Age-dependency of insulin-like growth factors, insulin-like growth factor-binding proteins, and acid labile subunit in plasma and wounds of surgical patients.
Wound problems are common in the elderly. We hypothesized that age-related decrements in blood levels of components of the insulin-like growth factor (IGF) system are reflected in the wound environment. In this prospective, observational study IGF-I, IGF-II, IGF-binding protein-2, IGF-binding protein-3, and acid labile subunit were measured by immunoassays in the wound fluid and plasma of young (23.5 +/- 3.3 years) and elderly (78.9 +/- 6.2 years) patients before and daily for 4 days after elective surgery. IGFs, IGFBP-3, and acid labile subunit in plasma were significantly lower in the elderly group (p < 0.0001). The decrements of these proteins in plasma were reflected in corresponding decrements of 25-70% in the wound fluid of elderly patients (p < 0.0001). Additionally, bioavailability of IGF-I was less in the aged. The IGF parameters in the wound displayed a constant ratio with those of blood, suggesting that blood contributes a major share of the IGF that enters the wound during the initial phase of healing. The current data adds to accumulating evidence that a decline in the IGF system in aged patients contributes to the healing deficits observed in the elderly.
Wicke
Corinna
C
Department of Surgery, Pediatric Endocrinology Section of the Children's Hospital, and BG-Trauma Center, University of Tübingen, Tübingen, Germany. corinna@wicke@med.uni-tuebingen.de
Wagner
Silvia
S
Trabold
Odilo
O
Müller
Jürgen
J
Hunt
Thomas K
TK
Ranke
Michael B
MB
Becker
Horst-Dieter
HD
Elmlinger
Martin W
MW
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018971:Insulin-Like Growth Factor Binding Protein 2 / Q000032:analysis* / Q000097:blood*; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000032:analysis* / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D007335:Insulin-Like Growth Factor II / Q000032:analysis*; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications; D011446:Prospective Studies; D013997:Time Factors; D014945:Wound Healing / Q000502:physiology; D014950:Wounds, Penetrating / Q000097:blood* / Q000209:etiology* / Q000503:physiopathology
D018971:Insulin-Like Growth Factor Binding Protein 2; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I; D007335:Insulin-Like Growth Factor II