The effects of exogenous insulin-like growth factor-I (IGF-I) on colonic adaptation were examined in male Sprague-Dawley rats (n = 60, 225-275 mg) after either a 60% small bowel and cecal resection (RX) or mid-small bowel transection with reanastomosis (TX). Animals received a 7-day treatment with either IGF-I (2.4 mg.kg-1.day-1) or vehicle (V; 0.1 mol/l acetic acid). Body weight decreased significantly after resection (-25.6 +/- 4.0 g; P < 0.05 vs. TX/V). IGF-I treatment significantly reduced weight loss after resection (-12.4 +/- 3.8 g; P < 0.01 vs. RX/V) and induced significant weight gain after transection (15.6 +/- 4.0 g; P < 0.05 vs. TX/V). Plasma IGF-I decreased with resection (526 +/- 41 TX/V vs. 344 +/- 17 ng/ml RX/V; P < 0.01). IGF-I treatment significantly increased plasma IGF-I levels (805 +/- 100 ng/ml TX/IGF, 677 +/- 56 ng/ml RX/IGF). After resection, IGF-I treatment significantly increased colonic mucosal weight, DNA, protein content, and crypt depth when compared with resection alone (P < 0.05). Colonic water absorption, measured by an in vivo [3H]polyethylene glycol assay, was significantly increased by IGF-I treatment in resected animals (399 +/- 23 RX/IGF vs. 306 +/- 32 microliter.cm-1.h-1 RX/V; P < 0.05). Resection resulted in increased steady-state colonic IGF-I mRNA (182% of TX/V; P < 0.01) without significantly affecting IGF-I receptor mRNA expression. Regulation of IGF binding protein (BP)-3 and -4 was discoordinate, with IGFBP-3 mRNA tending to decrease with resection (67% of TX/V; P is not significant) and IGFBP-4 increasing significantly (191% of TX/V; P < 0.05). An important role for IGF-I in colonic adaptation after massive intestinal resection is indicated by 1) significantly enhanced colonic mucosal growth and water absorption with IGF-I treatment and 2) postresection upregulation of colonic IGF-I mRNA and alteration of IGFBP-3 and IGFBP-4 mRNA expression.

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ObjectiveTo determine the prevalence of acute malnutrition and low biological markers in children with congenital heart disease (CHD) before and after corrective surgery, Children's Hospital 1, Ho Chi Minh City, Vietnam.MethodsProspective observational study of 30 consecutive children <24 month old with CHD admitted for corrective surgery, 5‐9/2013. Data included age, cardiac diagnosis, length of hospital stay, among others. Weight, height, serum markers of nutrition, inflammation and immunity were measured before and 1m after surgery. Anthro‐software (WHO) and STATA 12 were used.ResultsThe sample consisted of 30(40% male) patients aged 8.5±4.0m. The interval between diagnosis and surgery was 6.7±3.8m and hospital length of stay 27±14d. A total of 24(80%) children were wasted before and 18(60%) 1m after surgery (P<0.001). At baseline, 14(47%) had anemia, 8(27%) low retinol, 7(23%) low thiamine, and 20(67%) low IGG, among others. There was a significant improvement in the prevalence of low IGG (p=0.018) but not of other biological markers (p>0.05) after surgery.ConclusionEarlier surgery and comprehensive nutrition intervention might further improve these results. (Support: Abbott Fund)