Correlation between the components of the insulin-like growth factor I system, nutritional status and visceral...

Area of Science:

• Endocrinology
• Infectious Diseases
• Pediatrics

Background:

• The insulin-like growth factor I (IGF-I) system plays a crucial role in growth and development.
• Visceral leishmaniasis (VL) is an endemic parasitic disease affecting children, potentially impacting growth.
• Nutritional status is a known determinant of growth in pediatric populations.

Purpose of the Study:

• To investigate the relationship between the IGF-I system, nutritional status, and visceral leishmaniasis in Brazilian children.
• To determine if IGF-I system alterations or nutritional deficits are primary drivers of growth retardation in active VL.

Main Methods:

• Serum concentrations of growth hormone (GH), total and free IGF-I, and IGF binding-protein 3 (IGFBP3) were measured in 241 children using radioimmunoassay.
• Nutritional status was assessed through anthropometric indicators (weight-for-age Z, height-for-age Z scores) and biochemical markers (albumin).
• Statistical analyses, including multiple discriminant analysis, were employed to identify predictors of active and oligosymptomatic VL.

Main Results:

• Children with active VL exhibited significantly reduced serum concentrations of total and free IGF-I and IGFBP3 compared to uninfected children.
• Height-for-age Z scores, weight-for-age Z scores, and albumin levels were significantly lower in the active VL group.
• Albumin and height-for-age Z scores were identified as significant predictors for active and oligosymptomatic VL.

Conclusions:

• Active VL is associated with significant reductions in the IGF-I system components and nutritional status indicators.
• Growth retardation in children with active VL appears to be primarily driven by intrinsic factors of the disease, which may secondarily affect the GH/IGF axis.
• The study suggests that VL itself, rather than isolated IGF-I or IGFBP3 deficiency, is the main cause of impaired growth in affected children.