Cerebrospinal fluid and serum levels of growth hormone, insulinlike growth factor 1, insulinlike growth factor binding protein 3, and ghrelin in patients with bacterial and tuberculous meningitis

摘要

BACKGROUND: The somatotropic hormone levels change in acute and prolonged critical illnesses such as tuberculous meningitis (TbM). This study aimed to determine the cerebrospinal fluid (CSF) and serum levels of growth hormone (GH), insulinlike growth factor 1 (IGF-1), insulinlike growth factor-binding protein 3 (IGFBP-3), and ghrelin in patients with TbM and to compare the results with those of the patients with bacterial meningitis (BM) and of healthy controls. METHODS: Nine patients with TbM and 14 patients with BM between the ages of 7 and 12 years were enrolled in this study. The control group was composed of 14 patients with no central nervous system infections. Growth hormone, IGF-1, and IGFBP-3 levels in serum and CSF were measured by enzyme-linked immunosorbent assay, and ghrelin levels were measured by radioimmunoassay. RESULTS: Growth hormone and IGF-1 levels in serum and CSF were significantly lower in the TbM group than in the BM and control groups (P < 0.05). Insulinlike growth factor-binding protein 3 levels were lower in the TbM and BM groups than in the control group (P < 0.05). Ghrelin level in the TbM group was significantly higher than in the BM and control groups (P < 0.05). CONCLUSIONS: Levels of growth factors such as GH and IGF-1 were lower in TbM than in other central nervous system infections. These data suggest that IGF-1, which is known to have a neuroprotective effect, may be the cause of neuronal loss and cerebral atrophy in TbM.