title: Low circulating insulin-like growth factor I in coeliac disease and its relation to bone mineral density.
abstract: BACKGROUND
  Patients with coeliac disease have low bone mineral density (BMD), but the underlying mechanisms are unclear. Our aim was to study circulating insulin-like growth factor I (IGF-I) and its possible relationship to BMD in adults with untreated coeliac disease and after 1 year on a gluten-free diet.
  
  
  METHODS
  In 29 consecutive adult coeliac patients fasting IGF-I and BMD (n = 28) were examined before and 1 year after starting a gluten-free diet. Intact parathyroid hormone (PTH) was measured (n = 20) before the gluten-free diet was started.
  
  
  RESULTS
  Untreated coeliac patients had lower IGF-I values than controls matched for age and sex, and their BMD was low. A relationship was observed between BMD and IGF-I but not independent of age and body mass index. During the 1st year on a gluten-free diet BMD increased (P < 0.001), as did the circulating IGF-I levels in 21 of the 29 patients (P = 0.078). In the subgroup of 14 patients with normal initial PTH the increase in IGF-I correlated positively with the increase in BMD (femoral trochanter, r = 0.62, P < 0.05, and lumbar spine, r = 0.70, P < 0.02).
  
  
  CONCLUSIONS
  BMD and circulating IGF-I levels are low in adults with untreated coeliac disease. In patients with normal initial PTH level there is an association between the change in BMD and circulating IGF-I, although this parallel increase may not be causally connected.
authors.affiliation: Dept of Health and Environment, Faculty of Health Sciences, Linköping University, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Valdimarsson
authors.forename: H J
authors.initials: HJ
authors.lastname: Arnqvist
authors.forename: G
authors.initials: G
authors.lastname: Toss
authors.forename: G
authors.initials: G
authors.lastname: Järnerot
authors.forename: F
authors.initials: F
authors.lastname: Nyström
authors.forename: M
authors.initials: M
authors.lastname: Ström
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015519:Bone Density / Q000502:physiology*; D002446:Celiac Disease / Q000097:blood / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D015592:Immunoradiometric Assay; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D011863:Radioimmunoassay; D012044:Regression Analysis
chemical_list: D010281:Parathyroid Hormone; D007334:Insulin-Like Growth Factor I