title: [Plasma citrulline as a marker of loss of enterocitary mass in coeliac disease in childhood].
abstract: BACKGROUND
  Plasma citrulline is not incorporated in endogenous or exogenous proteins so it is a theoretical marker of villous atrophy. Our aim was to correlate plasma citrulline levels with severity of villous atrophy in celiac patients.
  
  
  METHODS
  Observational case-control study longitudinal in children 16 month-old to 14 year-old: 48 with untreated celiac disease, 9 celiac children under gluten free diet and 35 non-celiac healthy children. Plasma amino acids concentration is determined, expressed in μmol/L, and so are other clinical and analytical data.
  
  
  RESULTS
  No statistically significative difference found in the referring to BMI, age or renal function. Small increase in fecal fat in celiac children. Citrulline, arginine and glutamine are significantly lower in cases (17.7 μmol/l, 38.7 μmol/l, 479.6 μmol/l respectively) than in controls (28.9 μmol/l, 56.2 μmol/l, 563.7 μmol/l). Citrulline levels are significantly lower in the severe degrees of atrophy than in mild ones (13.8 μmol/l vs. 19.7 μmol/l, p < 0.05), not happening so with rest of amminoacids.
  
  
  CONCLUSIONS
  Postabsortive mean of plasma citrulline is a good marker of reduction in enterocyte mass in celiac patients with villous atrophy; secondary reduction in plasma arginine too. Just a small histological alteration in intestinal biopsy is enough to differentiate citrulline in cases and controls and besides it can be seen that high levels of atrophy present with lower plasma citrulline.
authors.affiliation: Sección de Gastroenterologia y Nutrición Infantil, Servicio de Pediatría Hospital Materno-Infantil, Hospital Regional Universitario Carlos Haya, Málaga, España. javierblascoalonso@yahoo.es
authors.forename: J
authors.initials: J
authors.lastname: Blasco Alonso
authors.forename: J
authors.initials: J
authors.lastname: Serrano Nieto
authors.forename: V M
authors.initials: VM
authors.lastname: Navas López
authors.forename: A
authors.initials: A
authors.lastname: Barco Gálvez
authors.forename: I
authors.initials: I
authors.lastname: Vicioso
authors.forename: B
authors.initials: B
authors.lastname: Carazo Gallego
authors.forename: P
authors.initials: P
authors.lastname: Ortiz Pérez
authors.forename: C
authors.initials: C
authors.lastname: Sierra Salinas
mesh_terms: D000293:Adolescent; D000596:Amino Acids / Q000097:blood; D001284:Atrophy; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood* / Q000178:diet therapy / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D002956:Citrulline / Q000097:blood*; D055050:Diet, Gluten-Free; D020895:Enterocytes / Q000502:physiology*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male
chemical_list: D000596:Amino Acids; D015415:Biomarkers; D002956:Citrulline