Overnutrition in Infants Is Associated With High Level of Leptin, Viral Coinfection and Increased Severity of Respiratory Infections: A Cross-Sectional Study

Abstract

Objective: To investigate the relationship of overnutrition (obese and overweight) with severity of illness in children hospitalized with acute lower respiratory infections (ALRIs), frequency of viral coinfections and leptin levels.Methods: We studied 124 children <2 years old that were hospitalized for ALRI. Nutritional status was calculated by z-scores according to weight-for-age z-scores, length or height-for-age z-scores, and weight-for-height z-scores. Nasopharyngeal aspirates (NPAs) were obtained and viral respiratory pathogens were identified using reverse transcription polymerase chain reactions (RT-PCR). Respiratory syncytial virus (RSV) load was assessed using quantitative RT-PCR. NPA and plasma leptin level were measured. Clinical data and nutritional status were recorded, and patients were followed up until hospital discharge. Viral coinfection was defined as the presence of two or more viruses detected in the same respiratory sample. Severity of illness was determined by length of hospitalization and duration of oxygen therapy.Results: Children with overnutrition showed a greater frequency of viral coinfection than those with normal weight (71% obese vs. 37% normal weight p = 0.013; 68% overweight vs. 37% normal weight p = 0.004). A lower RSV load was found in obese (5.91 log 10 copies/mL) and overweight children (6.49 log 10 copies/mL) compared to normal weight children (8.06 log 10 copies/mL; p = 0.021 in both cases). In multivariate analysis, obese, and overweight infants <6 months old were associated with longer hospital stays (RR = 1.68; CI: 1.30-2.15 and obese: RR = 1.68; CI: 1.01-2.71, respectively) as well as a greater duration of oxygen therapy (RR = 1.80; IC: 1.41-2.29 and obese: RR = 1.91; CI: 1.15-3.15, respectively). Obese children <6 months showed higher plasma leptin level than normal weight children (7.58 vs. 5.12 ng/µl; p < 0.046).Conclusions: In infants younger than 6 months, overnutrition condition was related to increased severity of infections and high plasma leptin level. Also, children with Arias-Bravo et al.Overnutrition Aggravates Childhood Respiratory Infections overnutrition showed a greater frequency of viral coinfection and low RSV viral load compared to normal weights children. These findings further contribute to the already existent evidence supporting the importance of overnutrition prevention in pediatric populations.

Overnutrition, Nasopharyngeal Pathogenic Bacteria and Proinflammatory Cytokines in Infants with Viral Lower Respiratory Tract Infections

“…Detection of RSV alone was more frequent in children with normal weight (24.1%) than in those with overnutrition (10.3%; Figure 1). Moreover, RSV viral loads were higher in children with normal weight (8.06 log10 copies/mL) as compared to overweight (6.49 log10 copies/mL) and obese children (5.91 log10 copies/mL; p = 0.02), as previously reported [1].…”

“…We included 116 previously healthy infants and young children hospitalized with viral LRTI that were enrolled as part of a cross-sectional study [ 1 ] conducted during two consecutive respiratory seasons (from May 2016 to August 2017). Children were included if they were <24 months old and hospitalized for viral LRTI, including bronchiolitis, bronchitis, or pneumonia, at two medical centers in Santiago, Chile: Urgencia Materno-Infantil at Clínica Dávila and Dr. Exequiel González Cortés Hospital.…”

“…Studies have shown that viral coinfections in children hospitalized for lower respiratory tract infections (LRTI) are more common in children with overnutrition, suggesting that overnutrition could influence the respiratory viral profile identified in the nasopharynx of these children [ 1 ]. In adults, the mouth, nose, and lung microbiota along with the serum proinflammatory cytokine profiles have proven to be altered in those with obesity [ 2 ].…”

“…For continuous data, a Kruskal-Wallis test followed by a Dunn's test, with Bonferroni correction, were conducted for multiple pairwise comparisons among groups. For categorical data, a chi-square test was performed for comparisons among groups 1. : Normal weight versus overweight; 2 : Overweight versus obese.…”

Alteration of Endogenous Fatty Acids Profile and Lipid Metabolism in Rats Caused by a High‐Colleseed Oil and a High‐Sunflower Oil Diet

“…In addition, adipose tissue has recently been found to play an important role in fat metabolism as an endocrine organ [ 20 ] through the secretion of adipokines, including adiponectin (ADPN). [ 21 ] ADPN signaling is triggered by ADPN binding to either of the two ADPN receptors (Adipo‐R1 or Adipo‐R2, abundantly expressed in muscle and liver, respectively).…”