title: Acute illness is associated with suppression of the growth hormone axis in Zimbabwean infants.
abstract: Frequent infections contribute to childhood stunting in developing countries but the causal pathways are uncertain. We tested the hypothesis that intercurrent illnesses suppress the growth hormone axis through reductions in insulin-like growth factor 1 (IGF-1). In a birth cohort of 202 HIV-unexposed Zimbabwean infants, we analyzed data on 7-day illness recall and measured plasma interleukin-6, C-reactive protein, alpha-1-acid glycoprotein, and IGF-1 by enzyme-linked immunosorbent assay, at age 6 weeks, and then 3, 6, 12, and 18 months. Children with recent acute illness had lower IGF-1 concentrations than healthy children and IGF-1 correlated inversely (P < 0.05) with inflammatory biomarkers at most time points between 3 and 18 months. Using path analysis, we showed that cough and fever had a predominantly indirect effect on suppressing IGF-1, through the acute-phase response, whereas diarrhea had a predominantly direct effect on IGF-1. Acute illness may therefore impact the growth hormone axis through both direct and indirect pathways.
authors.affiliation: School 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.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Jones
authors.affiliation: School 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.
authors.forename: Sandra
authors.initials: S
authors.lastname: Rukobo
authors.affiliation: School 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.
authors.forename: Bernard
authors.initials: B
authors.lastname: Chasekwa
authors.affiliation: School 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.
authors.forename: Kuda
authors.initials: K
authors.lastname: Mutasa
authors.affiliation: School 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.
authors.forename: Robert
authors.initials: R
authors.lastname: Ntozini
authors.affiliation: School 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.
authors.forename: Mduduzi N N
authors.initials: MN
authors.lastname: Mbuya
authors.affiliation: School 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.
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Stoltzfus
authors.affiliation: School 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.
authors.forename: Jean H
authors.initials: JH
authors.lastname: Humphrey
authors.affiliation: School 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.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Prendergast
mesh_terms: D000208:Acute Disease / Q000453:epidemiology*; D000367:Age Factors; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003371:Cough / Q000097:blood; D005260:Female; D005334:Fever / Q000097:blood; D006801:Humans; D007223:Infant; D007231:Infant, Newborn / Q000097:blood* / Q000254:growth & development; D007249:Inflammation / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D009961:Orosomucoid / Q000032:analysis; D015995:Prevalence; D015030:Zimbabwe / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D015850:Interleukin-6; D009961:Orosomucoid; D007334:Insulin-Like Growth Factor I; D002097:C-Reactive Protein