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.
Department of Surgery, Indiana University School of Medicine, Indianapolis.
S
S
Katz
O H
OH
Pescovitz
J L
JL
Grosfeld
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