Plasma insulin-like growth factor-1, type 1 procollagen, and serum tumor necrosis factor alpha in children recovering from Trichuris dysentery syndrome

Objectives. To explore: 1) the relationship between plasma insulin-like gro wth factor-1 (IGF-1) and other markers of growth; and 2) the effect of seru m concentrations of tumor necrosis factor alpha (TNF) on growth variables i n children (2-10 years) stunted by Trichuris dysentery syndrome (TDS), reco vering 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 m atched controls (n = 28) for 1 year. Anthropometric and biochemical measure ments were done on admission and then every 3 months for the year. Plasma I GF-1, the carboxyterminal propeptide of type 1 procollagen, serum TNF, tota l serum protein, serum albumin, and complete blood count were determined. Results. Low admission plasma levels of IGF-1 in IDS cases were accompanied by high serum levels of TNF, and total serum protein, normal serum albumin , low hemoglobin, reduced collagen synthesis (low plasma carboxyterminal pr opeptide of type 1 procollagen), and growth failure. These variables improv ed 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 weig ht-for-age (r = 0.69, 0.90, 0.69) of cases and controls, height-for-age (r = 0.51, 0.52, 0.54) and weight-for-age (r = 0.31, 0.52, 0.54) at each measu rement 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 fa ilure in children affected by other forms of chronic inflammatory bowel dis ease.