Alterations in the insulin-like growth factor system in trauma patients

M. M. Wojnar, J. Fan, R. A. Frost, M. C. Gelato, C. H. Lang

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Abstract

The aim of the present study was to elucidate changes in the growth hormone (GH)-insulin-like growth factor (IGF) axis in trauma patients throughout their stay in the surgical intensive care unit (SICU). The first venous blood sample was obtained within 24 h after admission to the SICU and before the start of nutritional support; the last sample was obtained within 24 h of each patient's discharge from the SICU. All patients were receiving nutritional support at this later time. Control subjects were healthy volunteers, matched for age and sex and fasted ~ 18 h before blood sampling. GH in trauma patients was increased 25-fold on the first day and was still elevated ≥ 5-fold on the last day. Trauma decreased circulating levels of both IGF-I (50-60%) and IGF-II (33-45%) throughout the duration of the patients' stay in the SICU. A sustained reduction in plasma IGF-binding protein (BP)-3 (55-75%) was observed in trauma patients throughout the protocol. In contrast, IGFBP-1 levels increased more than threefold during this same period. Furthermore, IGFBP-1 in these patients had undergone posttranslational modification and existed primarily in a highly phosphorylated form. Blood, collected from a cohort (n = 3) of these patients within 24 h of their discharge from the hospital, indicated that IGF-I and IGF-II were still reduced (30%) and that the decrease in IGFBP-3 and the elevation in IGFBP-1 were still evident at this time. These results indicate that trauma produces rapid changes in circulating IGFs and BPs that largely persist despite adequate nutritional intake and overall improvement in the patient's condition. Such changes in IGFs and their BPs may contribute to the altered muscle protein balance observed in these patients.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume268
Issue number4 37-4
StatePublished - Jan 1 1995

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Somatomedins
Wounds and Injuries
Critical Care
Insulin-Like Growth Factor Binding Protein 1
Intensive Care Units
Insulin-Like Growth Factor Binding Protein 3
Insulin-Like Growth Factor II
Nutritional Support
Insulin-Like Growth Factor I
Growth Hormone
Muscle Proteins
Patient Discharge
Post Translational Protein Processing
Healthy Volunteers

All Science Journal Classification (ASJC) codes

  • Physiology
  • Physiology (medical)

Cite this

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abstract = "The aim of the present study was to elucidate changes in the growth hormone (GH)-insulin-like growth factor (IGF) axis in trauma patients throughout their stay in the surgical intensive care unit (SICU). The first venous blood sample was obtained within 24 h after admission to the SICU and before the start of nutritional support; the last sample was obtained within 24 h of each patient's discharge from the SICU. All patients were receiving nutritional support at this later time. Control subjects were healthy volunteers, matched for age and sex and fasted ~ 18 h before blood sampling. GH in trauma patients was increased 25-fold on the first day and was still elevated ≥ 5-fold on the last day. Trauma decreased circulating levels of both IGF-I (50-60{\%}) and IGF-II (33-45{\%}) throughout the duration of the patients' stay in the SICU. A sustained reduction in plasma IGF-binding protein (BP)-3 (55-75{\%}) was observed in trauma patients throughout the protocol. In contrast, IGFBP-1 levels increased more than threefold during this same period. Furthermore, IGFBP-1 in these patients had undergone posttranslational modification and existed primarily in a highly phosphorylated form. Blood, collected from a cohort (n = 3) of these patients within 24 h of their discharge from the hospital, indicated that IGF-I and IGF-II were still reduced (30{\%}) and that the decrease in IGFBP-3 and the elevation in IGFBP-1 were still evident at this time. These results indicate that trauma produces rapid changes in circulating IGFs and BPs that largely persist despite adequate nutritional intake and overall improvement in the patient's condition. Such changes in IGFs and their BPs may contribute to the altered muscle protein balance observed in these patients.",
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Alterations in the insulin-like growth factor system in trauma patients. / Wojnar, M. M.; Fan, J.; Frost, R. A.; Gelato, M. C.; Lang, C. H.

In: American Journal of Physiology - Regulatory Integrative and Comparative Physiology, Vol. 268, No. 4 37-4, 01.01.1995.

Research output: Contribution to journalArticle

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AU - Fan, J.

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