ArticleHealth science reports2026
Structural and Hormonal Changes Associated With Starvation in Zambian Adult Patients With Esophageal Strictures: A Cross-Sectional Study.
Article in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Malnutrition disorders are associated with an enteropathy characterized by villus blunting, secretory cell loss, and mucosal inflammation. To investigate the contribution of undernutrition to enteropathy we conducted a case-control study of adult patients with starvation due to benign esophageal 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 hormones were measured by ELISA or Luminex. Multivariable models were adjusted for stricture, body mass index, HIV, and C-reactive protein. Results: Epithelial surface area was reduced in cases (median 323 μm (IQR 271, 392) per 100 μm muscularis mucosae) compared to controls (448 μm (IQR 384, 516); Conclusion: Starvation and malnutrition consequent upon esophageal stricturing drives a further reduction in epithelial surface area, superimposed on environmental enteropathy. There was some evidence of abnormalities in secretion of pancreatic hormones and GLP-2.
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