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

Ahmed, A. M. S., Magalhaes, R. J. S., Ahmed, T., Long, K. Z., Hossain, MdI, Islam, M. M., Mahfuz, M., Gaffar, S. M. A., Sharmeen, A., Haque, R., Guerrant, R. L., Petri Jr, W. A. and Mamun, A. A. (2016) 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. European Journal of Clinical Nutrition, 70 5: 620-628. doi:10.1038/ejcn.2016.7


Author Ahmed, A. M. S.
Magalhaes, R. J. S.
Ahmed, T.
Long, K. Z.
Hossain, MdI
Islam, M. M.
Mahfuz, M.
Gaffar, S. M. A.
Sharmeen, A.
Haque, R.
Guerrant, R. L.
Petri Jr, W. A.
Mamun, A. A.
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
Journal name European Journal of Clinical Nutrition   Check publisher's open access policy
ISSN 1476-5640
0954-3007
Publication date 2016-05-01
Year available 2016
Sub-type Article (original research)
DOI 10.1038/ejcn.2016.7
Open Access Status Not Open Access
Volume 70
Issue 5
Start page 620
End page 628
Total pages 9
Place of publication London, United Kingdom
Publisher Nature Publishing Group
Collection year 2017
Language eng
Formatted abstract
Background/Objective: 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.

Subjects/Methods: 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.

Results: 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.

Conclusion: 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.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

 
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