Anabolic effects of insulin-like growth factor in combination with insulin-like growth factor binding protein-3 in severely burned adults

Background: The purpose of this study was to determine the anabolic effects of recombinant human insulin-like growth factor-I (rhIGF-1) complexed with its principal binding protein IGF-1 binding protein-3 (IGFBP-3) in severel y burned adults. Methods: Ten burned adults were studied consecutively after receiving salin e (pretreatment), then rhIGF-1/IGFBP-3 (treatment) for 5 days. Doses were 1 , 2, and 4 mg/kg per day. Glucose, electrolytes, hormones, and leg muscle p rotein metabolism mere determined. Nine other studies were performed on sim ilarly injured adults at comparable times to the treatment studies to contr ol for time effects. Results: Serum IGF-1 and IGFBP-3 levels increased with all doses, but no in cremental increases were found. Leg protein balance improved with rhIGF-1/I GFBP-3, which was associated with an increase in muscle protein fractional synthetic rate. These effects were independent of time. All patients were e uglycemic without electrolyte imbalances. Conclusion: Net protein synthesis in the isolated leg of severely burned ad ults improved with rhIGF-1/IGFBP-3 without development of glucose abnormali ties.