Insulinlike growth factor 1 production is inhibited in human sepsis
M. S. Dahn, M. P. Lange and L. A. Jacobs
Surgical Service, Veterans Administration Medical Center, Allen Park, Mich.
We studied the response of 14 normal volunteers and five septic patients to
a 48-hour course of exogenous biosynthetic human growth hormone (hGH) or
placebo. Six normal controls (group 1) received saline, eight normal
controls received hGH (group 2), and five septic patients also received
biosynthetic hGH (group 3). Urinary urea excretion declined, and splanchnic
amino acid uptake was maintained only in group 2 subjects. Septic patients
exhibited changes in amino acid and urea dynamics comparable to those of
subjects receiving placebo. Insulinlike growth factor 1 (IGF-1) production
and plasma concentrations increased in group 2 in a fashion corresponding
to the changes in nitrogen exchange, whereas septic patients exhibited no
change in IGF-1 level. Therefore, in this septic patient group, exogenous
hGH was ineffective in attenuating nitrogen losses and stimulating IGF-1
production. This supports the hypothesis that IGF-1 is a mediator of the
anabolic effect of hGH.