Carbohydrate and lipid metabolism following infliximab therapy in pediatric Crohn's disease.
Improvements in insulin resistance after anti-TNF-alpha therapy have been reported in inflammatory conditions, although no changes were noted in adult patients with Crohn's disease. There is no information concerning insulin resistance and substrate metabolism in children with Crohn's disease after anti-TNF-alpha therapy. Our aim was to describe changes in carbohydrate and lipid metabolism in children with active Crohn's disease after their initial dose of infliximab. Children with active Crohn's disease underwent measurement of plasma insulin and glucose just before and 2 wk after their initial infusion of infliximab, an anti-TNF-alpha antibody. In addition, resting energy expenditure, with determination of both carbohydrate and lipid oxidation rates, was determined. Measurements were conducted in both fasting and parenterally fed states. Despite no changes in resting energy expenditure, a significant reduction (p < 0.05) in RQ (5%) and carbohydrate oxidation rate (24%), with a corresponding increase in lipid oxidation rate (42%) was found during parenteral nutrition infusion. No differences in plasma insulin, glucose, and insulin resistance were noted when comparing pre- and postinfliximab measurements.
Steiner
Steven J
SJ
Division of Pediatric Gastroenterology, Hepatology, Nutrition, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana 46202-5225, USA. ssteiner@iupui.edu
Pfefferkorn
Marian D
MD
Fitzgerald
Joseph F
JF
Denne
Scott C
SC
D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001481:Basal Metabolism; D001786:Blood Glucose / Q000378:metabolism; D002153:Calorimetry, Indirect; D050260:Carbohydrate Metabolism; D003424:Crohn Disease / Q000188:drug therapy / Q000378:metabolism; D004734:Energy Metabolism; D005215:Fasting; D005260:Female; D006801:Humans; D000069285:Infliximab; D007328:Insulin / Q000097:blood; D050356:Lipid Metabolism; D008297:Male
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D001786:Blood Glucose; D007328:Insulin; D000069285:Infliximab