Growth failure and insulin-like growth factor (IGF-I) in childhood celiac disease.
The prevalence of underweight, short stature, and abnormal laboratory tests was assessed in a retrospective study of 335 patients with biopsy-verified childhood celiac disease (CCD). Of the patients younger than 2 years old, 67.4% were underweight (body weight: less than - 2SD) and 33.9% were short (height: less than - 2SD). In children older than 2 years, underweight was present in 36.0% of patients; the prevalence of short stature was 50.0%. Therefore, diagnostic procedures related to CCD appear justified in all children with short stature of unknown etiology. However, because 50% of patients were neither short nor underweight, normal height and weight should not preclude workup of a patient with symptoms suggestive of CCD. Of the laboratory tests evaluated, antigliadin antibodies were the most sensitive for CCD. Insulin-like growth factor (IGF-I) serum levels were prospectively studied in 62 patients (32 CCD patients, 30 controls) referred for jejunal biopsy. IGF-I levels were significantly lower in female CCD patients than in control patients. There was a significant negative association between the duration of gluten exposure and IGF-I levels. Results indicate that significant reduction in IGF-I levels in CCD patients occurs only after prolonged gluten exposure but before growth failure. Reevaluation of IGF-I levels on a glutenfree diet showed rapid reversal of reduced IGF-I values.
Eichler
I
I
Universitätskinderklinik, Wien.
Frisch
H
H
Granditsch
G
G
D000293:Adolescent; D001706:Biopsy; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D002446:Celiac Disease / Q000097:blood* / Q000178:diet therapy / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D007334:Insulin-Like Growth Factor I / Q000502:physiology*; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D011446:Prospective Studies
D007334:Insulin-Like Growth Factor I; D005983:Glutens