To study whether or not plasma
enteroglucagon reflects changes of the small intestinal mucosa during different phases of
celiac disease, we studied fasting and postprandial concentrations of plasma
enteroglucagon, as well as small intestinal mucosa morphology, in children with
celiac disease and in a reference group of children without
gastrointestinal disorders. The children with
celiac disease were studied before dietary treatment, during
gluten-free diet, and during
gluten challenge. In untreated celiac children we found high mean basal and postprandial plasma
enteroglucagon concentrations compared with the reference group (p less than 0.001). After a
gluten-free diet period of 0.2-4.5 years (mean, 1.0 year), when the small intestinal histology was normal or only mildly abnormal, there was a decrease of both mean basal plasma
enteroglucagon concentration (from 81 to 17 pmol/L; p less than 0.001) and mean postprandial plasma
enteroglucagon concentration (from 129 to 39 pmol/L; p less than 0.001). During a subsequent
gluten challenge, which resulted in a mucosal relapse, there was a rise in mean postprandial plasma
enteroglucagon concentration (from 39 to 74 pmol/L; p less than 0.005), although there was a substantial overlap in values from treated and challenged patients. These findings suggest that plasma
enteroglucagon levels, particularly after a mixed meal, are correlated with the small intestinal mucosal morphology in childhood
celiac disease. Determination of plasma
enteroglucagon may facilitate the control of the dietary adherence during
gluten-free diet and may in some children indicate mucosal relapse during
gluten challenge. Thus, the number of control biopsies may be reduced.