TY - JOUR
T1 - Endocrine abnormalities and impaired growth in human immunodeficiency virus-infected children
AU - Chantry, Caroline J.
AU - Frederick, Margaret M.
AU - Meyer, William A.
AU - Handelsman, Edward
AU - Rich, Kenneth
AU - Paul, Mary E.
AU - Diaz, Clemente
AU - Cooper, Ellen R.
AU - Foca, Marc
AU - Adeniyi-Jones, Samuel K.
AU - Moye, Jack
PY - 2007/1
Y1 - 2007/1
N2 - 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.
AB - 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.
KW - Body composition
KW - Children
KW - Cortisol
KW - DHEA
KW - Growth
KW - Growth hormone
KW - HIV
KW - Insulin-like growth factor binding protein-3
KW - Thyroid
UR - http://www.scopus.com/inward/record.url?scp=33845992230&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33845992230&partnerID=8YFLogxK
U2 - 10.1097/01.inf.0000247131.76584.af
DO - 10.1097/01.inf.0000247131.76584.af
M3 - Article
C2 - 17195707
AN - SCOPUS:33845992230
SN - 0891-3668
VL - 26
SP - 53
EP - 60
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 1
ER -