title: The circulating insulin-like growth factor system in children with coeliac disease: an additional marker for disease activity.
abstract: 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 findings 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 significantly 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-specific 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 significantly with BMI and positivity of antibodies.
  
  
  CONCLUSIONS
  These results demonstrate that CD patients show significant 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.
authors.affiliation: Second Institute of Internal Medicine, Chair of Endocrinology, 'La Sapienza' University, Rome, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Locuratolo
authors.forename: G
authors.initials: G
authors.lastname: Pugliese
authors.forename: F
authors.initials: F
authors.lastname: Pricci
authors.forename: G
authors.initials: G
authors.lastname: Romeo
authors.forename: P
authors.initials: P
authors.lastname: Mariani
authors.forename: O
authors.initials: O
authors.lastname: Diaz-Horta
authors.forename: L
authors.initials: L
authors.lastname: Calvani
authors.forename: M
authors.initials: M
authors.lastname: Montuori
authors.forename: E
authors.initials: E
authors.lastname: Cipolletta
authors.forename: U
authors.initials: U
authors.lastname: Di Mario
authors.forename: M
authors.initials: M
authors.lastname: Bonamico
mesh_terms: D001323:Autoantibodies / Q000097:blood; D015992:Body Mass Index; D002446:Celiac Disease / Q000097:blood* / Q000175:diagnosis / Q000178:diet therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005903:Gliadin / Q000276:immunology; D005983:Glutens / Q000008:administration & dosage; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007223:Infant; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D018485:Muscle Fibers, Skeletal / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D018970:Insulin-Like Growth Factor Binding Protein 1; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D005983:Glutens; D005903:Gliadin