Plasma levels of insulin-like growth factor binding protein-3 in acute trauma patients

• Published in: Metabolism, clinical and experimental clinical and experimental, 1995-09, Vol.44 (9), p.1205-1208
• Main Authors: Jeevanandam, Malayappa, Holaday, Nancy J., Petersen, Scott R.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Aging - blood; Basal Metabolism; Biological and medical sciences; Carrier Proteins - blood; Energy Metabolism; Female; Growth Hormone - blood; Humans; Insulin-Like Growth Factor Binding Proteins; Insulin-Like Growth Factor I - metabolism; Male; Medical sciences; Middle Aged; Miscellaneous; Nitrogen - metabolism; Respiration, Artificial; Traumas. Diseases due to physical agents; Wounds and Injuries - blood; Wounds and Injuries - therapy
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/0026-0495(95)90017-9

Insulin-like growth factors (IGFs) are a family of polypeptides that regulate cell growth. Their action and bioavailability are modified by binding proteins such as IGF binding protein-3 (IGFBP-3). Plasma IGFBP-3 level was found to be growth hormone (GH)-dependent, which makes detection of IGFBP-3 useful in the evaluation of GH secretion. In the early catabolic flow phase of severe injury, when plasma levels of GH and IGF-1 are low versus uninjured levels, the role of IGFBP-3 has not been investigated. We have measured basal levels of these polypeptide hormones in 16 adult (13 men and three women aged 47 ± 7 years) severely injured (Injury Severity Score, 32 ± 2), hypermetabolic resting energy expenditure [REE] to basal energy expenditure [BEE] ratio, 1.30 ± 0.05), ventilator-dependent, multiple-trauma patients within 48 to 60 hours of injury when the patients were receiving maintenance fluids without calories or nitrogen. These basal values were compared with those of 16 age-matched postabsorptive normals. In the catabolic flow phase of injury, plasma levels of GH, IGF-1, and IGFBP-3 were significantly reduced by 50%, 46%, and 45%, respectively. There was a significant linear inverse relationship between IGFBP-3 and age and also a positive correlation between IGFBP-3 and IGF-1 in both control and injured subjects. The ratio of IGFBP-3 to IGF-1 was not changed in trauma victims. Measurement of plasma IGFBP-3 levels has potential as a marker for monitoring GH therapeutic efficacy.