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I: The Effects of Recombinant Human Insulin‐Like Growth Factor‐1 on Nutritional Recovery in the Malnourished Alcoholic Rat
Author(s) -
Mendenhall Charles L.,
Roselle Gary A.,
Grossman Charles J.,
Gartside Peter
Publication year - 1997
Publication title -
alcoholism: clinical and experimental research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.267
H-Index - 153
eISSN - 1530-0277
pISSN - 0145-6008
DOI - 10.1111/j.1530-0277.1997.tb04506.x
Subject(s) - calorie , malnutrition , medicine , calorie restriction , abstinence , endocrinology , weight loss , insulin , physiology , obesity , psychiatry
Background/aims : Alcoholics with severe liver disease (ALD) typically demonstrate the findings of protein calorie malnutrition. Such an occurrence might be anticipated with insulin‐like growth factor‐1 (IGF‐1) deficiency. Furthermore, serum levels of IGF‐1 are frequently very low in patients with alcoholic liver disease. The present study was undertaken to evaluate in an in vivo rat model of alcoholism and malnutrition, the possibility of a therapeutic application for IGF‐1. Methods : Controlled injury was induced by 14 days of calorie restriction and alcohol feeding (phase 1), which induced a 9% loss of body mass. Changes were compared with pair‐fed, calorie‐restricted controls that lost 7.8% of body mass and to unrestricted control rats that gained 28% above their pretreatment body mass during the same period. Recovery was evaluated after 28 days of treatment using various combinations of: (1) high calorie intake, (2) cessation from alcohol feeding, and (3) IGF‐1. Results : Liver injury was minimal, but protein calorie malnutrition was moderately severe after phase 1 treatments. During recovery (phase 2), continuous consumption of alcohol—even in the presence of high calories and IGF‐1 treatment—produced an incomplete nutritional recovery and, compared with normal rats, was associated with lower serum IGF‐1 levels. The group treated with all three modalities (high calories, IGF‐1, and abstinence from ethanol) had the most rapid and complete restoration of body weight Conclusions : Recovery of nutritional status in the malnourished rat correlates significantly with serum IGF‐1 levels. In the absence of ethanol and with sufficient caloric intake, IGF‐1 treatment increased serum IGF‐1 concentrations and accelerated nutritional recovery. Even with adequate calories, ethanol negated this recovery and was associated with lower serum IGF‐1 concentrations. Further studies, both basic and clinical, are needed to better understand the mechanisms involved and to establish whether in patients with severe Liver disease IGF‐1 treatment would produce an accelerated improvement in nutritional status and improve both morbity and mortality. These animal studies suggest that this is the case.