The effect of dietary protein supplementation on insulin-like growth factors (IGFs) and IGF-binding proteins in children with shigellosis.

Nutrient deficiency causes growth failure and decreases serum insulin-like growth factor-I (IGF-I) concentrations. Because IGFBPs modulate the concentrations and availability of IGFs in serum, IGF-binding proteins (IGFBPs) were measured along with IGF-I and IGF-II before and after 21 days of refeeding in 22 undernourished Bangladeshi children (2-4 yr of age) with shigellosis. The effects of a 150 Cal/kg.day diet with a normal protein (6%; n = 10) or high protein (15%; n = 12) content were studied. The results were compared with those of 25 age-matched healthy American children (controls). Body weight gain was better in patients receiving the high protein diet than in those receiving the normal protein diet. In both groups, initial IGF-I (32 +/- 6 and 24 +/- 7 ng/mL; mean +/- SD) and IGF-II (177 +/- 15, 174 +/- 45 ng/mL) concentrations were low compared to controls (100 +/- 12 and 542 +/- 29 ng/mL, respectively; P < 0.007). After refeeding, IGF-I increased to 160 +/- 26 ng/mL on the normal protein diet and to 322 +/- 41 ng/mL on the high protein diet, exceeding values in controls (P < 0.007). IGF-II increased more than 2-fold on each diet (P < 0.007), reaching control values. IGFBP-2 concentrations before refeeding were twice those in controls (750 +/- 200 vs. 317 +/- 33 ng/mL; P < 0.007) and normalized after refeeding in the high protein group (288 +/- 32 ng/mL; P = NS), but remained elevated in the normal protein group (526 +/- 77 ng/mL; P < 0.007). IGFBP-3 levels before refeeding were low and returned to normal on each diet. IGFBP-3 proteolytic activity in serum was initially increased and declined on the high protein diet. In conclusion, protein content in the refeeding diet differentially affects IGFs and IGFBPs in young undernourished children with infection. IGF-I and IGFBP-2 seem to be particularly sensitive to dietary protein alterations. We speculate that an increase in IGF-I concentrations, normalization of IGFBP levels, and a decrease in IGFBP-3 proteolytic activity in serum may all be involved in the improved recovery and catch-up growth observed with the high protein diet.

[1]  D. Clemmons,et al.  Insulin-like growth factor-binding protein-3 proteolysis is induced after elective surgery. , 1992, The Journal of clinical endocrinology and metabolism.

[2]  D. Clemmons,et al.  Variables controlling the secretion of insulin-like growth factor binding protein-2 in normal human subjects. , 1991, The Journal of clinical endocrinology and metabolism.

[3]  D. Wilson,et al.  Differential regulation of the insulin-like growth factors (IGF-I and -II) and IGF binding proteins during malnutrition in the neonatal rat. , 1991, Endocrinology.

[4]  M. Binoux,et al.  Evidence of enzymatic degradation of insulin-like growth factor-binding proteins in the 150K complex during pregnancy. , 1990, The Journal of clinical endocrinology and metabolism.

[5]  L. Giudice,et al.  Insulin-like growth factor binding proteins in maternal serum throughout gestation and in the puerperium: effects of a pregnancy-associated serum protease activity. , 1990, The Journal of clinical endocrinology and metabolism.

[6]  H. Zeisel,et al.  A specific radioimmunoassay for the growth hormone (GH)-dependent somatomedin-binding protein: its use for diagnosis of GH deficiency. , 1990, The Journal of clinical endocrinology and metabolism.

[7]  A. D'ercole,et al.  Effect of maternal fasting on fetal growth, serum insulin-like growth factors (IGFs), and tissue IGF messenger ribonucleic acids. , 1990, Endocrinology.

[8]  T. Unterman,et al.  Different tissue distribution and hormonal regulation of messenger RNAs encoding rat insulin-like growth factor-binding proteins-1 and -2. , 1990, Molecular endocrinology.

[9]  Y. Le Bouc,et al.  Molecular forms of serum insulin-like growth factor (IGF)-binding proteins in man: relationships with growth hormone and IGFs and physiological significance. , 1989, The Journal of clinical endocrinology and metabolism.

[10]  D. Clemmons,et al.  Serum concentrations of insulin-like growth factor II are not changed by short-term fasting and refeeding. , 1988, The Journal of clinical endocrinology and metabolism.

[11]  M. Binoux,et al.  Insulin-like growth factor (IGF) and IGF-binding proteins: comparison of human serum and lymph. , 1988, The Journal of clinical endocrinology and metabolism.

[12]  M. Binoux,et al.  Heterogeneity of insulin-like growth factor binding proteins and relationships between structure and affinity. 1. Circulating forms in man. , 1987, European journal of biochemistry.

[13]  A. Rogol,et al.  Serum Insulin-Like Growth Factors I and II Concentrations and Growth Hormone and Insulin Responses to Arginine Infusion in Children with Protein-Energy Malnutrition before and after Nutritional Rehabilitation , 1986, Pediatric Research.

[14]  W. Heizer,et al.  Use of plasma somatomedin-C/insulin-like growth factor I measurements to monitor the response to nutritional repletion in malnourished patients. , 1985, The American journal of clinical nutrition.

[15]  D. Clemmons,et al.  Changes in plasma somatomedin-C in response to ingestion of diets with variable protein and energy content. , 1984, JPEN. Journal of parenteral and enteral nutrition.

[16]  F. Liu,et al.  Plasma somatomedin-binding proteins in hypopituitarism: changes during growth hormone therapy. , 1981, The Journal of clinical endocrinology and metabolism.

[17]  K. Copeland,et al.  Induction of immunoreactive somatomedin C human serum by growth hormone: dose-response relationships and effect on chromatographic profiles. , 1980, The Journal of clinical endocrinology and metabolism.

[18]  J. Waterlow,et al.  The measurements of rates of protein turnover, synthesis, and breakdown in man and the effects of nutritional status and surgical injury. , 1977, The American journal of clinical nutrition.

[19]  D. Grant,et al.  Reduced sulphation factor in undernourished children. , 1973, Archives of disease in childhood.

[20]  M. Rechler,et al.  Tissue, developmental, and metabolic regulation of messenger ribonucleic acid encoding a rat insulin-like growth factor-binding protein. , 1990, Endocrinology.

[21]  R. Suskind,et al.  Plasma somatomedin and growth hormone values in children with protein-calorie malnutrition. , 1978, The Journal of pediatrics.