IGF-I, IGF-I-binding proteins and GH-binding protein in malnourished elderly patients with inflammation receiving refeeding therapy.

Abstract

OBJECTIVE:

To investigate the mechanisms determining the success or failure of refeeding therapy in malnourished elderly patients with inflammation by studying changes in plasma IGF-I, GH-binding protein (GHBP) and IGF-binding protein (IGFBP) levels and IGFBP-3 proteolysis.

DESIGN AND METHODS:

We studied 15 severely malnourished hospitalized elderly patients. Weight, food intake, plasma albumin, transthyretin, C-reactive protein (CRP), orosomucoid, interleukin-6 (IL-6), IGF-I, intact and proteolytically degraded IGFBP-3 and GHBP levels were determined on admission and during refeeding therapy designed to increase food intake to 40 kcal/kg body weight per day (15% protein).

RESULTS:

Plasma IGF-I, IGFBP-3 and GHBP levels were significantly low for age on admission in all malnourished elderly patients. They increased in nine patients as nutritional status improved (albuminemia >30 g/l; transthyretinemia >200 mg/l or weight gain >5% of initial body weight) and levels of inflammation markers decreased (group 1). In contrast, plasma IGF-I, IGFBP-3 and GHBP levels remained low in six patients in whom nutritional status failed to improve and levels of inflammation markers increased (group 2). IGF-I showed greater variations than IGFBP-3 or GHBP with respect to nutritional status. High plasma CRP and IL-6 levels were associated with high levels of IGFBP-3 proteolysis.

CONCLUSION:

Efficient refeeding therapy was associated with a significant increase in IGF-I plasma levels. In patients with severe and persistent inflammation, high levels of proteolysis of IGFBP-3 may have contributed to the low plasma IGF-I levels, persistence of hypercatabolism and lack of improvement in nutritional status.

• Authors: A Raynaud-Simon, L Perin, S Meaume, B Lesourd, R Moulias, M C Postel-Vinay, Y Le Bouc
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 146 Issue 5 Pg. 657-65 (May 2002) ISSN: 0804-4643 [Print] England
• PMID: 11980621 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Carrier Proteins
• Insulin-Like Growth Factor Binding Protein 3
• Insulin-Like Growth Factor Binding Proteins
• Interleukin-6
• Insulin-Like Growth Factor I
• C-Reactive Protein
• Peptide Hydrolases
• somatotropin-binding protein

Topics

• Aged
• Aged, 80 and over
• C-Reactive Protein (analysis)
• Carrier Proteins (blood)
• Female
• Food
• Humans
• Inflammation (complications)
• Insulin-Like Growth Factor Binding Protein 3 (metabolism)
• Insulin-Like Growth Factor Binding Proteins (blood)
• Insulin-Like Growth Factor I (analysis)
• Interleukin-6 (blood)
• Male
• Nutrition Disorders (blood, complications, physiopathology, therapy)
• Nutritional Status
• Peptide Hydrolases (metabolism)