Endocrine abnormalities and impaired growth in human immunodeficiency virus-infected children

Caroline J. Chantry, Margaret M. Frederick, William A. Meyer, Edward Handelsman, Kenneth Rich, Mary E. Paul, Clemente Diaz, Ellen R. Cooper, Marc Foca, Samuel K. Adeniyi-Jones, Jack Moye

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

OBJECTIVES: Identify endocrine differences between human immunodeficiency virus- (HIV) infected versus uninfected children and evaluate associations of growth and body composition with endocrine measures. STUDY DESIGN: Nested case-control study in 21 HIV-infected and 46 age- and sex-matched uninfected children in the Women and Infant Transmission Study. Plasma specimens from children between 2.5 to 7.0 years of age, taken during 3-4 visits, were tested for insulin-like growth factor binding protein-3 (IGFBP-3), cortisol, dehydroepiandrosterone (DHEA), growth hormone and thyroid studies. Longitudinal mixed and generalized estimating equation models compared group means and examined effects of endocrine measures on growth and body composition, respectively. RESULTS: HIV-infected children had lower IGFBP-3 than uninfected children (1.96 ± 0.09 mg/L versus 2.34 ± 0.06 mg/L, P < 0.001). In infected but not in uninfected children, IGFBP-3 values and DHEA:cortisol ratios were associated with weight- and body mass index-for-age z scores ([WAZ] P = 0.019, <.001 respectively, and [BMZ] P = 0.029, 0.038). DHEA concentration was associated with height-for-age z score (P = 0.049). CONCLUSIONS: In these HIV-infected children compared with their uninfected counterparts, IGFBP-3 concentration was different between groups. Infected children had multiple endocrine associations with growth and body composition not found in their uninfected peers. We hypothesize that in HIV-infected children, growth hormone resistance and shunting of precursors from adrenal androgen to cortisol production contributes to altered body composition and stunting.

Original languageEnglish (US)
Pages (from-to)53-60
Number of pages8
JournalPediatric Infectious Disease Journal
Volume26
Issue number1
DOIs
StatePublished - Jan 2007
Externally publishedYes

Keywords

  • Body composition
  • Children
  • Cortisol
  • DHEA
  • Growth
  • Growth hormone
  • HIV
  • Insulin-like growth factor binding protein-3
  • Thyroid

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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