Kessler Marion, Kaul Aditya, Santos-Malavé Claritsa, Borkowsky William, Kessler Jason, Shah Bina
J Pediatr Endocrinol Metab. 2013;26(7-8):639-44. doi: 10.1515/jpem-2011-0464.
This study aims to describe the final adult height (FAH) and pubertal growth patterns in human immunodeficiency virus (HIV)-infected adolescents and to compare these to an age-matched population of seroreverting HIV-exposed, uninfected (HEU) adolescents. It further aims to evaluate the interplay of proinflammatory cytokines with insulin-like growth factor 1 (IGF-1), insulin-like growth factor binding protein 3 (IGFBP-3), and IGFBP-1 during the pubertal growth spurt.
HIV-infected (n=34) and HEU (n=12) adolescents who had achieved FAH were evaluated. Auxologic data, viral load, CD4+ T-lymphocyte (CD4) count, and the use of highly active antiretroviral therapy were obtained via a retrospective chart review. Serum interleukin (IL)-1α, IL-6, tumor necrosis factor (TNF)-α, IGFBP-1, IGFBP-3, and IGF-1 were assessed.
The mean FAH standard deviation score for the HIV-infected group was -0.78 (±1.1) compared to 0.05 (±0.78) for the HEU (p=0.034). There was a positive correlation between CD4 count and FAH (p=0.019). The mean age and magnitude of peak growth velocity (GV) was within normal limits. IL-1α, IL-6, TNF-α, IGFBP-3, and IGF-1 were not significantly correlated with HIV RNA or height. IGFBP-1 was detectable in 100% of poorly controlled HIV-infected patients and 25% of the HEU cohort (p=0.0003).
The FAH of HIV-infected patients was significantly shorter than that of HEU patients, and it positively correlated with CD4 count. Our cohort demonstrated normal timing and magnitude of peak GV during puberty.
本研究旨在描述人类免疫缺陷病毒（HIV）感染青少年的最终成人身高（FAH）和青春期生长模式，并将其与年龄匹配的血清学逆转的HIV暴露未感染（HEU）青少年群体进行比较。它还旨在评估促炎细胞因子在青春期生长突增期间与胰岛素样生长因子1（IGF-1）、胰岛素样生长因子结合蛋白3（IGFBP-3）和IGFBP-1之间的相互作用。
对已达到FAH的HIV感染青少年（n = 34）和HEU青少年（n = 12）进行评估。通过回顾性病历审查获取人体测量数据、病毒载量、CD4 + T淋巴细胞（CD4）计数以及高效抗逆转录病毒疗法的使用情况。评估血清白细胞介素（IL）-1α、IL-6、肿瘤坏死因子（TNF）-α、IGFBP-1、IGFBP-3和IGF-1。
HIV感染组的平均FAH标准差分数为-0.78（±1.1），而HEU组为0.05（±0.78）（p = 0.034）。CD4计数与FAH之间存在正相关（p = 0.019）。平均年龄和峰值生长速度（GV）幅度在正常范围内。IL-1α、IL-6、TNF-α、IGFBP-3和IGF-1与HIV RNA或身高无显著相关性。IGFBP-1在100%控制不佳的HIV感染患者和25%的HEU队列中可检测到（p = 0.0003）。
HIV感染患者的FAH明显短于HEU患者，且与CD4计数呈正相关。我们的队列显示青春期GV峰值的时间和幅度正常。
