The relationship of FGF-21 levels with growth in celiac patients

Fibroblast growth factor-21 (FGF-21) affects growth by malabsorption or growth hormone resistance in long-term fasting. Celiac disease (CD) causes short stature by malabsorption. In this study, we planned to measure FGF-21 levels and investigate their relationship with height, body weight, Insulin-like growth factor-1 (IGF-1), basal growth hormone (GH) levels. A total of 30 celiac patients newly diagnosed in Fırat University Hospital were included in the study. Before the diet program, height, weight measurements and systemic examinations were made and recorded. Patients with chronic disease and celiac diet incompatibility were excluded from the study. Before and after the diet, 2 cc blood samples were taken from these patients for FGF-21, GH, IGF-1 levels, centrifuged at 3500 rpm, stored at -80°C, and studied in the microbiology laboratory by ELISA method. Of the 30 patients included in the study, 16 (53.3%) were girls and 14 (46.7%) were boys, mean age was 9.3±3.8 (min=2-max=16). After celiac diet, FGF-21 value (p<0.001) and GH value (p=0.022) decreased significantly, while height value (p=0.02) and BMI SDS (p=0.041) values significantly increased. There was no significant change in height SDS values. There was a negative correlation between the change in FGF-21 level and the change in IGF-1 (p<0.001, r= -0.673) and a positive correlation between the change in triglyceride (p=0.38, r=0.381) levels. There was no significant relationship between FGF-21 level and BMI, BMI SDS value, insulin, cholesterol and GH levels. High FGF-21 and basal GH levels in celiac patients, decrease in FGF-21 after celiac diet and decrease in basal GH values were evaluated in favor of GH resistance. Although there is no significant relationship between FGF-21 levels and GH levels, a strong negative correlation between FGF-21 levels and IGF-1 levels suggests that FGF-21 may have a role in the etiopathogenesis of GH resistance. Studies on the role of FGF-21 in the etiology of short stature due to celiac disease are scarce. Long-term and more detailed studies with larger number of patients are needed on this subject.