Growth hormone and insulin‐like growth factor 1 levels and their relation to survival in children with bacterial sepsis and septic shock

Önenli-Mungan, Neslihan; Yıldızdaş, Dinçer; Yapıcıoğlu, Hacer; Topaloglu, A. K. mal; Yüksel, Bilgin; Özer, Güler

doi:10.1111/j.1440-1754.2004.00342.x

Cited by 32 publications

(27 citation statements)

References 28 publications

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“…Interestingly, in children with meningococcal sepsis, non-surviving children had markedly higher GH levels and decreased IGF1 levels as compared with survivors (15). Another study in children with sepsis or septic shock found similar results (16). During prolonged critical illness, low serum concentrations of IGFBP-1 are a predictor for adverse outcome (3,17) and a low IGF1/GH ratio identified patients with chronic heart failure at higher risk of cardiac death (18).…”

Section: Introductionmentioning

confidence: 82%

Circulating levels of GH predict mortality and complement prognostic scores in critically ill medical patients

Schuetz¹,

Müller²,

Nusbaumer³

et al. 2009

European Journal of Endocrinology

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Background: Circulating levels of GH are increased during critical illness and correlate with outcome in children with meningococcal sepsis. We assessed the prognostic implications of GH on admission and during follow-up in critically ill adult patients admitted to a medical intensive care unit. Materials and methods: We measured GH, IGF1 and IGF-binding protein3 (IGFBP-3) plasma concentrations in 103 consecutive critically ill patients and compared it with two clinical severity scores (APACHE II, SAPS II). Results: Median GH levels on admission were similar in septic (nZ53) and non-septic (nZ50) patients and about 7-fold increased in the 24 non-survivors as compared with survivors (9.50 (interquartile ranges (IQR) 3.53-18.40) vs 1.4 (IQR 0.63-5.04), P!0.0001). GH levels increased with increasing severity of sepsis (sepsis, severe sepsis, and septic shock, PZ0.019). By contrast, IGF1 and IGFBP-3 did not correlate with severity of disease or mortality. Logistic regression models showed that GH and both clinical scores were independent predictors of mortality with a similar prognostic accuracy (GH: area under the curve (AUC) 0.81 (95% confidence interval (CI), 0.71-0.92), APACHE II: AUC 0.71 (95% CI, 0.58-0.83), PZ0.16, SAPS II: AUC 0.75 (95% CI, 0.63-0.86, PZ0.36)). GH improved the prognostic accuracy of the APACHE II score to an AUC of 0.78 (95% CI, 0.66-090, PZ0.04) and tended to improve the SAPS II score to an AUC of 0.79 (95% CI, 0.67-0.90, PZ0.09). Conclusion: GH plasma concentrations on admission are independent predictors for mortality in adult critically ill patients and may complement existing risk prediction scores, namely the APACHE II and the SAPS II score.

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Section: Introductionmentioning

confidence: 82%

Circulating levels of GH predict mortality and complement prognostic scores in critically ill medical patients

Schuetz¹,

Müller²,

Nusbaumer³

et al. 2009

European Journal of Endocrinology

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“…GH binding to GHRs through the ability of the intestinal mucosa to take up and utilize glutamine could promote growth differentiation and wound repair of the intestinal mucosa, ameliorate the impairment of the intestinal mucosa and maintain the structure and function of the intestinal mucosa barrier (9). The GH/IGF-1 axis is present in the body (10)(11)(12)(13)(14). GH binding to GHRs could increase IGF-1 lev- GH is an important anabolic hormone.…”

Section: Discussionmentioning

confidence: 99%

Beneficial effect of recombinant human growth hormone on the intestinal mucosa barrier of septic rats

Cao

Wang

et al. 2007

Braz J Med Biol Res

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The objective of the present study was to investigate the effects of recombinant human growth hormone (rhGH) on the intestinal mucosa barrier of septic rats and explore its possible mechanism. Female Sprague-Dawley rats were randomized into three groups: control, Escherichia coli-induced sepsis (S) and treatment (T) groups. Groups S and T were subdivided into subgroups 1d and 3d, respectively. Expression of liver insulin-like growth factor-1 (IGF-1) mRNA, Bcl-2 and Bax protein levels and the intestinal Bax/Bcl-2 ratio, and plasma GH and IGF-1 levels were determined. Histological examination of the intestine was performed and bacterial translocation was determined. rhGH significantly attenuated intestinal mucosal injuries and bacterial translocation in septic rats, markedly decreased Bax protein levels, inhibited the decrease of Bcl-2 protein expression and maintained the Bax/Bcl-2 ratio in the intestine. rhGH given after sepsis significantly improved levels of plasma GH (T1d: 1.28 ± 0.24; T3d: 2.14 ± 0.48 µg/L vs S1d: 0.74 ± 0.12; S3d: 0.60 ± 0.18 µg/L; P < 0.05) and T3d: 201.56 ± 64.98 µg/L vs S1d: 116.72 ± 13.96; S3d: 107.50 ± 23.53 µg/L; P < 0.05) and expression of liver IGF-1 mRNA (T1d: 0.98 ± 0.20; T3d: 1.76 ± 0.17 vs S1d: 0.38 ± 0.09; S3d: 0.46 ± 0.10; P < 0.05). These findings indicate that treatment with rhGH had beneficial effects on the maintenance of the integrity of the intestinal mucosa barrier in septic rats.

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“…Circulating levels of GH (13), IGFs and IGFBPs (14)(15)(16) are often taken into consideration as prognostic biomarkers in critically ill patients. Lower levels of IGF-I and IGFBP-3 and higher levels of GH, IGFBP-1 and IGFBP-2 are found in non-survivors compared with survivors.…”

Section: Discussionmentioning

confidence: 99%

Ligand-Binding Activity and Immunoreactivity of Insulin-Like growth Factor Binding Proteins in Patients with Colorectal Carcinoma And Postoperative Sepsis

Nedić¹,

Malenković²,

Đukancvić³

et al. 2013

Journal of Medical Biochemistry

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Summary Background: Postoperative sepsis alters the growth hormone (GH)/insulin-like growth factor (IGF) axis leading to reduction in IGF-I and IGF-binding protein (IGFBP) 3 and elevation of GH-independent IGFBPs. The aim of this work was to investigate the differences in ligand binding and immunoreactivity of the circulating IGFBPs between surviving and nonsurviving septic patients that underwent colorectal surgery. Methods: Ligand binding was detected only for IGFBP-3 and IGFBP-2 and, consecutively, immunoreactivity was assayed for these IGFBPs. Results: In survivors both ligand- and immunoblotting re - vea led two IGFBP-3 isoforms (40 and 45 kDa). In non-survivors ligand-blotting hardly detected the IGFBP-3 doublet, intact immunoreactive IGFBP-3 was not detected and the major species was the 29 kDa fragment. Immunoblotting with an anti-IGFBP-2 antibody indicated an increase in the amount of intact and fragmented IGFBP-2 along the progression of illness in the non-survivors. The amount of intact IGFBP-2 in the survivors did not differ during the treatment. The amount of immunoreactive IGFBP-2 corresponded to its ligand-binding activity. Conclusions: According to the results reported here, ligandreactivity and immunoreactivity of IGFBP-3 should be taken into account as variables that affect the GH/IGF axis in critically ill patients. The degree of their variation is not directly correlated to the total amount of IGFBP-3 determined by the immunoassay, but they may be related to patients’ meta bolic potential to combat a disease.

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Growth hormone and insulin‐like growth factor 1 levels and their relation to survival in children with bacterial sepsis and septic shock

Cited by 32 publications

References 28 publications

Circulating levels of GH predict mortality and complement prognostic scores in critically ill medical patients

Circulating levels of GH predict mortality and complement prognostic scores in critically ill medical patients

Beneficial effect of recombinant human growth hormone on the intestinal mucosa barrier of septic rats

Ligand-Binding Activity and Immunoreactivity of Insulin-Like growth Factor Binding Proteins in Patients with Colorectal Carcinoma And Postoperative Sepsis

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