Impaired Insulin-like Growth Factor-1 (IGF-1) Generation Causes Protein Catabolism and Poor Growth in Children With Crohn Disease

Nationwide Children's Hospital1 enrolled

Overview

The investigators will prospectively recruit 26 children with moderate - severe active Crohn disease (PCDAI \>30). Results will be compared to 26 patients in sustained remission (PCDAI \<10 and physician global assessment of remission over the previous 6 months) who are matched for age and gender. Subjects will be studied at baseline and six months. The primary study end-points will be leucine rate of appearance (a measure of protein breakdown) and IGF-1 levels. This study will test the hypothesis that children with greater disease severity will have worse longitudinal growth and protein catabolism. The investigators will also explore the secondary hypothesis that children with Crohn disease have abnormal IGF-1 generation which is linked to underlying inflammation and disease severity.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Crohns Disease

Interventions

ExaminationsOTHER

Growth hormone stimulation testing, Protein turnover, Dexa scan, Bone age x-ray

Eligibility

Medical Language ↔ Plain English

Inclusion Criteria: * Diagnosed with Crohn disease by endoscopy and histologic samples * Chronological and/or bone age 6-15 years old * Tanner 1 - 2 * Willing to participate in our longitudinal evaluation Exclusion Criteria: * Concomitant persistent chronic infectious disease * Inflammatory bowel disease not diagnosed as Crohn disease * Immunological disorder (excluding Crohn disease) * Associated severe concomitant chronic illnesses (CF, liver failure) * Pregnancy

Outcomes

Primary Outcomes

Height velocity

Time frame: 6 months

Secondary Outcomes

Protein catabolism