Differential influence of open surgery and sepsis on the circulating insulin-like growth factors and their binding proteins as representative metabolic markers

In critical illnesses and stress conditions many endocrine systems are disturbed. In the current study we determined the influence of open surgery, post-operative sepsis and its early therapy on the components of the insulin-like growth factor (IGF) system in patients with malignant gastric or pancr...

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Bibliographic Details
Published in:Clinical biochemistry 2007-10, Vol.40 (15), p.1122-1128
Main Authors: Baričević, Ivona, Jones, David R., Đorđević, Biljana, Malenković, Vesna, Nedić, Olgica
Format: Article
Language:English
Subjects:
Adult
Aged
Biomarkers - analysis
Case-Control Studies
Cortisol
Digestive System Surgical Procedures - adverse effects
Female
Humans
IGF-binding proteins
Insulin-Like Growth Factor Binding Proteins - analysis
Insulin-like growth factors
Male
Middle Aged
Open surgery
Postoperative Complications - blood
Postoperative Complications - metabolism
Sepsis
Sepsis - blood
Sepsis - diagnosis
Sepsis - etiology
Sepsis - metabolism
Somatomedins - analysis
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Summary:In critical illnesses and stress conditions many endocrine systems are disturbed. In the current study we determined the influence of open surgery, post-operative sepsis and its early therapy on the components of the insulin-like growth factor (IGF) system in patients with malignant gastric or pancreatic tumors. Twenty-one patients and eighty-one age- and sex-matched healthy subjects were included in this study. IGF-I, IGF-II, IGF binding proteins (IGFBPs), cortisol, insulin and protein concentrations (total, albumin and IgG) were determined pre-operatively, post-operatively, when sepsis was diagnosed and 48 h after initiating therapy. The concentrations of circulating IGF-I, IGF-II and IGFBP-3 were significantly lower in pre-operative patients compared to healthy subjects. Sepsis caused a further decrease in IGF-I and IGFBP-3 but an increase in IGFBP-1, IGFBP-2 and IGFBP-4 resulting in a redistribution of IGF molecules from ternary to binary complexes. The presence of malignant gastric or pancreatic tumors followed by post-operative sepsis caused a serious misbalance in components of the IGF system which failed to recover during the time of our longitudinal study.
ISSN:0009-9120
1873-2933
DOI:10.1016/j.clinbiochem.2007.06.008