The circulating insulin-like growth factor system in children with coeliac disease: an additional marker for disease activity
✍ Scribed by Nicola Locuratolo; Giuseppe Pugliese; Flavia Pricci; Giulio Romeo; Paolo Mariani; Oscar Diaz-Horta; Luisa Calvani; Monica Montuori; Elsa Cipolletta; Umberto Di Mario; Margherita Bonamico
- Publisher
- John Wiley and Sons
- Year
- 1999
- Tongue
- English
- Weight
- 118 KB
- Volume
- 15
- Category
- Article
- ISSN
- 1520-7552
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✦ Synopsis
Background Chronic undernutrition resulting from coeliac disease (CD) could be associated with changes in the circulating insulin-like growth factor (IGF) system, which may participate in the pathogenesis of growth retardation occurring in these patients.
Methods We performed a cross-sectional study in CD subjects attempting to (1) document the pattern of serum IGF-I and IGF binding protein (IGFBP) 1 and 3 at diagnosis and (2) assess the response of circulating IGF system to dietary treatments, in comparison with the response of clinical and laboratory ®ndings utilized for the diagnosis of CD. Thirty-two prepubertal CD children were divided into three groups based on the dietetic treatment: at diagnosis (D, n=18); on gluten-free diet for at least 6 months (GFD, n=7); and on gluten challenge for at least 3 months (CH, n=7). Six postpubertal CD patients were also studied at diagnosis.
Results
In prepubertal children IGF-I levels were signi®cantly reduced (by 29%) in D vs sex-and age-matched normal control (NC) subjects, with reductions being more pronounced before 3 years of age. Likewise, serum IGFBP-3 concentrations were decreased by 22%, whereas circulating IGFBP-1 levels were increased by 60%, compared with NC, with more marked IGFBP changes in older children. Similar alterations were observed in postpubertal patients. Changes in the circulating IGF system disappeared in GFD subjects and reappeared in CH children, as positivity of disease-speci®c antibodies. Body mass index (BMI) also improved in GFD subjects, but did not decrease in CH children. Changes in IGF-I and IGFBPs did not correlate with each other. Levels of IGF-I, but not of IGFBPs, maintained the relation with age and correlated signi®cantly with BMI and positivity of antibodies.
Conclusions These results demonstrate that CD patients show signi®cant changes in serum IGF-I, in younger children, and IGFBPs (particularly IGFBP-1), in older children and adolescents, correlating with clinical course and response to dietary treatments. The alteration in the circulating IGF system could be implicated in the pathogenesis of growth retardation occurring in CD and may provide an additional tool in monitoring of the disease.