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PEDIATRICS Vol. 103 No. 5 May 1999, p. e69

ELECTRONIC ARTICLE:
Plasma Insulin-like Growth Factor-1, Type 1 Procollagen, and Serum Tumor Necrosis Factor alpha  in Children Recovering From Trichuris Dysentery Syndrome

Received Jun 16, 1998; accepted Oct 23, 1998.

E. Marilyn Watson Duff, Nutr), MSc (Nutr), BScN, Norma McFarlane Anderson, and Edward S. Cooper

From the Tropical Metabolism Research Unit, University of the West Indies.

Objectives.  To explore: 1) the relationship between plasma insulin-like growth factor-1 (IGF-1) and other markers of growth; and 2) the effect of serum concentrations of tumor necrosis factor alpha  (TNF) on growth variables in children (2-10 years) stunted by Trichuris dysentery syndrome (TDS), recovering cases, and their matched controls.

Method.  Fourteen patients with TDS were admitted to the Tropical Metabolism Research Unit, treated with albendazole and iron, and then followed with matched controls (n = 28) for 1 year. Anthropometric and biochemical measurements were done on admission and then every 3 months for the year. Plasma IGF-1, the carboxyterminal propeptide of type 1 procollagen, serum TNF, total serum protein, serum albumin, and complete blood count were determined.

Results.  Low admission plasma levels of IGF-1 in TDS cases were accompanied by high serum levels of TNF, and total serum protein, normal serum albumin, low hemoglobin, reduced collagen synthesis (low plasma carboxyterminal propeptide of type 1 procollagen), and growth failure. These variables improved significantly after treatment. Plasma levels of IGF-1 were significantly related to the Z-scores for height-for-age (r = 0.60, 0.73, 0.68) and weight-for-age (r = 0.69, 0.80, 0.69) of cases and controls, height-for-age (r = 0.51, 0.52, 0.54) and weight-for-age (r = 0.51, 0.52, 0.54) at each measurement throughout the year. Serum levels of TNF were not related to any of the growth variables.

Conclusion.  These findings may contribute to the understanding of growth failure in children affected by other forms of chronic inflammatory bowel disease.  Key words:  Trichuris dysentery syndrome, insulin-like growth factor-1, type 1 procollagen, tumor necrosis factor alpha .




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