Background: Cardiometabolic disease is associated with chronic low-grade inflammation. While low birthweight, childhood stunting and rapid weight gain predict higher adult high-sensitivity C-reactive protein (hs-CRP) concentrations, associations between childhood infections and adulthood CRP are inconsistent.Aim: To assess the associations between sanitation, diarrhoea and a combined score of both from birth to age 2 years and hs-CRP at age 18 years, independently of early life nutrition and adult adiposity.Subjects and methods: This study collected data on sanitation and diarrhoea episodes from birth to 2 years on 756 participants of the Birth-to-Twenty Plus cohort, a birth cohort initiated in South Africa in 1990, and calculated a combined score of both variables. Anthropometry was measured at 2 years and 18 years and hs-CRP at 18 years.Results: Of the participants, 29.5% had no access to indoor flush sanitation and 38.2% experienced ≥1 diarrhoea episode between birth and 2 years. Not having access to indoor flush sanitation and experiencing ≥1 diarrhoea episodes were associated with 1.50 mg/L and 1.52 mg/L higher hs-CRP, respectively. Prevalence of both burdens in infancy was associated with a 2.18 mg/L higher hs-CRP.Conclusion: In this population, poor sanitation and diarrhoea in early life predict elevated CRP in young adulthood, independently of early life nutrition and adiposity.

中文翻译：

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18岁时的婴儿期卫生保健和腹泻和CRP水平：从出生到二十岁及以上人群。

背景：心脏代谢疾病与慢性低度炎症有关。低出生体重，儿童发育迟缓和体重快速增加预测成人高敏C反应蛋白（hs-CRP）浓度较高，但儿童感染与成年CRP之间的关联却不一致。目的：评估卫生，腹泻与综合性感染之间的关联受试者和方法：这项研究收集了756名受试者的从出生到2岁的卫生和腹泻发作数据，从出生到2岁，以及18岁时的hs-CRP得分。 “出生至二十岁以上”队列是1990年在南非发起的出生队列，计算了两个变量的综合得分。在2岁和18岁时进行人体测量，在18岁时进行hs-CRP测量。在参与者中，有29.5％的人无法获得室内冲洗卫生服务，而38.2％的人在出生至2岁之间经历了≥1的腹泻发作。无法获得室内冲洗卫生和出现≥1的腹泻发作分别与hs-CRP升高1.50 mg / L和1.52 mg / L有关。婴儿期这两种负担的患病率均与hs-CRP升高2.18 mg / L有关。结论：在这一人群中，较差的卫生条件和腹泻可预示着成年后CRP升高，与早期营养和肥胖无关。