The somatomedin activity in plasma from patients with multiple mechanical injuries: with observations on plasma cortisol

Coates, Claire L.; Burwell, R. G.; Carlin, Spencer; Milligan, Graeme; Littlejohn, Sheila; London, P.S.; Selby, C.; Swannell, A J

doi:10.1016/0020-1383(81)90042-5

Cited by 20 publications

(3 citation statements)

References 23 publications

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“…Case I, proportional changes in pre-albumin exceed those in IGF-l (P<0'02, n= [12][13][14][15]. This inconsistency suggests that different factors may govern the two analytes during TPN.…”

Section: Changes During Tpn In Plasma Igf-j and In Plasma Pre-albuminmentioning

confidence: 94%

Insulin-Like Growth Factor 1: A Valid Nutritional Indicator during Parenteral Feeding of Patients Suffering an Acute Phase Response

Burgess

1992

Ann Clin Biochem

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SUMMARY. Insulin-like growth factor I (IGF-I) is regulated by nutritional intake independently of growth hormone and may be a better nutritional indicator than the plasma proteins. This possibility was investigated in six malnourished inpatients, who suffered sepsis, surgical trauma, or both and who received total parenteral nutrition (TPN) for 10-35 days. Both plasma IGF-I and pre-albumin showed (P<0'05) increases during TPN from baseline values of O'042-0' 42 U/mL (median, O' 11) and 59-156 mg/L (median, 108), respectively, to maxima of 0'19-1,12 U/mL (median, 0'63) and 140-363 mg/L (median, 203). Statistically significant (P<0'05) positive correlation occurred between nitrogen balance (range, -7· 5 to + II . 0 g/day) and IGF-I or pre-albumin. Correlation between nitrogen balance and IGF-I is preserved during the acute phase response to tissue injury when C-reactive protein (CRP) varies in the range 40-248 mg/L. Under these circumstances, the correlation between nitrogen balance and pre-albumin is,.in contrast, abolished. These results suggest that IGF-I behaves as a valid index of nutritional adequacy during parenteral feeding whereas pre-albumin reflects mainly the acute phase response. Additional key phrases: C-reactive protein; nutrition assessment; parenteral hyperalimentation; prealbumin; somatomedinsDuring the administration of total parenteral nutrition (TPN) there is need for a plasma index of adequate provision of energy and nitrogen. Plasma proteins of sufficiently large fractional catabolic rate (e.g., pre-albumin: O' 59/day)1 respond to nutritional change with a speed and sensitivity that might make them suitable indices.s-' However, during an acute phase response to tissue injury, the general increase in microvascular permeability causes an almost immediate fall in the plasma concentration of these proteins, and there may be a supplementary decrease (>6 h) reflecting their altered metabolism." The latter change, perhaps an adaptation to catabolic nitrogen losses, might relate to nutritional status: but the former is an independent and therefore confounding phenomenon. J This phenomenon will occur in most patients receiving TPN, who are usually ill or perioperative and suffering an acute phase response.

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“…Case I, proportional changes in pre-albumin exceed those in IGF-l (P<0'02, n= [12][13][14][15]. This inconsistency suggests that different factors may govern the two analytes during TPN.…”

Section: Changes During Tpn In Plasma Igf-j and In Plasma Pre-albuminmentioning

confidence: 94%

Insulin-Like Growth Factor 1: A Valid Nutritional Indicator during Parenteral Feeding of Patients Suffering an Acute Phase Response

Burgess

1992

Ann Clin Biochem

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“…Exclusion criteria included certain mortality within 24 hours, residual or metastatic cancer, high-dose corticosteroid therapy, or pregnancy. The study was reviewed and approved by the New Zealand North Health Ethics Committee.…”

Section: Patient Selection and Clinical Managementmentioning

confidence: 99%

Sequential Changes in Insulin‐Like Growth Factor 1, Plasma Proteins, and Total Body Protein in Severe Sepsis and Multiple Injury

Clark

Hentzen

Plank

et al. 1996

J Parenter Enteral Nutr

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“…Depressed plasma IGf-1 activity occurs in trauma and burn patients within 2 days of injury and persists for up to 9 days. :": 45,47 No relationship has been observed with the catabolic response judged by nitrogen excretion. Hemodialysis patients with a recent history of infection were the only subgroup in whom IGf-1 did not correlate with undernutrttlon."…”

Section: Trials In Malnourished Patientsmentioning

confidence: 99%

Growth Factors in Nutritional Support

Hatton,

Luer,

Rapp

1993

Pharmacotherapy

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Protein catabolism occurs in the severely stressed patient despite adequate protein supplementation. Supplementation of endogenous growth factors is one mechanism being evaluated to promote anabolism and improve nitrogen retention. Recombinant technology has provided a means to reproduce these endogenous growth factors. Both recombinant human growth hormone (rGH) and recombinant human insulin‐like growth factor‐1 (rhIGf‐1) are undergoing clinical trials to establish their roles in nutritional support.

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The somatomedin activity in plasma from patients with multiple mechanical injuries: with observations on plasma cortisol

Cited by 20 publications

References 23 publications

Insulin-Like Growth Factor 1: A Valid Nutritional Indicator during Parenteral Feeding of Patients Suffering an Acute Phase Response

Insulin-Like Growth Factor 1: A Valid Nutritional Indicator during Parenteral Feeding of Patients Suffering an Acute Phase Response

Sequential Changes in Insulin‐Like Growth Factor 1, Plasma Proteins, and Total Body Protein in Severe Sepsis and Multiple Injury

Growth Factors in Nutritional Support

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