ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2007) 14 P592

Evaluation of hypotalamic-pituitary-gonadal (HPG) axis and GH-IGF-I axis in adult patients with celiac disease

Emanuele Ferrante1, Claudia Giavoli1, Silvia Bergamaschi1, Luca Elli2, Annamaria De Bellis3, Cristina L Ronchi1, Andrea Lania1, Maria Teresa Bardella2, Antonio Bellastella3, Paolo Beck-Peccoz1 & Anna Spada1

1Department of Medical Sciences, University of Milan, Endocrine and Metabolic Unit, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy; 2Department of Medical Sciences, University of Milan, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy; 3Departement of Clinical and Experimental Medicine and Surgery, Chair of Endocrinology, Second University of Naples, Naples, Italy.

Celiac disease is a chronic inflammatory autoimmune disorder often associated with other endocrine autoimmune diseases, such as type I diabetes mellitus, Addison’s disease and Hashimoto’s thyroiditis. In these patients, LH, FSH and GH secretion has been poorly investigated. Aim of this study is to evaluate anterior pituitary function, and in particular hypotalamic-pituitary-gonadal (HPG) axis and GH-IGF-I axis, in adult patients with treated celiac disease. For this purpouse, 22 celiac patients (15 M, 7 F, mean age: 34 years, range: 19–74 years) were studied by GHRH+arginine test. In male patients (mean age: 30 years, range: 19–47 years), GnRH test was also performed. All patients were evaluated for serum IGF-I, testosterone (M), basal thyroid and adrenal function and antithyroid antibodies. In 20 out of 22 patients, antipituitary antibodies (APA) were also evaluated.

No alterations in basal TSH, FT4, FT3, ACTH, cortisol, LH, FSH and testosterone levels were detected. Three patients (2 F, 1M) resulted positive for antithyroid antibodies. A normal response to GnRH test was detected in all cases. Four out of 22 patients (18.8%) showed an impaired GH secretion after GHRH+arginine test; in particular, four male patients (4/15, 26.7%) showed a GH deficiency (GHD)(1 patient with complete GHD and 3 with partial GHD), while in none female patients an impaired GH response was recorded. IGF-I levels where low in the patient with complete GHD. All patients, including these with complete or partial GHD, resulted negative for APA. No correlation between GHD deficiency and onset of disease was found.

In conclusion, adult celiac patients show an impaired GH secretion in a significant proportion of cases, this alteration seeming to be predominant in males and independent from disease onset. Given the absence of APA, the cause of this pituitary dysfunction is still unclear and requires further elucidations.