ObjectiveDespite repeated public health interventions, anemia prevalence among children remains a concern. We use an evolutionary medicine perspective to examine the intestinal microbiome as a pathway underlying the efficacy of iron‐sulfate treatment. This study explores whether gut microbiota composition differs between anemic children who respond and do not respond to treatment at baseline and posttreatment and if specific microbiota taxa remain associated with response to iron supplementation after controlling for relevant inflammatory and pathogenic variables.MethodsData come from 49 pre‐school‐aged anemic children living in San Juan de Lurigancho, Lima, Peru. We tested for differences in alpha and beta diversity using QIIME 2 and performed differential abundance testing in DESeq2 in R. We ran multivariate regression models to assess associations between abundance of specific taxa and response while controlling for relevant variables in Stata 17.ResultsWhile we found no evidence for gut microbiota diversity associated with child response to iron treatment, we observed several differential abundance patterns between responders and non‐responders at both timepoints. Additionally, we present support for a nonzero relationship between lower relative abundance of Barnesiellaceae and response to iron supplementation in samples collected before and after treatment.ConclusionWhile larger studies and more specific approaches are needed to understand the relationship between microbes and anemia in an epidemiological context, this study suggests that investigating nutritional status and pathogen exposure is key to better understanding the gut microbiome and impact of iron fortification.

中文翻译：

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秘鲁儿童肠道微生物群组成和补铁效果

目的尽管不断采取公共卫生干预措施，但儿童贫血患病率仍然令人担忧。我们使用进化医学的视角来检查肠道微生物组作为硫酸铁治疗功效的潜在途径。本研究探讨了贫血儿童在基线和治疗后对治疗有反应和无反应的肠道微生物群组成是否存在差异，以及在控制相关炎症和致病变量后，特定微生物群分类群是否仍然与铁补充剂的反应相关。方法数据来自 49 个研究前居住在秘鲁利马圣胡安德卢里甘乔的学龄贫血儿童。我们使用 QIIME 2 测试了 alpha 和 beta 多样性的差异，并在 R 中的 DESeq2 中进行了差异丰度测试。我们运行多元回归模型来评估特定类群的丰度与响应之间的关联，同时控制 Stata 17 中的相关变量。结果虽然我们没有发现为了证明肠道微生物群多样性与儿童对铁治疗的反应相关，我们在两个时间点观察到有反应者和无反应者之间存在几种不同的丰度模式。此外，我们支持较低相对丰度之间的非零关系巴氏菌科以及治疗前后收集的样本中对补铁的反应。结论虽然需要更大规模的研究和更具体的方法来了解流行病学背景下微生物与贫血之间的关系，但本研究表明，调查营养状况和病原体暴露是更好地了解微生物与贫血之间关系的关键。肠道微生物组和铁强化的影响。