Title |
Vitamin-D status is not a confounder of the relationship between zinc and diarrhoea: a study in 6–24-month-old underweight and normal-weight children of urban Bangladesh
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Published in |
European Journal of Clinical Nutrition, March 2016
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DOI | 10.1038/ejcn.2016.7 |
Pubmed ID | |
Authors |
A M S Ahmed, R J S Magalhaes, T Ahmed, K Z Long, MdI Hossain, M M Islam, M Mahfuz, S M A Gaffar, A Sharmeen, R Haque, R L Guerrant, W A Petri, A A Mamun |
Abstract |
The role of micronutrients particularly zinc in childhood diarrhoea is well established. Immunomodulatory functions of vitamin-D in diarrhoea and its role in the effect of other micronutrients are not well understood. This study aimed to investigate whether vitamin-D directly associated or confounded the association between other micronutrient status and diarrhoeal incidence and severity in 6-24-month underweight and normal-weight children in urban Bangladesh. Multivariable generalised estimating equations were used to estimate incidence rate ratios for incidence (Poisson) and severity (binomial) of diarrhoea on cohorts of 446 normal-weight and 466 underweight children. Outcomes of interest included incidence and severity of diarrhoea, measured daily during a follow-up period of 5 months. The exposure of interest was vitamin-D status at enrolment. Normal-weight and underweight children contributed 62 117 and 62 967 day observation, with 14.2 and 12.8 days/child/year of diarrhoea, respectively. None of the models showed significant associations of vitamin-D status with diarrhoeal morbidity. In the final model, zinc-insufficient normal-weight children had 1.3 times more days of diarrhoea than sufficient children (P<0.05). Again zinc insufficiency and mother's education (1-5 and >5 years) had 1.8 and 2.3 times more risk of severe diarrhoea. In underweight children, older age and female had 24-63 and 17% fewer days of diarrhoea and 52-54 and 31% fewer chances of severe diarrhoea. Vitamin-D status was not associated with incidence and severity of diarrhoea in study children. Role of zinc in diarrhoea was only evident in normal-weight children. Our findings demonstrate that vitamin-D is not a confounder of the relationship between zinc and diarrhoea.European Journal of Clinical Nutrition advance online publication, 9 March 2016; doi:10.1038/ejcn.2016.7. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
India | 2 | 50% |
Unknown | 2 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Practitioners (doctors, other healthcare professionals) | 3 | 75% |
Members of the public | 1 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 58 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 10 | 17% |
Student > Master | 9 | 16% |
Student > Ph. D. Student | 6 | 10% |
Student > Doctoral Student | 3 | 5% |
Student > Bachelor | 2 | 3% |
Other | 6 | 10% |
Unknown | 22 | 38% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 11 | 19% |
Nursing and Health Professions | 6 | 10% |
Social Sciences | 6 | 10% |
Agricultural and Biological Sciences | 2 | 3% |
Immunology and Microbiology | 2 | 3% |
Other | 8 | 14% |
Unknown | 23 | 40% |