Korean J Crit Care Med.  2016 Nov;31(4):324-333. 10.4266/kjccm.2016.00024.

Changes in Insulin-like Growth Factor-1 Level in Patients with Sepsis and Septic Shock

• Lee SH
• Park BH
• Song JH
• Kim SY
• Chung KS
• Kim EY
• Jung JY
• Kim YS
• Kim SK
• Chang J
• Park MS

• KMID: 2371188
• DOI: http://doi.org/10.4266/kjccm.2016.00024

Abstract

BACKGROUND
Despite many ongoing, prospective studies on the topic, sepsis still remains one of the main causes of death in hospital. The hormone insulin-like growth factor 1 (IGF-1) has a similar molecular structure to that of insulin. IGF-1 exerts anabolic effects and plays important roles in both normal physiology and pathologic processes. Previous studies have observed low serum IGF-1 level in patients with critical illnesses. Here, we evaluated changes in IGF-1 level based on survival of septic patients.
METHODS
We evaluated 140 patients with sepsis and septic shock (21 with sepsis and 119 with septic shock) admitted to the intensive care unit of a university-affiliated hospital in Korea. Serum IGF-1 level was measured on days 0, 1, 3, and 7. Patients with liver disease were excluded from this study. All data were analyzed using SPSS version 20 (SPSS Inc., Chicago, IL, USA).
RESULTS
Patients with septic shock had significantly lower serum IGF-1 level on days 1 and 3 than patients without septic shock (p = 0.002 and p = 0.007, respectively). Generally, there was a negative relationship between IGF-1 and serum cortisol levels; however, this relationship was only significant on day 3 (p = 0.029). Furthermore, renin showed significantly negative correlation with IGF-1 on day 3 (p = 0.038). IGF-1 level did not show significant difference between survivors and non-survivors.
CONCLUSIONS
Our results showed that IGF-1 was associated with septic shock, and that the IGF-1 axis is severely disrupted in septic patients. Additionally, serum cortisol and renin levels were associated with IGF-1 level.

Keyword

insulin-like growth factor-1; sepsis

MeSH Terms

Anabolic Agents
Cause of Death
Critical Illness
Humans
Hydrocortisone
Insulin
Insulin-Like Growth Factor I
Intensive Care Units
Korea
Liver Diseases
Molecular Structure
Pathologic Processes
Physiology
Prospective Studies
Renin
Sepsis*
Shock, Septic*
Survivors
Anabolic Agents
Hydrocortisone
Insulin
Insulin-Like Growth Factor I
Renin

Figure

• 

  Fig. 1. Flow chart of the study population. Initially, 179 intensive care unit (ICU) patients were enrolled from August to December 2008. The following patients were excluded: patients who were being admitted for a second time (n = 4), patients with liver disease (n = 23), patients diagnosed with systemic inflammatory response syndrome (SIRS) (n = 3), and patients with noninfectious disease (n = 9).

• 

  Fig. 2. Time course of insulin-like growth factor (IGF-1), cortisol, and renin levels in patients with sepsis and septic shock. Data for IGF-1 (A), cortisol (B), and renin (C) are shown. The values were examined on the day of admission (day 0) and on days 1, 3, and 7. The circles represent the mean, and the bars represent the standard error of the mean. *Significant differences between the sepsis patients and the septic shock patients.

Reference

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