THE EFFECT OF RECOMBINANT INSULIN-LIKE GROWTH-FACTOR-I ON KETONE-BODY, LIPID AND APOLIPOPROTEIN CONCENTRATIONS AND ITS USE TO TREAT KETOACIDOSIS IN SEVERE INSULIN-RESISTANCE

The effect of recombinant insulin-like growth factor I (rhlGF-I) on ke tone body concentrations was studied in a patient with the Mendenhall syndrome, a rare insulin-resistant state. Treatment with intravenous r hlGF-I for an episode of ketoacidosis led to a clinical and biochemica l improvement. One month later, the effect of 20 mg rhlGF-I infused da ily for 4 days on ketone body concentrations was studied. From peak co ncentrations 24 h prior to the study to a nadir 72 h after the infusio n commenced, acetoacetate fell from 4.17 mmol l-1 to 0.86 mmol l-1, be ta-hydroxybutyrate from 9.91 mmol l-1 to 2.03 mmol l-1, and acetone fr om 2 mmol l-1 to 0.4 mmol l-1. Further studies of rhlGF-1 use caused a fall in concentrations of cholesterol, triglyceride, VLDL, LDL, and a polipoprotein B. Infusion of rhlGF-1 reduces ketone body concentration s and may be life-saving in the treatment of ketoacidosis developing i n a patient with a severe insulin-resistant state.