Features of changes in insulin-like growth factor-1 in patients with chemoresistant pulmonary tuberculosis who are on palliative treatment
Keywords:drug-resistant pulmonary tuberculosis, palliative care, insulin-like growth factor-1
One of the causes of death of patients with pulmonary tuberculosis is cachexia. In the available literature, there are no data on the study of changes in the significate of insulin-like growth factor-1 (IGF-1) in patients with chemo-resistant pulmonary tuberculosis (CRTB) with a body mass deficit.
The purpose of the work is to determine the level of IGF-1 in the serum of patients with CRHT of the lungs who are under palliative treatment, and to establish the features of its change depending on the body mass index (BMI).
Materials and methods. The main group of follow-up consisted of 52 patients with CRTB of lungs, who are on palliative treatment (mean age 39.4 ± 1.8 years). The comparison group included 29 patients who receive anti-mycobacterial therapy for category 4 in accordance with the profile of drug resistance, the average age was 41.3 ± 1.8 years. The difference in P < 0.05 was considered statistically significant. The study of the level of IGF-1 in serum was performed by the method of solid-phase enzyme immunoassay on an Sirio S immunoassay reader using the Human IGF-1 ELISA kit (Germany), (ng/ml).
Results. In the main group of patients, the level of IGF-1 in serum was 5.09 (4.08; 7.81) ng/ml, which is 1.4 times lower (P < 0.01) than in the comparison group. In palliative CRTB patients with a BMI of ≤18.1 kg/m2, the serum IGF-1 level was 4.04 (2.38; 4.51) ng/ml, which was significantly lower by 1.9 times (P < 0.05) than in palliative patients with a BMI > 18.1 kg/m2 and 1.7 times than in the comparison group. It was established that, in patients with CRTB, who got the palliative care, a decrease in the level of IGF-1 in serum was significantly directly dependent on a decrease in BMI: in main group 1 (r = 0.91; P = 0.001) and in main group 2 (r = 0.97; P = 0.001).
Conclusions. In patients with CRTB of the lungs who got palliative treatment, a significant decrease in the serum IGF-1 level of 1.4 times is determined compared to patients with CRTB of the lungs who receive antimycobacterial therapy. At the same time, in patients CRTB of the lungs, who got palliative care and had a body mass index of ≤18.1 kg/m2, the level of serum IGF-1 is significantly lower by 1.9 times compared with patients with a body mass index of >18.1 kg/m2. In patients CRTB, who got palliative care, a decrease in serum IGF-1 levels reliably depends on a decrease in body mass index. Significate of serum IGF-1 can be used as an early marker of the increase and progression of cachexia.
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