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Journal of Parenteral and Enteral Nutrition
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Insulin-Like Growth Factor-I in Human Malnutrition: Relationship with Some Body Composition and Nutritional Parameters

Francesco Minuto, M.D.

Cattedra di Fisiopatologia Endocrina, University of Genova, Italy

Antonina Barreca, M.D.

Gian Franco Adami, M.D.

Cattedra di Patologia Chirurgica, University of Genova, Italy

Patricia Fortini, M.D.

Cattedra di Endocrinologia-ISMI, University of Genova, Italy

Patrizia Del Monte, M.D.

Cattedra di Endocrinologia-ISMI, University of Genova, Italy

Franca Cella, M.S.

Cattedra di Endocrinologia-ISMI, University of Genova, Italy

Nicola Scopinaro, M.D.

Cattedra di Patologia Chirurgica, University of Genova, Italy

Giulio Giordano, M.D.

Cattedra di Endocrinologia-ISMI, University of Genova, Italy

The insulin-like growth factor-I (IGF-I) plasma concentration was evaluated as a nutritional parameter in 18 patients affected with chronic malnutrition secondary to biliopancreatic bypass and compared with albumin, transferrin, and with body composition parameters: total body water (TBW), total body sodium (TBNa), total body potassium (TBK). Subjects were studied in malnutritional conditions and after 20 to 30 days of parenteral and enteral refeeding treatment. Immunoreactive IGF-I concentration was 0.35 U/ml ± 0.07 (mean ± SEM), significantly lower (p < 0.01) than in age-matched controls (1.14 ± 0.07 U/ml, n = 29) and rose significantly (0.84 ± 0.12 U/ml; p < 0.01) in parallel with the improvement of nutritional status. The ratios TBNa/TBW, TBNa/ TBK, and TBK/TBW were then considered as reference parameters for definition of malnutritional state, and compared with IGF-I as well as with the most commonly used parameters, albumin and transferrin. Before treatment, IGF-I evidenced higher specificity (true negative ratios 0.63, 0.43, and 0.40 with regard to TBNa/TBW, TBNa/TBK, and TBK/TBW, respectively) than albumin (0.13, 0.14, and 0.10) and transferrin (0 in all cases), and slightly less sensitivity (true positive ratios for IGF-I 0.80, 0.67, and 0.67; always one for albumin and transferrin). Moreover, IGF-I resulted definitely more sensitive in assessing the effectiveness of the refeeding treatment and, on the basis of the likelihood ratio, it appeared a good discriminator of the nutritional status. The data indicate that different nutritional factors regulate IGF-I, albumin, and transferrin, and suggest that IGF-I can be used as a reliable and specific nutritional parameter, complementary to the others currently used. ( Journal of Parenteral and Enteral Nutrition 13:392-396, 1989)

Journal of Parenteral and Enteral Nutrition, Vol. 13, No. 4, 392-396 (1989)
DOI: 10.1177/0148607189013004392
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