HIGH LEVELS OF GH-BP IN KWASHIORKOR AND MARASMUS:

Severe malnutritions are characterised by low IGF-I and high GH plasma levels. The reasons why high levels of GH do not stimulate IGF-I synthesis are not clear. With the aim of improving our knowledge of this problem, we assayed plasma basal GH (by RIA), GH-BP(by HPLC gel filtration), IGF-I (by RIA) and IGFBP-3 (by RIA) in 20 children (age range: 1-2.2 yrs.). Of these, 6 were affected by kwashiorkor, 8 by marasmus and 6 were controls of the same ethnic group and age, hospitalised for minimal pathologies. At the same time the same parameters were evaluated in 5 acromegalic adults for comparison. All blood samples were taken after informed consent in occasion of routine samples. High basal GH levels were observed in kwashiorkor (14.6 ±5.3 ng/ml)(M±SD), marasmus (13. 5 ±2.5 ng/ml) and acromegalic patients (52.7 ±32.4 ng/ml); as expected in kwashiorkor and marasmus low levels of IGF-I (62.8 ±14.8 and 47.2 ±12.6 ng/ml respectively) and IGFBP-3 (1.37 ±0.8 and 0.81 ±0.6 mg/l respectively) were also found. In normal controls IGF-I was significantly higher (165.2 ±34.8 ng/ml, p<0.05 vs. both) and IGFBP-3 was higher but not in a significant way (3.3 ±1.6 mg/l). The specific binding of [125]-hGH to peak II GH-BP was 22.17 ±2.53 % of radioactivity in normal controls, was significantly higher in marasmus (28.92 ±1.65 %; p<0.05), kwashiorkor (31.8 ±2.3 %; p<0.01) and acromegaly (27.3 ±2.2 %; p<0.05). Circulating GH-BP is known to be a part of GH cell receptor and his amount is correlated and controlled by GH levels. The high levels of GH present in acromegalic serum are known to decrease the specific binding of the added [125]hGH during HPLC gel nitration. Marasmus and kwashiorkor have high levels of GH but also significantly higher % levels of specific bound radioactivity. Therefore we can conclude that in these conditions the presence of high amounts of circulating GHBP is possible.