Regulation of the insulin-like growth factor system by insulin in burn patients

Charles H. Lang, Jie Fan, Robert A. Frost, Marie C. Gelato, Yoichi Sakurai, David Herndon, Robert R. Wolfe

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

The aim of the present investigation was to determine whether there is a net uptake of insulin-like growth factor I (IGF-I) or IGF-binding proteins (IGFBPs) by the leg alter bum injury and to elucidate the regulatory role of insulin exerted on this system under in vivo conditions in burn patients. Studies were performed on nine patients after burn injury (-60% body surface area). Each patient was studied twice during a continuous infusion of a carbohydrate-rich enteral diet. Blood was collected simultaneously from the femoral artery and vein for the measurement of various elements of the IGF system after 7 days of enters] diet alone (basal period) and after 7 days of the enteral diet plus the infusion of insulin (insulin period). Data from these patients were compared to values in age-matched fed healthy volunteers. During the basal period, burn patients demonstrated a significant reduction in the venous concentration of IGF-I and an increase in both IGFBP-1 and-2 compared to control values. Insulin produced a significant 15% increase in the IGF-I concentration in burn patients, but decreased the circulating levels of IGFBP-1 by 50%. The IGF-I and IGFBP-I concentrations at the end of the insulin period were still significantly different from those in control subjects. Burn patients also exhibited a marked reduction in intact IGFBP-3 oxid the acid-labile subunit under basal conditions, and these alterations were not reversed by insulin. Under basal conditions, all burn patients had a positive arteriovenous (A-V) difference for IGF-I across the leg. The A-V difference was increased 50% in response to insulin. The net uptake of IGF-I by the leg was 2.4 pg/min under basal conditions, and as leg blood flow also tended to increase in response to insulin, IGF-1 uptake was elevated more than 3-fold during the insulin period. No A-V difference across the leg was detected for IGFBP-1, -2, or -3 in burn patients. In conclusion, burn injury in humans produces dramatic and sustained alterations in various components of the IGF system that persist despite adequate nutritional support. Our data indicate the presence of a net uptake of IGF-I by the leg in burn patients that may serve to counteract the catabolic state.

Original languageEnglish (US)
Pages (from-to)2474-2480
Number of pages7
JournalJournal of Clinical Endocrinology and Metabolism
Volume81
Issue number7
DOIs
StatePublished - 1996
Externally publishedYes

Fingerprint

Somatomedins
Insulin-Like Growth Factor I
Insulin
Leg
Insulin-Like Growth Factor Binding Protein 1
Nutrition
Insulin-Like Growth Factor Binding Proteins
Insulin-Like Growth Factor Binding Protein 2
Diet
Small Intestine
Blood
Wounds and Injuries
Insulin-Like Growth Factor Binding Protein 3
Femoral Vein
Nutritional Support
Body Surface Area
Femoral Artery
Healthy Volunteers
Carbohydrates
Acids

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Lang, C. H., Fan, J., Frost, R. A., Gelato, M. C., Sakurai, Y., Herndon, D., & Wolfe, R. R. (1996). Regulation of the insulin-like growth factor system by insulin in burn patients. Journal of Clinical Endocrinology and Metabolism, 81(7), 2474-2480. https://doi.org/10.1210/jc.81.7.2474

Regulation of the insulin-like growth factor system by insulin in burn patients. / Lang, Charles H.; Fan, Jie; Frost, Robert A.; Gelato, Marie C.; Sakurai, Yoichi; Herndon, David; Wolfe, Robert R.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 81, No. 7, 1996, p. 2474-2480.

Research output: Contribution to journalArticle

Lang, CH, Fan, J, Frost, RA, Gelato, MC, Sakurai, Y, Herndon, D & Wolfe, RR 1996, 'Regulation of the insulin-like growth factor system by insulin in burn patients', Journal of Clinical Endocrinology and Metabolism, vol. 81, no. 7, pp. 2474-2480. https://doi.org/10.1210/jc.81.7.2474
Lang, Charles H. ; Fan, Jie ; Frost, Robert A. ; Gelato, Marie C. ; Sakurai, Yoichi ; Herndon, David ; Wolfe, Robert R. / Regulation of the insulin-like growth factor system by insulin in burn patients. In: Journal of Clinical Endocrinology and Metabolism. 1996 ; Vol. 81, No. 7. pp. 2474-2480.
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