Insulin­like growth factor system in remission and flare of inflammatory bowel diseases.

ABSTRACT

INTRODUCTION    Insulin­like growth factor 1 (IGF­1) is involved in the modulation of immunity and inflammation. It also plays a role in regulating the migration of endothelial cells and production of vasoactive agents. OBJECTIVES    This study assessed the concentrations of IGF­1 and insulin­like growth factor-binding protein 3 (IGFBP­3) and their relationships to disease activity in patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS    A total of 129 adult patients with IBD (69 with Crohn disease [CD] and 60 with ulcerative colitis [UC]) were involved in the study. The control group consisted of 31 healthy volunteers. Biochemical serum analyses were performed and the associations of IGF­1 and IGFBP­3 with inflammatory markers and disease activity were assessed. RESULTS    IGF­1 levels were decreased in patients with active UC compared with those with nonactive UC (mean [SD], 78.3 [22.7] ng/ml and 96.2 [24.5] ng/ml, respectively; P = 0.02) and controls (94.5 [26.5] ng/ml; P = 0.03). The IGF­1 level was lower in patients with active CD compared with those with nonactive CD (mean [SD], 79.2 [24.9] ng/ml and 110.1 [43.4] ng/ml, respectively; P <0.001). The IGFBP­3 level was lower in patients with active UC compared with those with nonactive UC (P = 0.04) and controls (P = 0.04). IGF­1 correlated negatively with C­reactive protein (CRP) levels (P <0.01), disease activity (P <0.05), and disease duration (P <0.05). IGFBP­3 levels correlated negatively with CRP levels (P <0.05). CONCLUSIONS    The IGF system is disrupted in patients with IBD. Systemic levels of the IGF axis components are related to disease activity and duration.