqFIXv~iRfTClnTsPUXirMY2FdX5u5rw__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA.
  20. World Health Organization (WHO). Expert Committee on Physical status: the use and interpretation of anthropometry. World Health Organization; 1995.
  21. WHO Multicentre Growth Reference Study Group, and Mercedes de Onis. WHO Child Growth Standards based on length/height, weight and age. Acta Paediatr Suppl 2006;95:76-85. https://doi.org/10.1111/j.1651-2227.2006.tb02378.x
  22. Harrington DJ. Laboratory assessment of vitamin B12 status. J Clin Pathol 2017;70:168-73. https://doi.org/10.1136/jclinpath-2015-203502
  23. Sarni ROS, Mattos AP, Brasil ALD, de Almeida CAN, de Mello ED, Lopez FA, et al. Anemia carencial ferropriva. Sociedade Brasileira de Pediatria, 2007.
  24. Mori JD, de Souza FIS, Munekata RV, Fonseca FLA, Sarni ROS. Deficiencia de vitamina D em criancas e adolescentes obesos. Rev Bras Nutr Clin 2015;30:116-9.
  25. Weffort VRS, Escrivao MAMS, Oliveira FLC, Rocha HF, de Mello ED, de Mattos AP, et al. Manual de orientacao para a alimentacao do lactente, do pre-escolar, do escolar, do adolescente e na escola. 2nd ed. Sociedade Brasileira de Pediatria, 2012. p. 148.
  26. Stabler SP. Vitamin B12 deficiency. N Engl J Med 2013;368:2041-2. https://doi.org/10.1056/NEJMcp1113996
  27. Akcaboy M, Malbora B, Zorlu P, Altinel E, Oguz MM, Senel S. Vitamin B12 deficiency in infants. Indian J Pediatr 2015;82:619-24. https://doi.org/10.1007/s12098-015-1725-3
  28. Garcia CP, Cardoso AL, Carneiro JDA, Macedo ACL. Deficiencia de vitamina B12 em lactente alimentado com leite materno. Rev Bras Nutr Clin 2009;25:264-6.
  29. Machin D, Campbell MJ, Tan SB, Tan SH. Sample sizes for clinical, laboratory and epidemiology studies. 4th ed. John Wiley & Sons, 2018.
  30. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods 2009;41:1149-60. https://doi.org/10.3758/BRM.41.4.1149
  31. Lovakov A, Agadullina ER. Empirically derived guidelines for effect size interpretation in social psychology. Eur J Soc Psychol 2021;51:485-504. https://doi.org/10.1002/ejsp.2752
  32. Christie L, Hine RJ, Parker JG, Burks W. Food allergies in children affect nutrient intake and growth. J Am Diet Assoc 2002;102:1648-51. https://doi.org/10.1016/S0002-8223(02)90351-2
  33. Joint FAO; World Health Organization. Protein and amino acid requirements in human nutrition: report of a joint FAO/WHO/UNU expert consultation. World Health Organization, 2007.
  34. Trakulpark C, Densupsoontorn N. Twelve-month growth and accession of tolerance in infants with cow's milk protein allergy compared among those fed with breast milk or alternative formulae. Asian Pac J Allergy Immunol 2021. doi: 10.12932/AP-300720-0933 [Epub ahead of print].
  35. Dror DK, Allen LH. Vitamin B12 in human milk: a systematic review. Adv Nutr 2018;9(suppl_1):358S-66S. https://doi.org/10.1093/advances/nmx019
  36. de Orcamentos Familiares. IBGE Pesquisa. Familiares 2017-2018: Analise do Consumo Alimentar Pessoal no Brasil. IBGE. Pesquisa de orcamentos familiares 2017-2018: analise do consumo alimentar pessoal no Brasil. Rio de Janeiro: IBGE, Coordenacao de Trabalho e Rendimento; 2020.
  37. Khusun H, Februhartanty J, Anggraini R, Mognard E, Alem Y, Noor MI, et al. Animal and plant protein food sources in Indonesia differ across socio-demographic groups: Socio-Cultural Research in Protein Transition in Indonesia and Malaysia. Front Nutr 2022;9:762459.
  38. Karademir F, Suleymanoglu S, Ersen A, Aydinoz S, Gultepe M, Meral C, et al. Vitamin B12, folate, homocysteine and urinary methylmalonic acid levels in infants. J Int Med Res 2007;35:384-8. https://doi.org/10.1177/147323000703500313
  39. Dror DK, Allen LH. Effect of vitamin B12 deficiency on neurodevelopment in infants: current knowledge and possible mechanisms. Nutr Rev 2008;66:250-5. https://doi.org/10.1111/j.1753-4887.2008.00031.x
  40. Ulak M, Chandyo RK, Thorne-Lyman AL, Henjum S, Ueland PM, Midttun O, et al. Vitamin Status among Breastfed Infants in Bhaktapur, Nepal. Nutrients 2016;8:149.
  41. Serin HM, Arslan EA. Neurological symptoms of vitamin B12 deficiency: analysis of pediatric patients. Acta Clin Croat 2019;58:295-302.
  42. Przybylowski P, Wasilewski G, Golabek K, Bachorzewska-Gajewska H, Dobrzycki S, Koc-Zorawska E, et al. Absolute and functional iron deficiency is a common finding in patients with heart failure and after heart transplantation. Transplant Proc 2016;48:173-6. https://doi.org/10.1016/j.transproceed.2015.12.023
  43. Weffort VRS, Maranhao HS, Mello ED, barreto JR, Fisberg M, Moretzsohn MA, et al. Manual de Avaliacao Nutricional da crianca e do adolescente. Sociedade Brasileira de Pediatria, 2021.
  44. Lai FP, Yang YJ. The prevalence and characteristics of cow's milk protein allergy in infants and young children with iron deficiency anemia. Pediatr Neonatol 2018;59:48-52. https://doi.org/10.1016/j.pedneo.2017.01.004
  45. Jarvinen KM, Konstantinou GN, Pilapil M, Arrieta MC, Noone S, Sampson HA, et al. Intestinal permeability in children with food allergy on specific elimination diets. Pediatr Allergy Immunol 2013;24:589-95. https://doi.org/10.1111/pai.12106
  46. Balasundaram P, Avulakunta ID. Human growth and development [Internet]. StatPearls Publishing; 2023 Jan [cited 2023 Mar 8]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK567767/
  47. Venter C, O'Mahony L. Immunonutrition: The importance of a new European Academy of Allergy and Clinical Immunology working group addressing a significant burden and unmet need. Allergy 2021;76:2303-5.
  48. Domellof M, Braegger C, Campoy C, Colomb V, Decsi T, Fewtrell M, et al. Iron requirements of infants and toddlers. J Pediatr Gastroenterol Nutr 2014;58:119-29. https://doi.org/10.1097/MPG.0000000000000206
  49. Nowak S, Wang H, Schmidt B, Jarvinen KM. Vitamin D and iron status in children with food allergy. Ann Allergy Asthma Immunol 2021;127:57-63. https://doi.org/10.1016/j.anai.2021.02.027
  50. Carvalho CN, Miranda VMM, Fontoura MSH, Fonseca SF, Acosta AX. (coordenadores e editores). Manual de condutas medicas. In: Brandao C, ed. Intervalos de referencia (normalidade) para testes laboratoriais em pediatria. Universidade Federal da Bahia, 2005:114-7.
  51. Bjorke-Monsen AL, Torsvik I, Saetran H, Markestad T, Ueland PM. Common metabolic profile in infants indicating impaired cobalamin status responds to cobalamin supplementation. Pediatrics 2008;122:83-91. https://doi.org/10.1542/peds.2007-2716
  52. de Benoist B. Conclusions of a WHO Technical Consultation on folate and vitamin B12 deficiencies. Food Nutr Bull 2008;29(2 Suppl):S238-44. https://doi.org/10.1177/15648265080292S129
  53. Braegger C, Campoy C, Colomb V, Decsi T, Domellof M, Fewtrell M, et al. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr 2013;56:692-701. https://doi.org/10.1097/MPG.0b013e31828f3c05
  54. Andersson M, de Benoist B, Delange F, Zupan J Prevention and control of iodine deficiency in pregnant and lactating women and in children less than 2-years-old: conclusions and recommendations of the Technical Consultation. Public Health Nutr 2007;10:1606-11. https://doi.org/10.1017/S1368980007361004
  55. Morkbak AL, Poulsen SS, Nexo E. Haptocorrin in humans. Clin Chem Lab Med 2007;45:1751-9. https://doi.org/10.1515/CCLM.2007.343
  56. Monsen AL, Refsum H, Markestad T, Ueland PM. Cobalamin status and its biochemical markers methylmalonic acid and homocysteine in different age groups from 4 days to 19 years. Clin Chem 2003;49:2067-75. https://doi.org/10.1373/clinchem.2003.019869
  57. Calixto-Lima L, Reis NT. Interpretacao de exames laboratoriais aplicados a nutricao clinica. Editora Rubio, 2012.