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Insulin‐Like Growth Factors (IGFs) and IGF Binding Proteins in Chronic Renal Failure: Evidence for Reduced Secretion of IGFs
Author(s) -
BLUM W.F.
Publication year - 1991
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1991.tb12039.x
Subject(s) - medicine , secretion , chronic renal failure , endocrinology , insulin like growth factor , insulin like growth factor binding protein , insulin , growth factor , receptor
To test the hypothesis that growth hormone (GH) insensitivity is responsible, amongst other mechanisms, for impaired growth in uraemic children, insulin‐like growth factor I (IGF‐I), IGF‐II, IGF binding protein‐1 (1GFBP‐1), IGFBP‐2 and IGFBP‐3 were measured by radioimmunoassay in normal control children, in patients with end‐stage renal failure (n = 51) and in patients with preterminal chronic renal failure (n = 11) and the production rate of IGF was calculated. A unique pattern of normal IGF‐I and IGF‐II levels and markedly increased levels of all three IGFBPs was present in uraemia. Measurement of free IGF‐II binding capacity, and affinity cross‐linking experiments showed that the excess immuno‐reactive IGFBP was able to bind IGFs. To explain the excess of unoccupied IGF binding sites in uraemia, a mathematical model was developed which describes the production of IGFs and their interaction with IGFBP. Calculations of IGF secretion rates suggested that production of IGF is two orders of magnitude lower in uraemic children than in control children, despite normal GH secretion. It is concluded that in uraemia there is a relative GH insensitivity with respect to IGF production.