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Exp Clin Endocrinol Diabetes 2009; 117(8): 413-416
DOI: 10.1055/s-2008-1080924
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Changes in Growth Hormone and Insulin-like Growth Factor-I Levels in the Acute Stage after Open Heart Surgery and at the Time of Discharge

M. Nakhjavani1 , A. Esteghamati1 , S. Hamidi1 , F. Esfahanian1 , H. Nabavi1 , M. Abbasi1 , S. H. Mirkhani2
  • 1Endocrinology and Metabolism Research Center (EMRC), Vali-Asr Hospital, School of Medicine, Medical Sciences/University of Tehran
  • 2Division of Cardiovascular Surgery, Imam Khomeini Hospital, School of Medicine, Medical Sciences/University of Tehran
Further Information

Publication History

received 13.12.2007 first decision 11.04.2008

accepted 03.06.2008

Publication Date:
16 July 2009 (online)

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Abstract

Introduction: Stress conditions are known to disturb the axis of growth hormone (GH)/insulin-like growth factor-I (IGF-I), but there is little data on this topic after open heart surgery. This study aimed to investigate changes in GH/IGF-I axis in adults undergoing open heart surgery.

Methods: A total of 162 adult patients admitted for elective major cardiac surgery were studied in a prospective setting. Serum concentrations of GH and IGF-I were measured at four time points: before operation as a baseline, 4 and 12 hours after operation in ICU, and at the time of discharge. Two to 4 venous blood samples were obtained from each patient. To study the changes of GH and IGF-I levels over time, general linear model for repeated measures was applied.

Results: Mean age of patients was 51.2±14.3 years. Compared with preoperative values (median 0.8, range 0.05–19.4 ng/mL), GH levels rose significantly at four (median 3.3, range 0.1–55 ng/mL) and twelve hours after surgery (median 5.45, range 0.55–61.2 ng/mL), and continued to remain high at the time of discharge (median 2.1, range 0.02–22.7 ng/mL) (p<0.05). Conversely, compared with preoperative levels (173.5±89.9 ng/mL), IGF-I decreased at four (140.9±66.9 ng/mL) and twelve hours after operation (135.9±59.9 ng/mL) and reached its nadir on the day of discharge (114.8±43.8 ng/mL) (p<0.01). The patterns of changes in GH and IGF-I over time were significantly different (p<0.01).

Conclusion: Adult patients undergoing open heart surgery go through a state of GH resistance characterized by elevated GH and decreased IGF-I levels from the initial hours after operation.

Key words

open heart surgery - growth hormone - insulin-like growth factor-I

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Correspondence

M. NakhjavaniMD 

Endocrinology and Metabolism Research Center (EMRC)

Vali-Asr Hospital

School of Medicine

Medical Sciences/University of Tehran

Tehran

Iran

Phone: +9821/220/498 85

Fax: +9821/664/340 20

Email: nakhjavanim@tums.ac.ir