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[Procollagen III propeptide. Values in the course of pediatric celiac disease]
1Universitäts-Kinderklinik, Berlin.
Insights
Serum procollagen-III-propeptide (PC-III-P) levels correlate with height velocity in children with coeliac disease. Reduced PC-III-P indicates incomplete catch-up growth, suggesting persistent growth regulation disorders even with a gluten-free diet.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Biochemistry
Context:
- Coeliac disease in children often presents with incomplete catch-up growth.
- The underlying mechanisms regulating growth in these children remain unclear.
- Procollagen-III-propeptide (PC-III-P) is a potential marker for assessing growth regulation.
Purpose:
- To investigate the relationship between serum PC-III-P levels and growth parameters in children with coeliac disease.
- To determine if PC-III-P can explain incomplete catch-up growth in this population.
Summary:
- A study involving 30 children with coeliac disease measured serum PC-III-P using radioimmunoassay.
- Significant correlations were found between height velocity and PC-III-P (r=0.75), and PC-III-P and alkaline phosphatase (r=0.54).
- Children with incomplete catch-up growth on a gluten-free diet exhibited reduced PC-III-P levels, while those with normal growth had normal levels.
Impact:
- Findings suggest PC-III-P is a reliable indicator of growth velocity in coeliac disease.
- Reduced PC-III-P levels in some patients indicate persistent growth regulation issues despite dietary adherence.
- Further research is needed to explore additional factors affecting growth in coeliac disease.
Objectives:
An explanation for an incomplete catch-up growth in children with coeliac disease has not yet been found. The marker of growth procollagen-III-propeptide could possible provide a better understanding of the actual regulation of growth in the situation.
Methods:
The investigation was made in children with established coeliac disease (n = 30). A commercial radioimmunoassay was used for the measurement of PC-III-P.
Results:
A close relationship (r = 0.75; P < 0.0001) was found between height velocity and PC-III-P in serum of coeliac children. There was also a good correlation (r = 0.54; P < 0.001; n = 72) with serum levels of alcaline phosphatase. Only weak correlations were found to insulin-like growth factor I (r = 0.33; P < 0.05; n = 62), to urinary calcium (r = 0.27; P < 0.05; n = 62), and to the maturation of bones (r = 0.25; P < 0.05; n = 54). In accordance with the good correlation between height velocity and PC-III-P normal results were found in normal growing children with coeliac disease. Reduced serum levels of PC-III-P were found in coeliac children who failed to show a complete catch-up growth while on a gluten-free diet.
Conclusions:
Gluen challenge, as required for the confirmation of the diagnosis, led to a significant further decrease of the values of PC-III-P. Parallel investigations for IgA endomysium antibodies in serum suggest that besides dietary errors additional factors may impede growth, or in other words that disorders of growth regulation persist in some patients with coeliac disease even under treatment. This assumption will have to be tested by further investigations.
