Systemic inflammation, growth factors, and linear growth in the setting of infection and malnutrition
Systemic inflammation, growth factors, and linear growth in the setting of infection and malnutrition
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DOI：
10.1016/j.nut.2016.06.013
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发表时间：
2017-01-01
期刊：
影响因子：
4.4
通讯作者：
Guerrant, Richard L.
中科院分区：
文献类型：
--
作者：
DeBoer, Mark D.;Scharf, Rebecca J.;Guerrant, Richard L.
目标：在营养不良和反复感染常见的地区，儿童经常出现体重增加和线性生长不足的情况。尽管炎症和营养不良都会导致生长激素（GH）抵抗，但发展中地区感染、炎症和生长缺陷之间的相互关系仍不清楚。本研究的目的是评估巴西北部体重不足和正常体重儿童病例对照队列中低水平的全身炎症、生长因子和人体测量之间的关系。方法：我们评估了 147 名 6 至 24 个月儿童的数据，这些儿童是从巴西福塔雷萨贫困家庭营养诊所招募的，这些儿童在 MAL-ED（营养不良与肠道疾病的相互作用）病例对照研究中进行了评估。我们使用非参数检验和线性回归来评估当前感染症状（通过问卷评估）、全身炎症（通过高敏 C 反应蛋白 [hsCRP1 评估）、GH 胰岛素样生长因子 1 (IGF-1) 轴和人体测量指标之间的关系。所有模型均根据年龄和性别进行调整。结果：近期有腹泻、咳嗽和发烧症状的儿童（与无症状的儿童相比）hsCRP 水平较高；最近腹泻和发烧的人的 IGF-1 水平也较低，而 GH 水平较高。粪便髓过氧化物酶与血清hsCRP呈正相关。 hsCRP 反过来与 GH 呈正相关，与 IGF-1 和 IGF 结合蛋白 3 (IGFBP-3) 呈负相关，表明存在 GH 抵抗状态。调整 hsCRP 后，IGF-1 和 IGFBP-3 呈正相关，GH 与身高和体重的 Z 评分呈负相关。结论：感染和炎症与 GH 抵抗的证据相关，而 GH、IGF-1 和 IGFBP-3 水平与独立于 hsCRP 的生长指数相关。这些数据暗示了发展中地区儿童的感染、营养状况、生长激素轴和线性生长之间复杂的相互关系。 (C) 2016 年作者。由爱思唯尔公司出版
Objectives: Deficits in weight gain and linear growth are seen frequently among children in areas where malnutrition and recurrent infections are common. Although both inflammation and malnutrition can result in growth hormone (GH) resistance, the interrelationships of infection, inflammation, and growth deficits in developing areas remain unclear. The aim of this study was to evaluate relationships between low levels of systemic inflammation, growth factors, and anthropometry in a case-control cohort of underweight and normal weight children in northern Brazil.Methods: We evaluated data from 147 children ages 6 to 24 mo evaluated in the MAL-ED (Interactions of Malnutrition and Enteric Disease) case-control study following recruitment from a nutrition clinic for impoverished families in Fortaleza, Brazil. We used nonparametric tests and linear regression to evaluate relationships between current symptoms of infections (assessed by questionnaire), systemic inflammation (assessed by high-sensitivity C-reactive protein [hsCRP1), the GH insulin-like growth factor-1 (IGF-1) axis, and measures of anthropometry. All models were adjusted for age and sex.Results: Children with recent symptoms of diarrhea, cough, and fever (compared with those without symptoms) had higher hsCRP levels; those with recent diarrhea and fever also had lower IGF-1 and higher GH levels. Stool myeloperoxidase was positively associated with serum hsCRP. hsCRP was in turn positively associated with GH and negatively associated with IGF-1 and IGF-binding protein-3 (IGFBP-3), suggesting a state of GH resistance. After adjustment for hsCRP, IGF-1 and IGFBP-3 were positively and GH was negatively associated with Z scores for height and weight.Conclusions: Infection and inflammation were linked to evidence of GH resistance, whereas levels of GH, IGF-1, and IGFBP-3 were associated with growth indices independent of hsCRP. These data implicate complex interrelationships between infection, nutritional status, GH axis, and linear growth in children from a developing area. (C) 2016 The Authors. Published by Elsevier Inc.