IGF-I, a marker of undernutrition in hemodialysis patients.
Early detection and treatment of malnutrition in patients on hemodialysis (HD) is hampered by lack of a sensitive biochemical marker. We compared the value of serum insulin-like growth factor-I (IGF-I) with other biochemical indices in detecting malnutrition in 61 HD patients. Protein and energy intakes were low in the majority of patients. Of all patients, 59.6% had severe reduction in triceps skinfold thickness (TSF thickness, less than or equal to 60% of normal), whereas midarm muscle circumference (MAMC) was mildly reduced (less than or equal to 90%) in 23%. Serum IGF-I proved superior to the other indices in predicting TSF thickness. A serum IGF-I concentration of 300 micrograms/L discriminated between wasted (TSF thickness less than or equal to 60%) and robust patients. In 16 patients with a history of recent infection, IGF-I was significantly reduced well before changes in anthropometric measurements could be detected. IGF-I is a useful and early marker of undernutrition in HD patients.
Jacob
V
V
Sheffield Renal Unit, Northern General Hospital, UK.
Le Carpentier
J E
JE
Salzano
S
S
Naylor
V
V
Wild
G
G
Brown
C B
CB
el Nahas
A M
AM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000886:Anthropometry; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D004032:Diet; D005260:Female; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D009748:Nutrition Disorders / Q000097:blood* / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects; D013002:Somatomedins / Q000032:analysis*
D015415:Biomarkers; D013002:Somatomedins; D007334:Insulin-Like Growth Factor I