Environmental enteropathy is associated with cardiometabolic risk factors in Peruvian children

G. O. Lee, M. Paredes Olortegui, M. Siguas Salas, P. Peñataro Yori, D. Rengifo Trigoso, P. Kosek, M. L. Mispireta, R. Oberhelman, L. E. Caulfield, M. N. Kosek

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Environmental enteropathy (EE) is a syndrome of altered small intestine structure and function hypothesized to be common among individuals lacking access to improved water and sanitation. There are plausible biological mechanisms, both inflammatory and non-inflammatory, by which EE may alter the cardiometabolic profile. Here, we test the hypothesis that EE is associated with the cardiometabolic profile among young children living in an environment of intense enteropathogen exposure. In total, 156 children participating in the Peruvian cohort of a multicenter study on childhood infectious diseases, growth and development were contacted at 3-5 years of age. The urinary lactulose:mannitol ratio, and plasma antibody to endotoxin core were determined in order to assess intestinal permeability and bacterial translocation. Blood pressure, anthropometry, fasting plasma glucose, insulin, and cholesterol and apolipoprotein profiles were also assessed. Extant cohort data were also used to relate biomarkers of EE during the first 18 months of life to early child cardiometabolic profile. Lower intestinal surface area, as assessed by percent mannitol excretion, was associated with lower apolipoprotein-AI and lower high-density lipoprotein concentrations. Lower intestinal surface area was also associated with greater blood pressure. Inflammation at 7 months of age was associated with higher blood pressure in later childhood. This study supports the potential for a relationship between EE and the cardiometabolic profile.

Original languageEnglish (US)
Pages (from-to)337-348
Number of pages12
JournalJournal of Developmental Origins of Health and Disease
Issue number3
StatePublished - Jun 1 2017


  • Cardiovascular risk
  • Environmental enteropathy
  • Peru

ASJC Scopus subject areas

  • Medicine (miscellaneous)


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