Abstract
Improvements in insulin resistance after anti-TNF-α therapy have been reported in inflammatory conditions, although no changes were noted in adult patients with Crohn's disease. There is no information concerning insulin resistance and substrate metabolism in children with Crohn's disease after anti-TNF-α therapy. Our aim was to describe changes in carbohydrate and lipid metabolism in children with active Crohn's disease after their initial dose of infliximab. Children with active Crohn's disease underwent measurement of plasma insulin and glucose just before and 2 wk after their initial infusion of infliximab, an anti-TNF-α antibody. In addition, resting energy expenditure, with determination of both carbohydrate and lipid oxidation rates, was determined. Measurements were conducted in both fasting and parenterally fed states. Despite no changes in resting energy expenditure, a significant reduction (p < 0.05) in RQ (5%) and carbohydrate oxidation rate (24%), with a corresponding increase in lipid oxidation rate (42%) was found during parenteral nutrition infusion. No differences in plasma insulin, glucose, and insulin resistance were noted when comparing pre- and postinfliximab measurements.
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Abbreviations
- ESR:
-
Erythrocyte sedimentation rate
- GIR:
-
Glucose/insulin ratio
- HOMA:
-
Homeostasis model assessment
- ISI:
-
Insulin sensitivity index
- PCDAI:
-
Pediatric Crohn's disease activity index
- QUICKI:
-
Quantitative insulin sensitivity check index
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This study was supported by a CReFF awarded to SJS by the GCRC at Indiana University School of Medicine, M01 RR000750, and from National Institutes of Health Grant RO-1 HD29153 (SCD).
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Steiner, S., Pfefferkorn, M., Fitzgerald, J. et al. Carbohydrate and Lipid Metabolism Following Infliximab Therapy in Pediatric Crohn's Disease. Pediatr Res 64, 673–676 (2008). https://doi.org/10.1203/PDR.0b013e318186dde2
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DOI: https://doi.org/10.1203/PDR.0b013e318186dde2
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