{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T08:11:20Z","timestamp":1793261480903,"version":"4.5.0"},"reference-count":42,"publisher":"The Endocrine Society","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Low levels of insulinlike growth factor 1 (IGF-1) in pediatric and adolescent Crohn disease (CD) likely contribute to bone and muscle deficits.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Assess changes in IGF-1 levels and associations with bone and muscle accrual following initiation of anti\u2013tumor necrosis factor \u03b1 (TNF-\u03b1) therapy in pediatric and adolescent CD.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design and Participants<\/jats:title>\n                  <jats:p>Participants (n = 75, age 5 to 21 years) with CD were enrolled in a prospective cohort study; 63 completed the 12-month visit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>IGF-1 levels at baseline and 10 weeks, as well as dual-energy x-ray absorptiometry (DXA) and tibia peripheral quantitative computed tomography (pQCT) measures of bone and muscle at baseline and 12 months after initiation of anti\u2013TNF-\u03b1 therapy. Outcomes were expressed as sex-specific z scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>IGF-1 z scores increased from a median (interquartile range) of \u22121.0 (\u22121.58 to \u22120.17) to \u22120.36 (\u22121.04 to 0.36) over 10 weeks (P &amp;lt; 0.001). Lesser disease severity and systemic inflammation, as well as greater estradiol z scores (in girls), was significantly associated with greater IGF-1 z scores over time. DXA whole-body bone mineral content, leg lean mass, and total hip and femoral neck bone mineral density (BMD) z scores were low at baseline (P &amp;lt; 0.0001 vs reference data) and increased significantly (P &amp;lt; 0.001) over 12 months. Greater increases in IGF-1 z scores over 10 weeks predicted improvement in DXA bone and muscle outcomes and pQCT trabecular BMD and cortical area. Adjustment for changes in muscle mass markedly attenuated the associations between IGF-1 levels and bone outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Short-term improvements in IGF-1 z scores predicted recovery of bone and muscle outcomes following initiation of anti\u2013TNF-\u03b1 therapy in pediatric CD. These data suggest that disease effects on growth hormone metabolism contribute to musculoskeletal deficits in CD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/jc.2017-01916","type":"journal-article","created":{"date-parts":[[2018,1,11]],"date-time":"2018-01-11T01:59:31Z","timestamp":1515635971000},"page":"936-945","source":"Crossref","is-referenced-by-count":38,"title":["Increases in IGF-1 After Anti\u2013TNF-\u03b1 Therapy Are Associated With Bone and Muscle Accrual in Pediatric Crohn Disease"],"prefix":"10.1210","volume":"103","author":[{"given":"Mark D","family":"DeBoer","sequence":"first","affiliation":[{"name":"Department of Pediatrics, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur M","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirabo","family":"Herbert","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Virginia, Charlottesville, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Long","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Stanford University School of Medicine, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meena","family":"Thayu","sequence":"additional","affiliation":[{"name":"Janssen Pharmaceuticals, Titusville, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay M","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Wisconsin School of Medicine, Madison, Wisconsin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert 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