Comparison of Skin Structural and Functional Parameters in Well-Nourished and Moderately Undernourished Infants

Betsy Hughes-Formella, Oliver Wunderlich, Ragna Williams, Josefina Fernández, Yun Zyong Kim, Walter Wigger-Alberti, Sophie Pecquet, Angus Moodycliffe, Betsy Hughes-Formella, Oliver Wunderlich, Ragna Williams, Josefina Fernández, Yun Zyong Kim, Walter Wigger-Alberti, Sophie Pecquet, Angus Moodycliffe

Abstract

Background: Little is known about the impact of nutrition on the development of skin structure and function in infants.

Methods: We investigated epidermal, dermal, and subcutis parameters of aged-matched well-nourished and moderately undernourished infants in this single-center, cross-sectional, noninterventional study using noninvasive methods (skin caliper, 20-MHz sonography, transepidermal water loss, skin pH, and corneometry). Plasma fatty acids were determined as an indicator of nutritional differences. 310 infants from different age groups, i.e., 1 week, 4 weeks, and 6, 9, 12, 24, and 36 months were included. Approximately half of each age group was well-nourished (WHO reference values weight-for-height/length Zscore: -0.75 ≤ Z ≤ 0.75) and the other half was moderately undernourished (-3 ≤ Z < -2).

Results: Structural maturational differences in the deeper dermis and subcutis regions of the skin and subtle functional changes in the epidermis were observed in moderately undernourished infants without notable clinical symptoms. Reduced skin barrier function or skin hydration were not observed in the undernourished infants, and skin pH shifted to more acidic values in this group.

Conclusion: These findings reveal a greater impact of moderate undernutrition on the development of the dermis and subcutis and suggest that critical epidermal functions such as skin barrier and pH are mostly maintained.

Keywords: Fatty acids; Functional skin parameters; Infant skin; Nutrition; Skin development; Skin barrier function; Structural skin parameters.

Conflict of interest statement

The authors state no conflicts of interest.

© 2019 The Author(s) Published by S. Karger AG, Basel.

Figures

Fig. 1
Fig. 1
Comparison of skin-fold thickness in well-nourished and undernourished infants in the 7 age groups. Values are shown as mean + SD. The number in each group is shown beneath the respective bar. *** p < 0.001.
Fig. 2
Fig. 2
Comparison of dermal thickness in well-nourished and undernourished infants in the 7 age groups. The values are shown as mean + SD. The number in each group is shown beneath the respective bar. * p < 0.05, ** p < 0.01, *** p < 0.001.
Fig. 3
Fig. 3
Comparison of TEWL values in well-nourished and undernourished infants in the 7 age groups. To enable a reliable measurement of TEWL in the infants, it was necessary to make the measurement interval as short as possible. The close-chambered device used allowed for cutting off the measurement at a target precision of 0.3 gm2/h standard deviation, a setting which led to a systematic overestimation of TEWL, but which was consistent across all groups. The values are shown as mean + SD. The number in each group is shown beneath the respective bar. * p < 0.05, ** p < 0.01
Fig. 4
Fig. 4
Comparison of skin pH in well-nourished and undernourished infants in the 7 age groups. The values are shown as mean + SD. The number in each group is shown beneath the respective bar. p < 0.05, ** p < 0.01, *** p < 0.001.

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