title: Somatotropic axis resistance and ghrelin in critically ill foals.
abstract: BACKGROUND
  Resistance to the somatotropic axis and increases in ghrelin concentrations have been documented in critically ill human patients, but limited information exists in healthy or sick foals.
  
  
  OBJECTIVE
  To investigate components of the somatotropic axis (ghrelin, growth hormone and insulin-like growth factor-1 [IGF-1]) with regard to energy metabolism (glucose and triglycerides), severity of disease and survival in critically ill equine neonates. It was hypothesised that ghrelin and growth hormone would increase and IGF-1 would decrease in proportion to severity of disease, supporting somatotropic axis resistance, which would be associated with severity of disease and mortality in sick foals.
  
  
  METHODS
  Prospective multicentre cross-sectional study.
  
  
  METHODS
  Blood samples were collected at admission from 44 septic, 62 sick nonseptic (SNS) and 19 healthy foals, all aged <7 days. Foals with positive blood cultures or sepsis scores ≥12 were considered septic, foals with sepsis scores of 5-11 were classified as SNS. Data were analysed by nonparametric methods and multivariate logistic regression.
  
  
  RESULTS
  Septic foals had higher ghrelin, growth hormone and triglyceride and lower IGF-1 and glucose concentrations than healthy foals (P<0.01). Sick nonseptic foals had higher growth hormone and triglycerides and lower IGF-1 concentrations than healthy foals (P<0.05). Growth hormone:IGF-1 ratio was higher in septic and SNS foals than healthy foals (P<0.05). Hormone concentrations were not different between septic nonsurvivors (n = 14) and survivors (n = 30), but the growth hormone:IGF-1 ratio was lower in nonsurvivors (P = 0.043).
  
  
  CONCLUSIONS
  Somatotropic axis resistance, characterised by a high growth hormone:IGF-1 ratio, was frequent in sick foals, associated with the energy status (hypoglycaemia, hypertriglyceridaemia) and with mortality in septic foals.
  
  
  CONCLUSIONS
  A functional somatotropic axis appears to be important for foal survival during sepsis. Somatotropic resistance is likely to contribute to severity of disease, a catabolic state and likelihood of recovery.
authors.affiliation: Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, USA.
authors.forename: R J I M
authors.initials: RJ
authors.lastname: Barsnick
authors.forename: S D A
authors.initials: SD
authors.lastname: Hurcombe
authors.forename: K
authors.initials: K
authors.lastname: Dembek
authors.forename: M L
authors.initials: ML
authors.lastname: Frazer
authors.forename: N M
authors.initials: NM
authors.lastname: Slovis
authors.forename: W J A
authors.initials: WJ
authors.lastname: Saville
authors.forename: R E
authors.initials: RE
authors.lastname: Toribio
mesh_terms: D000818:Animals; D016638:Critical Illness; D003430:Cross-Sectional Studies; D005260:Female; D054439:Ghrelin / Q000097:blood / Q000378:metabolism*; D006734:Horse Diseases / Q000097:blood / Q000378:metabolism*; D006736:Horses; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis
chemical_list: D054439:Ghrelin
keywords: energy metabolism; ghrelin; growth hormone; horse; insulin-like growth factor-1; resistance; sepsis