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Acute illness is associated with suppression of the growth hormone axis in Zimbabwean infants

Andrew D Jones1, Sandra Rukobo2, Bernard Chasekwa2

  • 1School 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 jonesand@umich.edu.

The American Journal of Tropical Medicine and Hygiene
|December 24, 2014
PubMed

Insights

Frequent infections in developing countries can stunt child growth. This study found that illnesses like cough, fever, and diarrhea reduce insulin-like growth factor 1 (IGF-1), impacting the growth hormone axis.

Area of Science:

  • Pediatric endocrinology
  • Infectious disease epidemiology
  • Global child health

Background:

  • Childhood stunting in developing nations is a significant public health issue.
  • The precise mechanisms linking frequent infections to stunting remain unclear.
  • The growth hormone axis, particularly insulin-like growth factor 1 (IGF-1), is crucial for child growth.

Purpose of the Study:

  • To investigate the hypothesis that intercurrent illnesses suppress the growth hormone axis via reduced IGF-1.
  • To explore the relationship between acute illnesses, inflammatory markers, and IGF-1 levels in infants.

Main Methods:

  • A birth cohort of 202 HIV-unexposed Zimbabwean infants was studied.
  • Data collected included 7-day illness recall and plasma measurements of inflammatory biomarkers (interleukin-6, C-reactive protein, alpha-1-acid glycoprotein) and IGF-1.
  • Measurements were taken at 6 weeks, and at 3, 6, 12, and 18 months of age.

Main Results:

  • Infants experiencing recent acute illness exhibited lower IGF-1 concentrations compared to healthy infants.
  • IGF-1 levels showed a significant inverse correlation with inflammatory biomarkers between 3 and 18 months.
  • Path analysis indicated that cough and fever primarily suppressed IGF-1 indirectly through inflammation, while diarrhea had a more direct suppressive effect.

Conclusions:

  • Acute illnesses can impact the infant growth hormone axis through both direct and indirect pathways.
  • Inflammation plays a key role in mediating the suppressive effects of infections like cough and fever on IGF-1.
  • Understanding these pathways is crucial for developing interventions to prevent stunting in vulnerable populations.

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