{
  "abstract": "Introduction Malnutrition disorders are associated with an enteropathy characterised by villus blunting, secretory cell loss, and mucosal inflammation. To investigate the contribution of undernutrition to enteropathy we conducted a case-control study of patients with starvation due to benign oesophageal strictures, compared with non-malnourished community controls.Methods Fasting blood samples and duodenal biopsies were collected from 34 cases and 66 controls. Duodenal biopsies were evaluated by morphometry while circulating C-reactive protein and metabolic hormones were measured by ELISA or Luminex.Results Epithelial surface area was reduced in cases (median 323 (IQR 271,392) µm per 100 µm muscularis mucosae) compared to controls (448µm (IQR 384,516); p=0.0001) ( figure 1).Hormonal analysis showed lower median concentrations of C-peptide (0.36 ng/ml vs 0.7ng/ml; p=0.003), insulin (639 pg/ml vs 2037pg/ml; p=0.0001) and GLP-2 (0 ng/ml vs 2.3ng/ml: p=0.0063) in cases compared to controls. Cases also had higher glucagon (52.4pg/ml vs 36.6pg/ml p=0.0012) and secretin concentrations (24.4pg/ml vs 11.7pg/ml; p=0.009). Body mass index was correlated with C-peptide (ρ=0.39, p=0.002), insulin (ρ=0.48, p=0.0001) and glucagon (ρ= -0.28, p=0.03).Conclusions Starvation and malnutrition consequent upon oesophageal stricturing drives a further reduction in epithelial surface area, superimposed on environmental enteropathy. It is associated with abnormalities in secretion of pancreatic hormones and GLP-2 and may have implications for gut healing.Abstract FP50 Figure 1",
  "authors": [
    {
      "affiliations": [
        "Tropgan, Lusaka, Zambia"
      ],
      "name": "Paul Kelly"
    },
    {
      "affiliations": [
        "Tropgan, Lusaka, Zambia"
      ],
      "name": "Ellen Besa"
    }
  ],
  "title": "FP50 Malnutrition enteropathy: structural and hormonal changes associated with starvation in Zambian patients with oesophageal strictures",
  "uid": "5bb7a672-ff6c-5360-940e-e31cbeb7eb84"
}