The insulin-like growth factor (IGF)-system in active ulcerative colitis and Crohn's disease: relations to disease activity and corticosteroid treatment.
BACKGROUND
Metabolic bone disease (MBD) and muscle wasting (MW) are serious complications in adults suffering from inflammatory bowel disease (IBD). The inflammatory process and corticosteroid treatment may lead to changes in the IGF-system associated with MBD and MW.


OBJECTIVE
To assess changes in the IGF-system and clinical and biochemical markers in ulcerative colitis (UC) and Crohn's disease (CD).


METHODS
We studied 37 IBD patients with severe clinical exacerbation (20 with UC, 17 with CD) before and during high dose corticosteroid treatment and tapering (8-12 weeks).


RESULTS
Total IGF-I was reduced in CD (36% p<0.01) and UC (41% p<0.001) before treatment and normalized completely. Free IGF-I baseline levels were unchanged compared to controls. In UC, free IGF-I levels increased significantly at week 1 and week 4 (p<0.01, respectively). In CD, no changes in free IGF-I levels were observed. IGFBP-2 baseline levels were increased by a factor 2.3 in UC and CD compared to controls (p<0.01 respectively) and normalized during treatment. IGFBP-3 was reduced by 38% (p<0.01) in CD and 32% (p<0.01) in UC with only partial normalization. Harvey-Bradshaw index, C - reactive protein and albumin normalized during treatment.


CONCLUSIONS
Significant changes in total and free IGF-I and IGFBP-2 and IGFBP-3 were demonstrated in CD and UC patients in exacerbation with only partial normalization during high dose corticosteroid treatment and tapering without differences between UC and CD. These changes may be part of MBD and MW in active IBD.
Eivindson
Martin
M
Department of Gastroenterology and Hepatology, Aarhus University Hospital, VLN-Research, Nørrebrogade 44, Building 1c, 2. floor, DK-8000 Aarhus C, Denmark. DocMartin@dadlnet.dk
Grønbaek
Henning
H
Flyvbjerg
Allan
A
Frystyk
Jan
J
Zimmermann-Nielsen
Erik
E
Dahlerup
Jens Frederik
JF
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D003093:Colitis, Ulcerative / Q000097:blood* / Q000188:drug therapy*; D003424:Crohn Disease / Q000097:blood* / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000097:blood*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D009961:Orosomucoid / Q000032:analysis; D013002:Somatomedins / Q000032:analysis*
D000305:Adrenal Cortex Hormones; D006454:Hemoglobins; D018969:Insulin-Like Growth Factor Binding Proteins; D009961:Orosomucoid; D013002:Somatomedins; D002097:C-Reactive Protein; D008775:Methylprednisolone