The effect of recombinant insulin-like growth factor I on ketone body, lipid and apolipoprotein concentrations and its use to treat ketoacidosis in severe insulin resistance.
The effect of recombinant insulin-like growth factor I (rhIGF-I) on ketone body concentrations was studied in a patient with the Mendenhall syndrome, a rare insulin-resistant state. Treatment with intravenous rhlGF-I for an episode of ketoacidosis led to a clinical and biochemical improvement. One month later, the effect of 20 mg rhlGF-I infused daily for 4 days on ketone body concentrations was studied. From peak concentrations 24 h prior to the study to a nadir 72 h after the infusion commenced, acetoacetate fell from 4.17 mmol l-1 to 0.86 mmol l-1, beta-hydroxybutyrate from 9.91 mmol l-1 to 2.03 mmol l-1, and acetone from 2 mmol l-1 to 0.4 mmol l-1. Further studies of rhlGF-1 use caused a fall in concentrations of cholesterol, triglyceride, VLDL, LDL, and apolipoprotein B. Infusion of rhlGF-1 reduces ketone body concentrations and may be life-saving in the treatment of ketoacidosis developing in a patient with a severe insulin-resistant state.
University Department of Medicine, King's College Hospital, London, UK.
J D
JD
Quin
K
K
Smith
G H
GH
Beastall
J P
JP
Miell
A C
AC
MacCuish
D020155:3-Hydroxybutyric Acid; D000090:Acetoacetates / Q000652:urine; D000293:Adolescent; D001053:Apolipoproteins / Q000097:blood*; D016883:Diabetic Ketoacidosis / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D006885:Hydroxybutyrates / Q000652:urine; D007262:Infusions, Intravenous; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000008:administration & dosage / Q000627:therapeutic use*; D007657:Ketone Bodies / Q000652:urine*; D008055:Lipids / Q000097:blood*; D008297:Male; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D013577:Syndrome
D000090:Acetoacetates; D001053:Apolipoproteins; D006885:Hydroxybutyrates; D007657:Ketone Bodies; D008055:Lipids; D011994:Recombinant Proteins; C016635:acetoacetic acid; D007334:Insulin-Like Growth Factor I; D020155:3-Hydroxybutyric Acid