P225 Insulin-like growth factor-i of children with coeliac disease having protein-energetic insufficiency

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Abstract

Background and aims

the IGF-I data analysis of children with coeliac disease (CD), keeping to the gluten-free diet (GFD) against the background of supplementation of the ration with hypercaloric mixture.

Materials and methods

The IGF-I level analysis of 22 children with CD (8 boys and 14 girls) at the age of from 2 till 10 who kept to the strict GFD during not less then a year was conducted. Depending on the type of protein-energetic insufficiency, the patients were divided into 3 groups: the first group consists of 8 (36,4%) children with acute protein-energetic insufficiency, the second one consists of 9 (40,9%) children with chronic protein-energetic insufficiency, the third group is a group of 5 (22,7%) patients without protein-energetic insufficiency. During 1 month children were getting 200 ml of hypercaloric mixture in addition to their ration. The test group consisted of 30 healthy children at the age of from 2 till 10. The research of IGF-I of children with CD was conducted twice-before and after the course of ration enrichment.

Results and discussion

The level of IGF-I in the test group is (X±m) 141,8±11,1 mg/l, the level of IGF-I of patients with CD against the background of the GFD is 98,0±9,6 mk/n; (p<0,01). Despite of keeping to the GFD the IGF-I secretion of children with CD doesn’t reach the level of healthy children. The result is many of them has protein-energetic insufficiency. The analysis of interrelation between a kind of protein-energetic insufficiency and IGF-I activity shows that index of acute protein-energetic insufficiency is 93,0±13,3 mg/l, the index of chronic protein-energetic insufficiency is 78,5±11,6 mg/l, the absence of PEI is 141,2±22,4 mg/l. It is logically that the level of somatomedin of children with growth retardation is 1,8 times lower than the level of somatomedin of healthy children (p<0,05) and it is 1,8 times lower than the level of somatomedin of children with CD without PEI (p<0,05). The course of nutritional support with the hypercaloric mixture for children who keep to the GFD has led to the secretion growth of IGF-I in 1,21 times (p<0,001), and the data differ much according to the presence and the kind of PEI. The IGF-I level of acute PEI is 103,6±13,5 mg/l (the rise is 11,4%,p>0,05),the IGF-I level of chronic PEI is 116,7±16,3 mg/l (the rise is 48,7%, p<0,005), with the absence of PEI the IGF-I level is 157,8±32,5 mg/l( the rise is 11,8%, p>0,05). The maximum rise of IGF-I secretion against the background of ration supplementation was achieved during the chronic PEI and with the least initial level, children without PEI have minor dynamics of IGF-I. We can mark the parallelism of the body length growth and IGF-I, which is typical for children with chronic PEI.

Conclusions

The definition of IGF-I level of children with CD who keep to the GFD can be used as one of the laboratory criteria which reflect the presence and the kind of PEI. The absence of growth increase against the background of patients‘ keeping to the GFD is determined with the secretion decreasing of IGF-I. The ration supplementation of children with CD stimulates the rise of IGF-I secretion, which is typical mainly for the patients with chronic PEI.

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