TY - JOUR
T1 - Acute illness is associated with suppression of the growth hormone axis in Zimbabwean infants
AU - Jones, Andrew D.
AU - Rukobo, Sandra
AU - Chasekwa, Bernard
AU - Mutasa, Kuda
AU - Ntozini, Robert
AU - Mbuya, Mduduzi N.N.
AU - Stoltzfus, Rebecca J.
AU - Humphrey, Jean H.
AU - Prendergast, Andrew J.
N1 - Publisher Copyright:
Copyright © 2015 by The American Society of Tropical Medicine and Hygiene.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Frequent infections contribute to childhood stunting in developing countries but the causal pathways are uncertain. We tested the hypothesis that intercurrent illnesses suppress the growth hormone axis through reductions in insulin-like growth factor 1 (IGF-1). In a birth cohort of 202 HIV-unexposed Zimbabwean infants, we analyzed data on 7-day illness recall and measured plasma interleukin-6, C-reactive protein, alpha-1-acid glycoprotein, and IGF-1 by enzyme-linked immunosorbent assay, at age 6 weeks, and then 3, 6, 12, and 18 months. Children with recent acute illness had lower IGF-1 concentrations than healthy children and IGF-1 correlated inversely (P < 0.05) with inflammatory biomarkers at most time points between 3 and 18 months. Using path analysis, we showed that cough and fever had a predominantly indirect effect on suppressing IGF-1, through the acute-phase response, whereas diarrhea had a predominantly direct effect on IGF-1. Acute illness may therefore impact the growth hormone axis through both direct and indirect pathways.
AB - Frequent infections contribute to childhood stunting in developing countries but the causal pathways are uncertain. We tested the hypothesis that intercurrent illnesses suppress the growth hormone axis through reductions in insulin-like growth factor 1 (IGF-1). In a birth cohort of 202 HIV-unexposed Zimbabwean infants, we analyzed data on 7-day illness recall and measured plasma interleukin-6, C-reactive protein, alpha-1-acid glycoprotein, and IGF-1 by enzyme-linked immunosorbent assay, at age 6 weeks, and then 3, 6, 12, and 18 months. Children with recent acute illness had lower IGF-1 concentrations than healthy children and IGF-1 correlated inversely (P < 0.05) with inflammatory biomarkers at most time points between 3 and 18 months. Using path analysis, we showed that cough and fever had a predominantly indirect effect on suppressing IGF-1, through the acute-phase response, whereas diarrhea had a predominantly direct effect on IGF-1. Acute illness may therefore impact the growth hormone axis through both direct and indirect pathways.
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U2 - 10.4269/ajtmh.14-0448
DO - 10.4269/ajtmh.14-0448
M3 - Article
C2 - 25535308
AN - SCOPUS:84922281693
SN - 0002-9637
VL - 92
SP - 463
EP - 470
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 2
ER -