慢性腎不全患者および一側腎摘出患者のEnzyme-linked Immunosorbent Assay法による血清Insulin-like Growth Factor-1値の測定

Abstract

合成IGF-1をウサギに免疫してえられたポリクロナール抗体を用いてELISA系を確立し, 血清IGF-1濃度を測定した。1)正常人および透析患者の血中IGF-1値は年齢とともに低下傾向を示した。正常人には有意な性差は認められなかったが透析患者では女性が男性より有意に高値を示した。2)血液透析患者のIGF-1値は正常人に比し各年齢層で有意に低値を示した。3)一側腎摘出後のIGF-1値は術後早期に一過性に低下するが, その原因として術後の絶食および創傷治癒による消費の影響が関与している

Using the enzyme-linked immunosorbent assay (ELISA), we determined the serum insulin-like growth factor-I (IGF-I) levels in the patients on hemodialysis and patients who had undergone unilateral nephrectomy. This ELISA system was able to detect IGF-I over the range of 1.6 to 50 ng/ml. The serum IGF-I levels in 45 male and 34 female dialytic patients (12.7 +/- 7.4 ng/ml and 29.0 +/- 15.9 ng/ml) were significantly low (P < 0.01) compared with 50 normal adult men and 53 normal adult women (34.9 +/- 11.4 ng/ml and 44.5 +/- 20.5 ng/ml). The serum IGF-I level tended to decrease with aging. Furthermore, we determined the IGF-I levels in 5 donors for living-related kidney transplantation and 7 patients with upper urinary tract tumor before and after unilateral nephrectomy in order to examine the endocrine effect of IGF-I. The IGF-I level in the donors decreased significantly (P < 0.05) on the fifth postoperative day and returned to the preoperative level on the 14th postoperative day. The IGF-I level in the tumor patients decreased significantly on the fifth postoperative day (P < 0.01) and remained at a low level up to the 14th postoperative day. However, the changes in the postoperative IGF-I level in the patients who had undergone surgical operations other than unilateral nephrectomy showed patterns similar to those in the kidney transplantation donors. These findings suggest that the postoperative fall in the serum IGF-I is affected by either fasting after surgery or consumption due to healing of the operative wound.