Growth failure and decreased levels of insulin-like growth factor I in obstructive jaundice are reversed by bile diversion.
Insulin-like growth factor I (IGF-I) is one of the principal stimuli of linear growth. Growth failure in children with chronic cholestatic jaundice may be related to decreased hepatic synthesis of IGF-I. It was hypothesized that (1) biliary obstruction would lead to growth retardation and decreased circulating IGF-I levels; and (2) surgical drainage of the obstructed biliary system would reverse these effects. To test this hypothesis, the following study of male Sprague-Dawley rats (135 g; 10 animals per group) was performed. Group I underwent common bile duct ligation (CDL); group II underwent choledochoduodenostomy 2 weeks following CDL; group III were sham-operated and fed with CDL rats; and group IV were sham-operated and fed ad libitum. Daily food intake and weekly body weight were recorded. Statistical analysis was by repeated-measures analysis of variance and individual comparisons were evaluated by Student's t test. Biliary obstruction results in decreased food intake, rate of weight gain, and IGF-I levels. A significant reduction in IGF-I levels was also noted in the pair-fed sham-operated rats (group III). Relief of obstructive jaundice by surgical drainage results in a reversal of these changes. It is concluded that the growth failure and decreased IGF-I levels associated with obstructive jaundice can be reversed by surgical drainage of the obstructed biliary system and, in part, are due to inadequate nutrition.
Katz
S
S
Department of Surgery, Indiana University School of Medicine, Indianapolis.
Pescovitz
O H
OH
Grosfeld
J L
JL
D000704:Analysis of Variance; D000818:Animals; D002768:Choledochostomy; D001651:Cholestasis, Extrahepatic / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery; D004322:Drainage; D004435:Eating / Q000502:physiology; D006130:Growth Disorders / Q000209:etiology*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008026:Ligation; D008297:Male; D051381:Rats; D011919:Rats, Inbred Strains; D015430:Weight Gain
D007334:Insulin-Like Growth Factor I