IGF-I concentration and changes in critically ill patients.

Area of Science:

• Endocrinology
• Critical Care Medicine
• Metabolic Research

Background:

• Insulin-like Growth Factor 1 (IGF-I) is a key anabolic hormone impacting nitrogen balance.
• The dynamic changes and prognostic value of IGF-I in critically ill patients remain incompletely understood.

Purpose of the Study:

• To investigate the association between serum IGF-I levels and mortality in critically ill patients.
• To evaluate the changing trend of IGF-I concentrations during intensive care unit (ICU) stay and its correlation with patient outcomes.

Main Methods:

• A nested case-control study involving 90 critically ill patients admitted to medical ICUs.
• Serum IGF-I concentrations were measured at ICU admission and on days 4, 7, and 10.
• Patients were monitored until ICU discharge or expiration.

Main Results:

• On admission, 47.7% of patients presented with low IGF-I levels.
• No significant difference in IGF-I concentrations was observed across the four measurement points between patients who died and those discharged.
• A significant decrease in IGF-I was noted from day 1 to day 4 (p = 0.005), but the changing trend did not differ between mortality groups.

Conclusions:

• Low IGF-I on admission was not directly linked to increased adverse outcomes, although overall lower levels were observed in these patients.
• No clear association was established between the changing trend of IGF-I and mortality.
• The initial decrease in IGF-I within the first four days may be attributed to the physiological stress of critical illness.