Endocrine abnormalities and impaired growth in human immunodeficiency virus-infected children.
OBJECTIVE
Identify endocrine differences between human immunodeficiency virus- (HIV) infected versus uninfected children and evaluate associations of growth and body composition with endocrine measures.


METHODS
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.
Chantry
Caroline J
CJ
University of California, Davis, Medical Center, Sacramento, CA 95817, USA. caroline.chantry@ucdmc.ucdavis.edu
Frederick
Margaret M
MM
Meyer
William A
WA
Handelsman
Edward
E
Rich
Kenneth
K
Paul
Mary E
ME
Diaz
Clemente
C
Cooper
Ellen R
ER
Foca
Marc
M
Adeniyi-Jones
Samuel K
SK
Moye
Jack
J
D001827:Body Height; D001835:Body Weight; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003687:Dehydroepiandrosterone / Q000378:metabolism; D005260:Female; D015658:HIV Infections / Q000378:metabolism* / Q000503:physiopathology*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D008297:Male; D013961:Thyroid Gland / Q000503:physiopathology; D014284:Triiodothyronine / Q000378:metabolism
D018972:Insulin-Like Growth Factor Binding Protein 3; D014284:Triiodothyronine; D003687:Dehydroepiandrosterone