title: Differential influence of open surgery and sepsis on the circulating insulin-like growth factors and their binding proteins as representative metabolic markers.
abstract: 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.
authors: Institute for the Application of Nuclear Energy-INEP, University of Belgrade, Banatska 31b, 11080 Belgrade-Zemun, Serbia. ivona@inep.co.yu
authors: Ivona
authors: I
authors: Baricević
authors: David R
authors: DR
authors: Jones
authors: Biljana
authors: B
authors: Dordević
authors: Vesna
authors: V
authors: Malenković
authors: Olgica
authors: O
authors: Nedić
mesh_terms: 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*
chemical_list: D015415:Biomarkers; D018969:Insulin-Like Growth Factor Binding Proteins; D013002:Somatomedins