Serum n-6 Fatty Acids are Positively Associated with Growth in 6-to-10-Year Old Ugandan Children Regardless of HIV Status—A Cross-Sectional Study

Abstract

Fatty acids (FAs) are crucial in child growth and development. In Uganda, antiretroviral therapy (ART) has drastically reduced perinatal human immunodeficiency virus (HIV) infection of infants, however, the interplay of FAs, ART, and HIV in relation to child growth is not well understood. To investigate this, serum was collected from 240 children between 6–10 years old in Uganda and analyzed for FAs using gas-chromatography mass-spectrometry. HIV status and anthropometric measurements were taken, and relationships with FAs were assessed. No significant differences in growth parameters or serum FAs were found between HIV uninfected children with and without exposure to ART. HIV positive children had significantly lower height-for-age-z-scores (HAZ) than uninfected children (p < 0.001). HIV-positive children had higher arachidonic acid than uninfected children (p = 0.003). Total omega-6 FAs were significantly associated with HAZ regardless of HIV status (p = 0.035). Mean total omega-3 FAs (2.90%) were low in this population compared to other cohorts in Africa. These results provide reference serum FA values for 6–10-year-old children in Uganda and may be used to inform lipid supplementation programs to promote child growth. Future studies should investigate the relationships between child growth trajectories in relation to HIV status and serum FAs.

Association of serum PUFA and linear growth over 12 months among 6–10 years old Ugandan children with or without HIV

“…Three hundred and five Ugandan children (6-10 years old) with and without HIV infection were enrolled from the Kawaala Health Center (KHC) in Kawempe Division of Kampala, Uganda, as part of a 12-month prospective cohort study (20) . Of these, serum levels of PUFA were available for 237 children including perinatally acquired HIV infection (CPHIV, n 82), perinatally HIV exposed but uninfected (CHEU, n 76) and HIV unexposed uninfected (CHUU, n 78) community control children that constituted the study sample for this investigation.…”

“…Of the total samples shipped, 237 were analysable for FA. FA were extracted and methylated from serum as previously described (20) . A modified methylation described by Jenkins (2010) was conducted (22) .…”

“…MS transfer line and ion source temperature were set at 180°C. Quantification of FAME was conducted using internal standard and chromatographic peak area, and FA were reported as percent of total FA quantified as previously described (20) . A GC reference standard was created by combining Supelco 37 Component FAME Mix (Sigma-Aldrich) with Mead acid, docosatetraenoic acid, n-3 docosapentaenoic acid (DPA), n-6 DPA and palmitelaidic acid purchased from Cayman Chemical (Ann Arbor, MI).…”

“…Similarly, an inverse association was reported between growth and triene-to-tetraene (T/T) ratio (a metric indicative of EFAD) among children from Tanzania (18) , although this association was not confirmed in Ghanaian children (17,19) . Among Ugandan children with and without HIV infection or exposure (20) , we have reported inverse associations between T/T ratio and several growth parameters (HAZ, weight-for-age and BMI-for-age), but the prospective relationship between FA and child growth has not been specifically examined. The present study addresses this knowledge gap.…”

In utero and peripartum antiretroviral exposure as predictor of cognition in 6‐ to 10‐year‐old HIV‐exposed Ugandan children – a prospective cohort study

“…This unstable association of sdNVP ± ZDV with adaptive skills over 12 months beginning from age 6–10 years, if true, may suggest that sustaining the cognitive advantage of a beneficial exposure in the long term requires intentional efforts to optimize current biopsychosocial circumstances. Our team has recently reported on the importance of high‐quality nutrition [47,48] and stress [49,50] in relationship to cognition in this sample. With respect to stress, we found that SEA, QOL and psychosocial adjustment of CPHIV are comparable to CHEU and HUU peers in Uganda among children of caregivers who reported low psychosocial stress.…”