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Sökning: onr:"swepub:oai:DiVA.org:oru-56320" > Free dissociable IG...

Free dissociable IGF-I : Association with changes in IGFBP-3 proteolysis and insulin sensitivity after surgery

Bang, Peter, (författare)
Fac Hlth Sci, Div Pediat, Dept Clin & Expt Med, Linköping Univ, Linköping, Sweden
Thorell, Anders, (författare)
Dept Clin Sci, Danderyds Hosp, Karolinska Inst, Stockholm, Sweden; Dept Surg, Ersta Hosp, Stockholm, Sweden
Carlsson-Skwirut, Christine, (författare)
Dept Woman & Child Hlth, Pediat Endocrinol Unit, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
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Ljungqvist, Olle, 1954- (författare)
Region Örebro län, Department of Surgery, Örebro University Hospital, Örebro, Sweden
Brismar, Kerstin, (författare)
Dept Mol Endocrinol, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
Nygren, Jonas, (författare)
Dept Clin Sci, Danderyds Hosp, Karolinska Institute, Stockholm, Sweden; Dept Surg, Ersta Hosp, Stockholm, Sweden
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2016
Engelska.
Ingår i: Clinical Nutrition. - Churchill Livingstone. - 0261-5614 .- 1532-1983. ; 35:2, s. 408-413
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • <p>Background: Patients receiving a carbohydrate drink (CHO) before major abdominal surgery display improved insulin sensitivity postoperatively and increased proteolysis of IGFBP-3 (IGFBP-3-PA) compared to patients undergoing similar surgery after overnight fasting. Aims: We hypothesized that serum IGFBP-3-PA increases bioavailability of circulating IGF-I and preserves insulin sensitivity in patients given CHO. Design: Matched control study. Methods: At Karolinska University Hospital, patients given CHO before major elective abdominal surgery (CHO,n = 8) were compared to patients undergoing similar surgical procedures after overnight fasting (FAST,n = 10). Results from two different techniques for determination of free-dissociable IGF-I (fdIGF-I) were compared with changes in IGFBP-3-PA and insulin sensitivity. Results: Postoperatively, CHO displayed 18% improvement in insulin sensitivity (hyperinsulinemic clamp) and increased IGFBP-3-PA vs. FAST. As determined by IRMA, fdIGF-I increased by 48 +/- 25% in CHO while fdIGF-I decreased by 13 +/- 18% in FAST (p &lt; 0.01 vs. CHO, when corrected for duration of surgery). However, fdIGF-I determined by ultra-filtration decreased similarly in both groups (-22 +/- 8% vs. -25 +/- 8%, p = 0.8) and IGFBP-1 increased similarly in both groups. Patients with less insulin resistance after surgery demonstrated larger increases in fdIGF-I by IRMA (r = 0.58, p &lt; 0.05). Fifty-three % of the variability of the changes in fdIGF-I by IRMA could be explained by changes in IGFBP-3-PA and total IGF-I levels (p &lt; 0.05), while IGFBP-1 did not contribute significantly. Conclusion: During conditions when serum IGF-I bioavailability is regulated by IGFBP-3 proteolysis, measurements of fdIGF-I by IRMA is of physiological relevance as it correlates with the associated changes in insulin sensitivity.</p>

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskaper -- Näringslära (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nutrition and Dietetics (hsv//eng)

Nyckelord

Insulin resistance
IGF-I
IGFBP-3
Proteolysis
IGF bioavaialbility
Free dissociable IGF

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