Endocrine pancreatic dysfunction in HIV-infected children: association with growth alterations.
BACKGROUND
The pancreatic endocrine system normally guarantees a quick and efficient response to daily metabolic perturbations, but associated data for human immunodeficiency virus (HIV)-infected patients are lacking. A prospective study was performed to evaluate pancreatic endocrine secretion and its possible association with failure to thrive among HIV-infected children.


METHODS
Fourteen well-nourished, prepubertal, HIV-infected children (6 boys and 8 girls; age range, 5-11 years), none of whom were receiving protease inhibitors, and 16 clinically healthy sex- and age-matched children formed the patient group and the control group, respectively. At yearly follow-up examinations, insulin, glucagon, C-peptide, and glucose levels were measured; the ratio of insulin to glucose, the ratio of insulin to glucagon, and the homeostasis model assessment (HOMA) index were calculated; the glucagon test was administered; and growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, cortisol, and lipid patterns were evaluated.


RESULTS
Insulin, glucagon, C-peptide, glucose, and HOMA measurements were significantly higher among patients, compared with control subjects, at all 3 follow-ups performed to date. The glucagon test revealed a normal glycemic response in all the healthy control subjects and a significantly impaired response in 11 patients. A significant correlation emerged between the ratio of insulin to glucagon and the growth velocity of HIV-infected children.


CONCLUSIONS
To our knowledge, the present study provides the first evidence of altered pancreatic endocrine secretion and its association with growth failure among HIV-infected children.
Department of Internal Medicine and Medical Therapy, University of Pavia, Italy. nutrizione.iar@virgilio.it
Mariangela
M
Rondanelli
Desiree
D
Caselli
Rosita
R
Trotti
Sebastiano Bruno
SB
Solerte
Mohamed
M
Maghnie
Anna
A
Maccabruni
Lorenzo
L
Minoli
Ettore
E
Ferrari
D001786:Blood Glucose; D002096:C-Peptide / Q000097:blood; D002648:Child; D005260:Female; D005934:Glucagon / Q000097:blood; D006130:Growth Disorders / Q000209:etiology* / Q000503:physiopathology*; D015658:HIV Infections / Q000150:complications* / Q000503:physiopathology; D006706:Homeostasis; D006728:Hormones / Q000097:blood; D006801:Humans; D007328:Insulin / Q000097:blood; D008055:Lipids / Q000097:blood; D008297:Male; D010179:Pancreas / Q000503:physiopathology*; D011446:Prospective Studies
D001786:Blood Glucose; D002096:C-Peptide; D006728:Hormones; D007328:Insulin; D008055:Lipids; D005934:Glucagon