Dataset Information

Infections and systemic inflammation are associated with lower plasma concentration of insulin-like growth factor I among Malawian children.

ABSTRACT:

Background

Insulin-like growth factor I (IGF-I) is the most important hormonal promoter of linear growth in infants and young children.

Objectives

The objectives of this study were to compare plasma IGF-I concentration in a low- compared with a high-income country and characterize biological pathways leading to reduced IGF-I concentration in children in a low-income setting.

Methods

We analyzed plasma IGF-I concentration from 716 Malawian and 80 Finnish children at 6-36 mo of age. In the Malawian children, we studied the association between IGF-I concentration and their environmental exposures; nutritional status; systemic and intestinal inflammation; malaria parasitemia and viral, bacterial, and parasitic enteric infections; as well as growth at 18 mo of age. We then conducted a pathway analysis to identify direct and indirect associations between these predictors and IGF-I concentration.

Results

The mean IGF-I concentrations were similar in Malawi and Finland among 6-mo-old infants. At age 18 mo, the mean ± SD concentration was almost double among the Finns compared with the Malawians [24.2 ± 11.3 compared with 12.5 ± 7.7 ng/mL, age- and sex-adjusted difference in mean (95% CI): 11.8 (9.9, 13.7) ng/mL; P < 0.01]. Among 18-mo-old Malawians, plasma IGF-I concentration was inversely associated with systemic inflammation, malaria parasitemia, and intestinal Shigella, Campylobacter, and enterovirus infection and positively associated with the children's weight-for-length z score (WLZ), female sex, maternal height, mother's education, and dry season. Seasonally, mean plasma IGF-I concentration was highest in June and July and lowest in December and January, coinciding with changes in children's length gain and preceded by ∼2 mo by the changes in their WLZ.

Conclusions

The mean plasma IGF-I concentrations are similar in Malawi and Finland among 6-mo-old infants. Thereafter, mean concentrations rise markedly in Finland but not in Malawi. Systemic inflammation and clinically nonapparent infections are strongly associated with lower plasma IGF-I concentrations in Malawi through direct and indirect pathways.

SUBMITTER: Maleta K

PROVIDER: S-EPMC7851819 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Infections and systemic inflammation are associated with lower plasma concentration of insulin-like growth factor I among Malawian children.

Maleta Kenneth K Fan Yue-Mei YM Luoma Juho J Ashorn Ulla U Bendabenda Jaden J Dewey Kathryn G KG Hyöty Heikki H Knip Mikael M Kortekangas Emma E Lehto Kirsi-Maarit KM Matchado Andrew A Nkhoma Minyanga M Nurminen Noora N Parkkila Seppo S Purmonen Sami S Veijola Riitta R Oikarinen Sami S Ashorn Per P

The American journal of clinical nutrition 20210201 2

<h4>Background</h4>Insulin-like growth factor I (IGF-I) is the most important hormonal promoter of linear growth in infants and young children.<h4>Objectives</h4>The objectives of this study were to compare plasma IGF-I concentration in a low- compared with a high-income country and characterize biological pathways leading to reduced IGF-I concentration in children in a low-income setting.<h4>Methods</h4>We analyzed plasma IGF-I concentration from 716 Malawian and 80 Finnish children at 6-36 mo ...[more]

PMID: 33381802

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Project description:Debilitating rickets-like lower limb deformities are common in children throughout the world, particularly in Malawi, Africa where the causes are unknown. We have identified that Blount disease and calcium deficiency rickets are the likely causes of these deformities and propose calcium supplementation as a potential treatment of Malawian rickets.Surgical correction of rickets-like lower limb deformities is the most common paediatric operation performed at Beit Cure Orthopaedic Hospital, Malawi. The aim of this study was to investigate the aetiology of these deformities.Children with a tibio-femoral angle of deformity >20° were enrolled (n = 42, 3.0-15.0 years). Anthropometric and early life and well-being data were collected. Early morning serum and urine samples were collected on the morning of the operation for markers of calcium and phosphate homeostasis. Knee radiographs were obtained, and the children were diagnosed with either Blount (BD, n = 22) or evidence of rickets disease (RD, n = 20). As BD is a mechanical rather than metabolic disease, BD were assumed to be biochemically representative of the local population and thus used as a local reference for RD.There were no differences in anthropometry or early life experiences between BD and RD. Parathyroid hormone (PTH), 1,25-dihydroxyvitamin D, total alkaline phosphatase and urinary phosphate were significantly higher and serum phosphate, 25-hydroxyvitamin D (25OHD) and tubular maximal reabsorption of phosphate significantly lower in RD than BD. There was no difference in serum calcium, fibroblast growth factor 23 or markers of iron status between groups. All children had 25OHD > 25 nmol/L.Vitamin D deficiency is not implicated in the aetiology of RD or BD in Malawian children. The cause of RD in Malawi is likely to be dietary calcium deficiency leading to elevated PTH resulting in increased losses of phosphate from the bone and glomerular filtrate. The causes of BD remain unclear; there was no evidence in support of previously suggested risk factors such as being overweight or starting to walk early. Prior to surgical intervention, supplementation with calcium should be considered for children with RD.

Dataset Information

Infections and systemic inflammation are associated with lower plasma concentration of insulin-like growth factor I among Malawian children.

Background

Objectives

Methods

Results

Conclusions

Publications

Infections and systemic inflammation are associated with lower plasma concentration of insulin-like growth factor I among Malawian children.

Similar Datasets

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