Insulin-like growth factors (IGFs) and IGF binding proteins in active Crohn's disease treated with omega-3 or omega-6 fatty acids and corticosteroids.
OBJECTIVE
Catabolism and growth impairment are well-known complications of inflammatory bowel disease (IBD). This may be caused by the disease activity itself and/or the medical treatment, and both may lead to changes in the growth hormone (GH)/insulin-like growth factor I (IGF-I) axis. The aim of the present study was to examine the effects of enteral nutrition, Impact Powder, as adjuvant therapy to corticosteroid treatment on changes in the GH/IGF-I axis in patients with Crohn's disease (CD).


METHODS
The patients were randomized to 3-IP (omega-3-fatty acid (FA), 3 g/day) or 6-IP (omega-6-FA, 9 g/day). Changes in total IGF-I (tIGF-I) and total IGF-II (tIGF-II), free IGF-I (fIGF-I), IGF binding proteins (IGFBP-1 and IGFBP-3), IGFBP-3 protease activity and insulin levels were examined in 31 patients with active CD (CDAI: 186-603) during treatment with prednisolone (40 mg for 1 week) and tapering the dose by 5 mg/week. Clinical and biochemical markers of inflammation were studied at day 0, and after 5 and 9 weeks.


RESULTS
There were no differences at baseline between the two groups. During the treatment period, tIGF-I, fIGF-I and IGFBP-3 increased significantly in both groups compared to baseline (p<0.05) without differences between the groups. Insulin and IGFBP-1 showed no significant changes throughout the treatment period.


CONCLUSIONS
There was no difference between 3-IP and 6-IP as adjuvant enteral nutrition on the GH/IGF-I axis. The changes observed in the GH/IGF-I axis are in line with previously published studies and may be explained by corticosteroid treatment; however, we cannot exclude an additional effect of omega3-/omega6 FA as adjuvant enteral nutrition.
Eivindson
Martin
M
Department of Medicine, Vejle Hospital, and Department of Medicine V, Aarhus University Hospital, Denmark. DocMartin@dadlnet.dk
Grønbaek
Henning
H
Nielsen
Jens Nederby
JN
Frystyk
Jan
J
Flyvbjerg
Allan
A
Jørgensen
Lone
L
Vind
Ida
I
Munkholm
Pia
P
Jensen
Søren
S
Brandslund
Ivan
I
Hey
Henrik
H
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003424:Crohn Disease / Q000097:blood / Q000188:drug therapy*; D010450:Endopeptidases / Q000097:blood / Q000187:drug effects; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D043371:Fatty Acids, Omega-6 / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007118:Immunoassay; D007328:Insulin / Q000097:blood; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood / Q000145:classification / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D013002:Somatomedins / Q000145:classification / Q000187:drug effects* / Q000378:metabolism; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D007328:Insulin; D018969:Insulin-Like Growth Factor Binding Proteins; D013002:Somatomedins; D002097:C-Reactive Protein; D011239:Prednisolone; D010450:Endopeptidases; C080473:insulin-like growth factor binding protein-3 protease