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Effects of IGF-I administration to the postoperative patient
Linköping University, Department of Biomedicine and Surgery, Division of surgery. Linköping University, Faculty of Health Sciences.
2005 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

n/a

Place, publisher, year, edition, pages
Linköping: Kopierat själv , 2005. , 39 p.
Series
Linköping Studies in Health Sciences. Thesis, ISSN 1100-6013 ; 72
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-32756Local ID: 18682ISBN: 91-85299-18-9 (print)OAI: oai:DiVA.org:liu-32756DiVA: diva2:253579
Available from: 2009-10-09 Created: 2009-10-09 Last updated: 2013-09-20
List of papers
1. Effect of postoperative insulin-like growth factor I supplementation on protein metabolism in humans
Open this publication in new window or tab >>Effect of postoperative insulin-like growth factor I supplementation on protein metabolism in humans
1995 (English)In: British Journal of Surgery, ISSN 0007-1323, E-ISSN 1365-2168, Vol. 82, no 7, 921-925 p.Article in journal (Refereed) Published
Abstract [en]

Insulin-like growth factor I (IGF-I) has been shown experimentally to exert a nitrogen-sparing effect in both animals and humans. Its effects on protein metabolism during the first 5 days after radical large bowel resection were investigated. Nineteen patients were randomly allocated to receive either human recombinant IGF-I (2 × 80 μ/kg body weight subcutaneously, n = 10) or placebo (n = 9) starting on the morning of the first day after operation. All patients received parenteral nutrition (glucose 3 g and nitrogen 0.1 g/kg/day). The mean(s.e.m.) urinary nitrogen: creatinine ratio was significantly reduced in patients who received IGF-I compared with those given placebo (275.0(17.1) compared with 386.3(23.6), P<0.01). The mean urinary 3-methylhistidine: creatinine ratio and nitrogen balance were lower in the IGF-I group, but not significantly so. Plasma IGF-I concentrations were four times higher in the treated group compared with those in the placebo group. Insulin-like growth factor binding protein 3 (IGFBP-3) increased significantly after the start of IGF-I treatment, compared with mean postoperative levels. The mean blood glucose concentration was significantly lower in the IGF-I group than the placebo group (P < 0.05) but no patient had a hypoglycaemic attack. The authors conclude that IGF-I does not significantly influence the nitrogen balance, but that results indicate a possible nitrogen-sparing effect in patients after major abdominal operations. IGF-I therapy is safe, and may be of value in catabolic patients after serious injury and major operations.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97710 (URN)10.1002/bjs.1800820722 (DOI)A1995RG57400018 ()
Available from: 2013-09-20 Created: 2013-09-20 Last updated: 2017-12-06
2. Gastrointestinal growth factors and pancreatic islet hormones during postoperative IGF-I supplementation in man
Open this publication in new window or tab >>Gastrointestinal growth factors and pancreatic islet hormones during postoperative IGF-I supplementation in man
Show others...
2000 (English)In: Journal of Endocrinology, ISSN 0022-0795, E-ISSN 0022-0795, Vol. 167, no 2, 331-338 p.Article in journal (Refereed) Published
Abstract [en]

Insulin-like growth factor-I (IGF-I) has been demonstrated to exert a nitrogen sparing effect, both experimentally and in patients after abdominal surgery. IGF-I is a major mediator for the anabolic effects of growth hormone (GH). Whether elevated circulating IGF-I levels are the sole mediator of the anabolic effects following GH has not been clarified. IGF-I influences glucose metabolism, both through its own specific receptor and by activating the insulin receptor, and has also been proposed to influence pancreatic islet secretion directly. In the present study, the postoperative effects of IGF-I on plasma levels of other gastrointestinal and pancreatic islet hormones and growth factors were measured in patients after abdominal surgery. Fifteen patients who were candidates for large bowel resection were randomly divided into two groups: IGF-I-treated (n=8) and placebo-treated (n=7). The IGF-I group received daily two s.c. injections of human recombinant IGF-I (80 microg/kg body weight) for five days, beginning on the morning of the first postoperative day. The other group received placebo injections. Fasting plasma levels of gastrointestinal growth factors (epidermal growth factor, transforming growth factor-alpha, IGF-II), gastrointestinal hormones (gastrin, enteroglucagon, peptide YY), and islet hormones (insulin, islet amyloid polypeptide (IAPP) and pancreatic glucagon) were determined by RIA preoperatively and after five days of treatment. No significant effects of IGF-I on other growth factors or gastrointestinal hormones were seen. A marked increase in plasma insulin postoperatively compared with the preoperative levels (42+/-3 vs 61+/-5 pM, P<0.05) was seen in the placebo group, whereas the postoperative levels in the IGF-I-treated patients remained unchanged (44+/-3 vs 45+/-4 pM). A similar pattern was observed for IAPP and cortisol concentrations. No differences in glucagon concentrations were seen. In conclusion, these results suggest that IGF-I does not influence production of other gastrointestinal hormones thought to be involved in alimentary growth or pancreatic glucagon. In contrast, IGF-I caused a marked reduction of insulin and IAPP secretion. The inhibition of beta-cell secretion could be direct or, alternatively, could involve an improvement in postoperative insulin resistance, perhaps by reducing serum cortisol.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-49362 (URN)10.1677/joe.0.1670331 (DOI)000167209400016 ()
Available from: 2009-10-11 Created: 2009-10-11 Last updated: 2013-09-20

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