Response of IGF-1 to nutritional support in malnourished hospital patients: a possible indicator of short-term changes in nutritional status.
IGF-1 is a circulating growth factor with hepatic release dependent on nutritional status. To determine if IGF-1 could be a useful nutritional index, 15 malnourished patients were assessed during nutritional support. Patients with protein or protein-calorie malnutrition had lower IGF-1 (39 +/- 7 micrograms/L) than did patients with calorie-only malnutrition (109 +/- 25 micrograms/L, p less than 0.005); transferrin concentrations did not differ between the two groups. Nutritional supplementation produced an increase in IGF-1 (123 +/- 32 micrograms/L, p less than 0.005); the relative increase in IGF-1 (264 +/- 62%, p less than 0.001) exceeded increases in albumin or transferrin (9 +/- 6% and 59 +/- 16%, NS and p less than 0.005, respectively). Reduction or termination of support was followed by a decrease in IGF-1 to 59 +/- 9% of peak values (p less than 0.001) but neither albumin nor transferrin decreased significantly. Changes in IGF-1 were correlated with nitrogen balance (r = 0.45, p less than 0.005). The strong relationship between IGF-1 and nutritional status suggests that IGF-1 determinations may be useful in guiding nutritional therapy in patients whose nitrogen balance is difficult to assess.
Donahue
S P
SP
Department of Medicine, Emory University School of Medicine, Atlanta, GA 30303.
Phillips
L S
LS
D004044:Dietary Proteins / Q000008:administration & dosage; D002149:Energy Intake; D006760:Hospitalization; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008099:Liver / Q000378:metabolism; D009584:Nitrogen / Q000378:metabolism; D009748:Nutrition Disorders / Q000178:diet therapy / Q000378:metabolism*; D009752:Nutritional Status; D011488:Protein Deficiency / Q000178:diet therapy / Q000378:metabolism*; D013002:Somatomedins / Q000378:metabolism*
D004044:Dietary Proteins; D013002:Somatomedins; D007334:Insulin-Like Growth Factor I; D009584:Nitrogen