Administration of human recombinant insulin-like growth factor-I in critically ill patients

Yarwood, G. D.; Ross, R. J. M.; Medbak, S.; Coakley, J. H.; Hinds, C. J.

doi:10.1097/00003246-199708000-00023

Cited by 54 publications

(18 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Postoperative IGF-I treatment significantly decreased postoperative insulin, IAPP and cortisol as well as blood glucose levels. This dose of IGF-I given together with nutrients does not cause hypoglycaemia, which is in line with previous studies (Miell et al 1992, Yarwood et al 1997. No effects of IGF-I on gastrointestinal hormones or growth factors were seen.…”

Section: Discussionsupporting

confidence: 92%

Gastrointestinal growth factors and pancreatic islet hormones during postoperative IGF-I supplementation in man

Leinsköld

Adrian²,

Arnelo³

et al. 2000

Journal of Endocrinology

View full text Add to dashboard Cite

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-Itreated (n=8) and placebo-treated (n=7). The IGF-I group received daily two s.c. injections of human recombinant IGF-I (80 µg/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-, 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 -cell secretion could be direct or, alternatively, could involve an improvement in postoperative insulin resistance, perhaps by reducing serum cortisol.

show abstract

Section: Discussionsupporting

confidence: 92%

Gastrointestinal growth factors and pancreatic islet hormones during postoperative IGF-I supplementation in man

Leinsköld

Adrian²,

Arnelo³

et al. 2000

Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…The Growth Hormone Research Society has recommended the cessation of rhGH (and by inference rIGF-I) use during critical illness [46][47][48][49] .…”

Section: Igf-i As a Therapeutic Agentmentioning

confidence: 99%

Insulin-like Growth Factors in a clinical setting: Review of IGF-I

Fryšák

Schovánek

Iacobone

et al. 2015

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

View full text Add to dashboard Cite

“…Diabetes 49:789-796, 2000 I GF-I shares a 40% sequence homology with human proinsulin and exhibits both insulin-like and anabolic effects (1,2). The availability of recombinant human IGF-I (rhIGF-I) has led to interest in the potential of this peptide in the treatment of a variety of disease states (3)(4)(5)(6)(7). Type 1 diabetes has received particular attention, because the relative portal insulin deficiency of this condition is thought to be responsible for the reduced circulating levels of IGF-I (8), which in turn, through decreased negative feedback, leads to increased secretion of growth hormone (GH) (9).…”

Section: Type 1 Diabetes Is Associated With Abnormalities Of the Growmentioning

confidence: 99%

IGF-I treatment in adults with type 1 diabetes: effects on glucose and protein metabolism in the fasting state and during a hyperinsulinemic-euglycemic amino acid clamp.

et al. 2000

View full text Add to dashboard Cite

Type 1 diabetes is associated with abnormalities of the growth hormone (GH)-IGF-I axis. Such abnormalities include decreased circulating levels of IGF-I. We studied the effects of IGF-I therapy (40 µg · kg -1 · day -1 ) on protein and glucose metabolism in adults with type 1 diabetes in a randomized placebo-controlled trial. A total of 12 subjects participated, and each subject was studied at baseline and after 7 days of treatment, both in the fasting state and during a hyperinsulinemiceuglycemic amino acid clamp. Protein and glucose metabolism were assessed using infusions of [1- 13C]leucine and [6-6-2 H 2 ]glucose. IGF-I administration resulted in a 51% rise in circulating IGF-I levels (P < 0.005) and a 56% decrease in the mean overnight GH concentration (P < 0.05). After IGF-I treatment, a decrease in the overnight insulin requirement (0.26 ± 0.07 vs. 0.17 ± 0.06 U/kg, P < 0.05) and an increase in the glucose infusion requirement were observed during the hyperinsulinemic clamp (~67%, P < 0.05). Basal glucose kinetics were unchanged, but an increase in insulin-stimulated peripheral glucose disposal was observed after IGF-I therapy (37 ± 6 vs. 52 ± 10 µmol · kg -1 · min -1 , P < 0.05). IGF-I administration increased the basal metabolic clearance rate for leucine (~28%, P < 0.05) and resulted in a net increase in leucine balance, both in the basal state and during the hyperinsulinemic amino acid clamp (-0.17 ± 0.03 vs. -0.10 ± 0.02, P < 0.01, and 0.25 ± 0.08 vs. 0.40 ± 0.06, P < 0.05, respectively). No changes in these variables were recorded in the subjects after administration of placebo. These findings demonstrated that IGF-I replacement resulted in significant alterations in glucose and protein metabolism in the basal and insulinstimulated states. These effects were associated with increased insulin sensitivity, and they underline the major role of IGF-I in protein and glucose metabolism in type 1 diabetes. Diabetes 49:789-796, 2000 I GF-I shares a 40% sequence homology with human proinsulin and exhibits both insulin-like and anabolic effects (1,2). The availability of recombinant human IGF-I (rhIGF-I) has led to interest in the potential of this peptide in the treatment of a variety of disease states (3-7). Type 1 diabetes has received particular attention, because the relative portal insulin deficiency of this condition is thought to be responsible for the reduced circulating levels of IGF-I (8), which in turn, through decreased negative feedback, leads to increased secretion of growth hormone (GH) (9).Recent studies have demonstrated improved glycemic control in patients with types 1 and 2 diabetes after IGF-I treatment (10,11). IGF-I administration has also been shown to reduce the GH hypersecretion of adolescents and adults with type 1 diabetes (12,13). In those studies, the reductions in GH secretion were associated with decreased insulin requirements, without alteration in glycemic control, which indicates an increase in insulin sensitivity.In addition to disordered glucose metabolism, patients with t...

show abstract

Administration of human recombinant insulin-like growth factor-I in critically ill patients

Abstract: We observed no adverse effects (e.g., hypoglycemia) that could be attributed to recombinant human IGF-I therapy.

Cited by 54 publications

References 31 publications

Gastrointestinal growth factors and pancreatic islet hormones during postoperative IGF-I supplementation in man

Gastrointestinal growth factors and pancreatic islet hormones during postoperative IGF-I supplementation in man

Insulin-like Growth Factors in a clinical setting: Review of IGF-I

IGF-I treatment in adults with type 1 diabetes: effects on glucose and protein metabolism in the fasting state and during a hyperinsulinemic-euglycemic amino acid clamp.

Contact Info

Product

Resources

About