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

Pediatr Res. 1986 Nov;20(11):1122-30. doi: 10.1203/00006450-198611000-00012.

Abstract

Serum insulin, growth hormone (GH), insulin-like growth factors (IGFs) I and II, cortisol, and albumin concentrations were measured in 15 children with kwashiorkor, 15 with marasmic-kwashiorkor, and 21 with marasmus, before and in the survivors, after nutritional rehabilitation, as well as in 10 underweight and eight normal Egyptian children. We also evaluated arginine-induced insulin and GH secretion. IGF-I concentrations were reduced in the three severely malnourished groups (0.07 +/- 0.03, 0.05 +/- 0.03, and 0.09 +/- 0.09 U/ml, respectively) but returned to normal after refeeding. IGF-II concentrations were low in the kwashiorkor (175 +/- 79 ng/ml), marasmic-kwashiorkor (111 +/- 57 ng/ml), and marasmic children (128 +/- 70.9 ng/ml) and returned to normal after nutritional rehabilitation. Basal GH levels were high in the three severely malnourished groups (21.9, 28.8, and 16.6 ng/ml, respectively) and returned to normal after refeeding (8.1, 6.5, and 6.0 ng/ml, respectively). GH responses to arginine were depressed in the three malnourished groups and improved significantly in marasmic-kwashiorkor and marasmic children after nutritional rehabilitation. Insulin responses to arginine were impaired in kwashiorkor, and marasmic-kwashiorkor children and improved significantly after refeeding. IGF-I levels correlated significantly with percent of expected weight (r = 0.52, p less than 0.001), percent of expected height (r = 0.42, p less than 0.001), and weight/(height)2 index (r = 0.34, p less than 0.01). IGF-I levels correlated positively with insulin levels (r = 0.421, p less than 0.001) and negatively with cortisol concentrations (r = -0.400, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Anthropometry
  • Arginine / pharmacology
  • Child, Preschool
  • Growth Hormone / blood*
  • Growth Hormone / metabolism
  • Humans
  • Hydrocortisone / blood
  • Infant
  • Insulin / blood*
  • Insulin / metabolism
  • Insulin Secretion
  • Insulin-Like Growth Factor I / blood*
  • Insulin-Like Growth Factor II / blood*
  • Kwashiorkor / blood*
  • Kwashiorkor / diet therapy
  • Kwashiorkor / metabolism
  • Protein-Energy Malnutrition / blood*
  • Protein-Energy Malnutrition / diet therapy
  • Protein-Energy Malnutrition / metabolism
  • Serum Albumin / analysis
  • Somatomedins / blood*

Substances

  • Insulin
  • Serum Albumin
  • Somatomedins
  • Insulin-Like Growth Factor I
  • Insulin-Like Growth Factor II
  • Growth Hormone
  • Arginine
  • Hydrocortisone