Differential influence of open surgery and sepsis on the circulating insulin-like growth factors and their binding proteins as representative metabolic markers.
OBJECTIVE
In critical illnesses and stress conditions many endocrine systems are disturbed. In the current study we determined the influence of open surgery, post-operative sepsis and its early therapy on the components of the insulin-like growth factor (IGF) system in patients with malignant gastric or pancreatic tumors.


METHODS
Twenty-one patients and eighty-one age- and sex-matched healthy subjects were included in this study. IGF-I, IGF-II, IGF binding proteins (IGFBPs), cortisol, insulin and protein concentrations (total, albumin and IgG) were determined pre-operatively, post-operatively, when sepsis was diagnosed and 48 h after initiating therapy.


RESULTS
The concentrations of circulating IGF-I, IGF-II and IGFBP-3 were significantly lower in pre-operative patients compared to healthy subjects. Sepsis caused a further decrease in IGF-I and IGFBP-3 but an increase in IGFBP-1, IGFBP-2 and IGFBP-4 resulting in a redistribution of IGF molecules from ternary to binary complexes.


CONCLUSIONS
The presence of malignant gastric or pancreatic tumors followed by post-operative sepsis caused a serious misbalance in components of the IGF system which failed to recover during the time of our longitudinal study.
Baricević
Ivona
I
Institute for the Application of Nuclear Energy-INEP, University of Belgrade, Banatska 31b, 11080 Belgrade-Zemun, Serbia. ivona@inep.co.yu
Jones
David R
DR
Dordević
Biljana
B
Malenković
Vesna
V
Nedić
Olgica
O
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D018969:Insulin-Like Growth Factor Binding Proteins / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000378:metabolism; D018805:Sepsis / Q000097:blood* / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D013002:Somatomedins / Q000032:analysis*
D015415:Biomarkers; D018969:Insulin-Like Growth Factor Binding Proteins; D013002:Somatomedins