PubMed2003
BACKGROUND: The majority of cases of failure to thrive (FTT) are non-organic. Many of these patients present with significant decreased caloric intake. It appears as if the appetite regulation center in the hypothalamus is not attuned to the calorie requirements of the infant. OBJECTIVE: Our hypothesis was that some cases of non-organic FTT might be caused by abnormalities in hunger/satiety control secondary to neuroendocrine or cytokine imbalance. The aim of this study was to investigate which hormonal/cytokine profiles could be assigned to a defined category of FTT, namely organic, psychosocial and idiopathic subgroups. STUDY DESIGN: 34 patients were enrolled and 32 completed the study (12 controls, 12 idiopathic FTT, 5 organic FTT, and 3 psychosocial FTT). Each child was assessed by a pediatric gastroenterologist, dietician, and social worker and underwent appropriate laboratory investigation during which leptin, IL1, IL6 and TNF-alpha levels were determined. The Mann-Whitney U test was used to compare the groups. RESULTS: IL6 was the only cytokine that showed significant differences between FTT patients (4.06 +/- 6.3 pg/ml) and normal controls (0.0 pg/ml (p = 0.028). Leptin values were significantly higher in the normal control group (1632 +/- 483 pg/ml) as compared to FTT patients (685 +/- 687 pg/ml) (p = 0.001). CONCLUSIONS: Our results indicate that leptin does not play a role in the pathogenesis of anorexia in children with FTT. It is however, possible that IL6 may be an important factor in the etiology of anorexia in patients with FTT.