Jones Andrew D, Rukobo Sandra, Chasekwa Bernard, Mutasa Kuda, Ntozini Robert, Mbuya Mduduzi N N, Stoltzfus Rebecca J, Humphrey Jean H, Prendergast Andrew J
School of Public Health, University of Michigan, Ann Arbor, Michigan; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Division of Nutritional Sciences, Cornell University, Ithaca, New York; Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Paediatrics, Blizard Institute, Queen Mary University of London, London, United Kingdom
School of Public Health, University of Michigan, Ann Arbor, Michigan; Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Division of Nutritional Sciences, Cornell University, Ithaca, New York; Department of International Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Centre for Paediatrics, Blizard Institute, Queen Mary University of London, London, United Kingdom.
Am J Trop Med Hyg. 2015 Feb;92(2):463-70. doi: 10.4269/ajtmh.14-0448. Epub 2014 Dec 22.
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.
在发展中国家，频繁感染会导致儿童发育迟缓，但因果关系尚不确定。我们检验了一个假说，即并发疾病通过降低胰岛素样生长因子1（IGF-1）来抑制生长激素轴。在一个由202名未感染艾滋病毒的津巴布韦婴儿组成的出生队列中，我们分析了关于7天疾病回顾的数据，并在6周龄以及随后的3、6、12和18个月时，通过酶联免疫吸附测定法测量血浆白细胞介素-6、C反应蛋白、α-1-酸性糖蛋白和IGF-1。近期患急性病的儿童的IGF-1浓度低于健康儿童，并且在3至18个月的大多数时间点，IGF-1与炎症生物标志物呈负相关（P<0.05）。通过路径分析，我们发现咳嗽和发烧主要通过急性期反应对抑制IGF-1产生间接影响，而腹泻对IGF-1主要产生直接影响。因此，急性病可能通过直接和间接途径影响生长激素轴。
