Lecornu M, David L, François R
Helv Paediatr Acta. 1978 Dec;33(6):509-16.
In 4 children with celiac disease, aged 7 months to 11 years, serum somatomedin activities (SMA) were consistently low: less than 0.40 U/ml (N greater than 0.50 U/ml). Basal plasma growth hormone (GH) levels were not elevated and increased normally under arginine-insulin stimulation in 3 patients. Human GH administration at a dosage which usually determines an increase of serum SMA in children with GH deficiency (4 mg/day/2 days) did not modify significantly the low serum SMA. However, in 1 child a clear-cut increase of serum SMA (0.22-0.82 U/ml) was noted under a higher dosage of human GH (8 mg/day/2 days). In 3 patients serum SMA was studied 3 weeks to 4 months after starting the gluten-free diet and was found to be normal. A limitation of the somatomedin generation unrelated to a deficit in GH secretion and probably resistant to GH appears therefore to be present in celiac disease. The rapid normalization of serum SMA under gluten-free diet suggests that the low serum SMA is induced through some unknown hormonal or metabolic signal by the protein malabsorption and/or the nutritional deficiency present in celiac disease.
在4名年龄为7个月至11岁的乳糜泻患儿中，血清生长调节素活性（SMA）持续偏低：低于0.40 U/ml（正常范围大于0.50 U/ml）。3例患儿的基础血浆生长激素（GH）水平未升高，在精氨酸 - 胰岛素刺激下正常升高。给予通常能使生长激素缺乏儿童血清SMA升高的剂量（4mg/天/2天）的人生长激素，并未显著改变低血清SMA水平。然而，在1名儿童中，给予更高剂量的人生长激素（8mg/天/2天）后，血清SMA明显升高（从0.22 U/ml升至0.82 U/ml）。3例患者在开始无麸质饮食3周后至4个月后研究血清SMA，发现其正常。因此，乳糜泻可能存在与生长激素分泌不足无关且可能对生长激素有抵抗的生长调节素生成受限情况。无麸质饮食后血清SMA迅速恢复正常，提示低血清SMA是由乳糜泻中存在的蛋白质吸收不良和/或营养缺乏通过某种未知的激素或代谢信号诱导产生的。
