Regulation of the insulin-like growth factor system by insulin in burn patients
- PMID: 8675563
- DOI: 10.1210/jcem.81.7.8675563
Regulation of the insulin-like growth factor system by insulin in burn patients
Abstract
The aim of the present investigation was to determine whether there is a net uptake of insulin-like growth factor I (IGF-I) or IGF-binding proteins (IGFBPs) by the leg after burn injury and to elucidate the regulatory role of insulin exerted on this system under in vivo conditions in burn patients. Studies were performed on nine patients after burn injury (approximately 60% body surface area). Each patient was studied twice during a continuous infusion of a carbohydrate-rich enteral diet. Blood was collected simultaneously from the femoral artery and vein for the measurement of various elements of the IGF system after 7 days of enteral diet alone (basal period) and after 7 days of the enteral diet plus the infusion of insulin (insulin period). Data from these patients were compared to values in age-matched fed healthy volunteers. During the basal period, burn patients demonstrated a significant reduction in the venous concentration of IGF-I and an increase in both IGFBP-1 and -2 compared to control values. Insulin produced a significant 15% increase in the IGF-I concentration in burn patients, but decreased the circulating levels of IGFBP-1 by 50%. The IGF-I and IGFBP-1 concentrations at the end of the insulin period were still significantly different from those in control subjects. Burn patients also exhibited a marked reduction in intact IGFBP-3 and the acid-labile subunit under basal conditions, and these alterations were not reversed by insulin. Under basal conditions, all burn patients had a positive arterio-venous (A-V) difference for IGF-I across the leg. The A-V difference was increased 50% in response to insulin. The net uptake of IGF-I by the leg was 2.4 micrograms/min under basal conditions, and as leg blood flow also tended to increase in response to insulin, IGF-I uptake was elevated more than 3-fold during the insulin period. No A-V difference across the leg was detected for IGFBP-1, -2, or -3 in burn patients. In conclusion, burn injury in humans produces dramatic and sustained alterations in various components of the IGF system that persist despite adequate nutritional support. Our data indicate the presence of a net uptake of IGF-I by the leg in burn patients that may serve to counteract the catabolic state.
Similar articles
-
Decreased bioavailability of insulin-like growth factor-I, a cause of catabolism in hemodialysis patients?Growth Regul. 1996 Sep;6(3):137-43. Growth Regul. 1996. PMID: 8894646
-
Diagnostic value of the acid-labile subunit in acromegaly: evaluation in comparison with insulin-like growth factor (IGF) I, and IGF-binding protein-1, -2, and -3.J Clin Endocrinol Metab. 2001 Mar;86(3):1091-8. doi: 10.1210/jcem.86.3.7288. J Clin Endocrinol Metab. 2001. PMID: 11238491
-
Sequential changes in insulin-like growth factor I (IGF-I) and IGF-binding proteins in children with end-stage liver disease before and after successful orthotopic liver transplantation.J Clin Endocrinol Metab. 1996 Jan;81(1):160-8. doi: 10.1210/jcem.81.1.8550746. J Clin Endocrinol Metab. 1996. PMID: 8550746
-
Protein nutrition and insulin-like growth factor system.Br J Nutr. 2000 Dec;84 Suppl 2:S241-4. doi: 10.1079/096582197388617. Br J Nutr. 2000. PMID: 11242477 Review.
-
Nutrition in Pediatric Burns.Semin Plast Surg. 2024 Apr 4;38(2):125-132. doi: 10.1055/s-0044-1782648. eCollection 2024 May. Semin Plast Surg. 2024. PMID: 38746694 Free PMC article. Review.
Cited by
-
Insulin-Like growth factor I: implications in aging.Drugs Aging. 2000 Jan;16(1):29-40. doi: 10.2165/00002512-200016010-00003. Drugs Aging. 2000. PMID: 10733262 Review.
-
IGFBP-3. Functional and structural implications in aging and wasting syndromes.Endocrine. 1997 Aug;7(1):81-5. doi: 10.1007/BF02778069. Endocrine. 1997. PMID: 9449038 Review.
-
Burn injury induces high levels of phosphorylated insulin-like growth factor binding protein-1.Int J Burns Trauma. 2013 Nov 1;3(4):180-9. eCollection 2013. Int J Burns Trauma. 2013. PMID: 24273693 Free PMC article.
-
Elevated serum levels of IGFBP-2 found in children suffering from acute leukaemia is accompanied by the occurrence of IGFBP-2 mRNA in the tumour clone.Br J Cancer. 1998 Aug;78(4):515-20. doi: 10.1038/bjc.1998.525. Br J Cancer. 1998. PMID: 9716037 Free PMC article.
-
Human conditions of insulin-like growth factor-I (IGF-I) deficiency.J Transl Med. 2012 Nov 14;10:224. doi: 10.1186/1479-5876-10-224. J Transl Med. 2012. PMID: 23148873 Free PMC article. Review.
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous