Frequency of oligosymptomatic gastrointestinal tract diseases and its relation to insulin-like growth factor I in idiopathic (non-GH-deficient) short stature children

Renata Stawerska; Marzena Kolasa-Kicińska; Michał Kolejwa; Joanna Smyczyńska; Maciej Hilczer; Elżbieta Czkwianianc; Andrzej Lewiński

doi:10.5114/aoms.2020.93809

Frequency of oligosymptomatic gastrointestinal tract diseases and its relation to insulin-like growth factor I in idiopathic (non-GH-deficient) short stature children

Arch Med Sci. 2020 Mar 21;17(6):1663-1671. doi: 10.5114/aoms.2020.93809. eCollection 2021.

Authors

Renata Stawerska^{1

2}, Marzena Kolasa-Kicińska¹, Michał Kolejwa³, Joanna Smyczyńska¹, Maciej Hilczer¹, Elżbieta Czkwianianc³, Andrzej Lewiński^{1

4}

Affiliations

¹ Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.
² Department of Pediatric Endocrinology, Medical University of Lodz, Lodz, Poland.
³ Department of Gastroenterology, Allergology and Pediatrics, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.
⁴ Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland.

Abstract

Introduction: There is a discussion about growth hormone therapy in idiopathic short stature (ISS) children. To diagnose ISS, it is necessary to exclude other diseases; gastrointestinal tract diseases (GIDs) are among them. However, GID symptoms may be scarce. The aim of the study was to evaluate the frequency of unexpected oligosymptomatic GIDs in ISS and assess their influence on auxological parameters and insulin-like growth factor I (IGF-I) concentration.

Material and methods: The analysis included 101 children with ISS and 95 controls. All patients were tested for celiac disease (CD), inflammatory bowel disease (IBD), lactose malabsorption (LM), cystic fibrosis (CF), Helicobacter pylori (HP) and Ascaris sp. (Asc) infections, as well as Candida albicans (Calb) colonization, by applying simple blood and stool tests and gastrofiberoscopy.

Results: In 75.2% of short children, one or more than one GIDs listed above were diagnosed, with the highest frequency of: Calb (46.5%), LM (33.7%), HP (24.7%) and/or Asc (21.8%). The incidence of GIDs was significantly higher than in the control group. The GID frequency increases with the age of children. In most ISS children, the IGF-I SDS was below -1.0 and it was the lowest in children with HP (p < 0.05).

Conclusions: High frequency of unexpected oligosymptomatic GIDs in children diagnosed with ISS indicates the need to search for gastrointestinal (GI) causes in each case of short stature in children. The pathomechanisms responsible for short stature in these cases may vary, although it seems that reduced production of IGF-I plays an important role.

Keywords: Helicobacter pylori; gastrointestinal tract diseases; insulin-like growth factor I; short stature.