Deuterium dilution technique for body composition assessment: resolving methodological issues in children with moderate acute malnutrition

Childhood malnutrition is highly prevalent and associated with high mortality risk. In observational and interventional studies among malnourished children, body composition is increasingly recognised as a key outcome. The deuterium dilution technique has generated high-quality data on body composition in studies of infants and young children in several settings, but its feasibility and accuracy in children suffering from moderate acute malnutrition requires further study. Prior to a large nutritional intervention trial among children with moderate acute malnutrition, we conducted pilot work to develop and adapt the deuterium dilution technique. We refined procedures for administration of isotope doses and collection of saliva. Furthermore, we established that equilibration time in local context is 3 h. These findings and the resulting standard operating procedures are important to improve data quality when using the deuterium dilution technique in malnutrition studies in field conditions, and may encourage a wider use of isotope techniques.

儿童营养不良的患病率极高，且与较高的死亡风险密切相关。在针对营养不良儿童的观察性与干预性研究中，身体成分已日益被视为核心结局指标。氘稀释技术（deuterium dilution technique）已在多场景下的婴幼儿身体成分研究中产出高质量数据，但该技术在中度急性营养不良（moderate acute malnutrition）儿童群体中的可行性与准确性，仍需进一步研究验证。在开展针对中度急性营养不良儿童的大型营养干预试验前，我们启动了试点研究以开发并适配氘稀释技术。我们优化了同位素剂量给药与唾液样本采集的操作流程，同时明确了本地研究场景下的同位素平衡时长为3小时。上述研究结果与据此制定的标准操作流程，对于在现场条件下开展营养不良相关研究并应用氘稀释技术以提升数据质量具有重要意义，同时有望推动同位素技术的更广泛应用。