Insulin-like growth factor-1 lowers protein oxidation in patients with thermal injury

William G. Cioffi, Dennis Gore, Loring W. Rue, Gretchen Carrougher, Hans Peter Guler, William F. McManus, Basil A. Pruitt

113 Scopus citations

Abstract

Objective: The effect of insulin-like growth factor-1 (IGF-1) on energy expenditure and protein and glucose metabolism in a group of patients with thermal injury was determined. Summary Background Data: Accelerated protein catabolism is a constant feature of the hypermetabolic response to thermal injury. Insulin-like growth factor-1 has been reported to minimize protein catabolism and normalize energy expenditure in animal models of thermal injury. Methods: To determine the efficacy of IGF-1 in human burn patients, resting energy expenditure (metabolic cart), whole body protein kinetics ((N)15 Lysine), and glucose disposal (glucose tolerance test) were assessed in eight burn patients before and after a 3-day infusion of GF-1 (20 μg/kg/hr). All patients were fluid-resuscitated uneventfully and were without obvious infection at the time of study. Enteral nutrition was administered at a constant rate before and during the IGF-1 infusion. Results: Resting energy expenditure was not altered by IGF-1 (40.3 ± 2.2 vs. 39.1 ± 2.3 kcal/kg/day). However, glucose uptake was promoted, and protein oxidation decreased significantly (0.118 ± 0.029 vs. 0.087 ± 0.021 g/kg/d, p < 0.05) by IGF-1. In addition, insulin secretion, in response to a glucose challenge was blunted. Conclusions: Insulin-like growth factor-1 therapy has a beneficial effect in preserving lean body mass during severe stress conditions by minimizing the flux of amino acids toward oxidation.

Original languageEnglish (US)
Pages (from-to)310-319
Number of pages10
JournalAnnals of Surgery
Volume220
Issue number3
StatePublished - Sep 1994
Externally publishedYes

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ASJC Scopus subject areas

  • Surgery

Cite this

Insulin-like growth factor-1 lowers protein oxidation in patients with thermal injury. / Cioffi, William G.; Gore, Dennis; Rue, Loring W.; Carrougher, Gretchen; Guler, Hans Peter; McManus, William F.; Pruitt, Basil A.

In: Annals of Surgery, Vol. 220, No. 3, 09.1994, p. 310-319.

Research output: Contribution to journalArticle