Insulin-like growth factor I, IGF binding protein 3, and IGFBP protease activity: relation to anthropometric indices in solid tumours or leukaemia
a Department of
Paediatric Oncology, Manchester Children's Hospitals, Manchester M27
4HA, UK, b Department of Gastroenterology, Manchester
Children's Hospitals, c Endocrine Science Research Group, University of
Manchester, Manchester M13 9PT, UK
Correspondence to: Dr P E Clayton, Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Pendlebury, Manchester M27 4HA, UK.
Accepted 24
September 1998
OBJECTIVES
To measure
the serum concentrations of insulin-like growth factor I (IGF-I) and
IGF binding protein 3 (IGFBP-3), and the level of IGFBP-3 protease
activity in 38 children presenting with malignancies, and to assess
their relation with auxological parameters and nutritional status.
METHODSHeight,
weight, skinfold thickness, and mid-upper arm circumference (MUAC) were
recorded using standard techniques. IGF-I and IGFBP-3 were measured
using specific radioimmunoassays. Serum IGFBPs were also visualised
on western ligand blot. IGFBP-3 protease activity was assessed by the
extent of fragmentation of recombinant [125I]-IGFBP-3,
compared with that induced by pregnancy serum. Anthropometric and
radioimmunoassay data were expressed as standard deviation scores (SDS).
RESULTSThe median
(range) IGF-I SDS was significantly reduced in all patients (
1.1
(5.1 to 1.2)) and lower in children who were malnourished (2.5
(3.9 to 0.1)). IGFBP-3 SDS was within the normal range for 31 of 38 patients but IGFBP-3 protease activity was raised in all patients.
Neither IGFBP-3 concentration nor protease activity was affected by
nutritional status. IGF-I correlated with MUAC
(r = 0.41) and subscapular skinfold
thickness SDS (r = 0.38), but not with
weight, height, weight for height, or triceps skinfold thickness.
CONCLUSIONSIGF-I is
low in children with malignancies, and even lower in those who are
malnourished. IGFBP-3 concentrations were normal in most patients but
interpretation is complicated by the presence of raised IGFBP-3
protease activity, which could lead to overestimating concentrations of
intact peptide. IGF-I appears to relate to arm anthropometry as an
index of nutritional status but not height, weight, or weight for
height, as would be expected in normal children.
© 1999 by Archives of Disease in Childhood
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