Ahmed S F, Farquharson C, McGrogan P, Russell R K
Royal Hospital for Sick Children, University of Glasgow, Glasgow, UK.
World Rev Nutr Diet. 2013;106:142-8. doi: 10.1159/000342529. Epub 2013 Feb 11.
Many children with a variety of chronic diseases suffer from a variable component of chronic inflammation and often have co-existing growth retardation. The aetiology of this growth retardation may be multifactorial and in a condition such as inflammatory bowel disease it includes the effects of the disease on nutrition as well as the effect of drugs such as glucocorticoids. Growth is primarily regulated through the endocrine and paracrine component of the GH/IGF-1 axis which may be modulated by other factors such as sex steroids. There is increasing evidence that this axis may be affected in children with chronic inflammation. An improved understanding of the GH/IGF-1 axis and how it is affected in chronic inflammation will lead to an improved rationale for developing therapeutic regimens that can improve growth in those children whose growth does not improve despite optimal management of the disease. This review will illustrate these aspects by concentrating primarily on the pathophysiology of growth retardation in inflammatory bowel disease and possible interventions for improving growth.
许多患有各种慢性疾病的儿童都患有程度不一的慢性炎症，并且常常伴有生长发育迟缓。这种生长发育迟缓的病因可能是多因素的，在诸如炎症性肠病等病症中，其病因包括疾病对营养的影响以及糖皮质激素等药物的影响。生长主要通过生长激素/胰岛素样生长因子-1（GH/IGF-1）轴的内分泌和旁分泌成分进行调节，而这一轴可能会受到其他因素（如性类固醇）的调节。越来越多的证据表明，患有慢性炎症的儿童的这一轴可能会受到影响。更好地了解GH/IGF-1轴以及它在慢性炎症中是如何受到影响的，将为制定治疗方案提供更合理的依据，这些治疗方案可以促进那些尽管疾病得到了最佳管理但生长仍未改善的儿童的生长。本综述将主要通过关注炎症性肠病中生长发育迟缓的病理生理学以及改善生长的可能干预措施来说明这些方面。
