Effects Of Intensive Insulin Therapy On The Growth Hormone/Insulin-Like Growth Factor-1 Axis And Interleukin-6 Levels In The Diabetic Rats With Scald And Trauma

Objective To investigate the influence of intensive insulin therapy on the growth hormone/insulin-like growth factor-1 axis and Interleukin-6 levels in the diabetic rats with scald and trauma.Methods 60 Wistar rats received intraperitoneal injection of streptozotocin to establish diabetes model. Then they were made deep II degree scald and traumatic model. They were randomly allocated to either the intensive insulin therapy approach,with insulin infused to maintain blood glucose at the level of 3.9～5.6mmol/L,or the conventional group,with insulin infused to maintain blood glucose at the level of 10～12mmol/L. The GH levels were measured by radioimmunoassy, The levels of IGF-1 and Interleukin-6 were detected by ELISA.We also observed the mortality rates in each group.Results①The serum levels of glucose:Intensive insulin therapy significantly suppressed blood glucose levels compared with those using the conventional treatment schedule in the scald rats (P<0.001) and the traumatic rats (P<0.001).②Changes of serum GH,IGF-1 levels and GH/IGF-1 ratios:Compared with the conventional group,the intensive approach had a marked high IGF-1 levels(P<0.05).The serum levels of GH in intensive group were significantly lower than those of the conventional group.(P<0.05).The GH/IGF-1 ratios in intensive group were significantly lower than those of the conventional group (P<0.05),suggesting the inhibition of GH resistance by intensive insulin therapy.③Changes of serum Interleukin-6 levels:The serum levels of Interleukin-6 in intensive group were significantly lower than those of the conventional group. (P<0.05).④Relationship between serum levels of Interleukin-6 and GH/IGF-1 ratios:Between serum levels of Interleukin-6 and GH/IGF-1 ratios at three time spots in scald rats, positive significant correlation were found(r=0.763,r=0.855 and r=0.917(P<0.01)).Positive significant correlation were also found in traumatic rats between serum levels of Interleukin-6 and GH/IGF-1 ratios(r=0.786,r=0.924和r=0.872 (P<0.01)).⑤The changes of body weight:The body weights in intensive group were significantly higher than those of the conventional group(P<0.01).⑥Intensive insulin therapy to maintain blood glucose reduced mortality compared with the conventional group(P<0.05).Conclusion①Intensive insulin therapy to maintain blood glucose between 3.9～5.6mmol/L was able to inhibit the GH resistance,reverse the disturbance of GH/IGF-1 axis and improve the metabolism.②Intensive insulin therapy to maintain blood glucose between 3.9～5.6mmol/L was able to decrease the serum Interleukin-6 levels, inhibit the inflammation and reinforce the immunity.③Intensive insulin therapy to maintain blood glucose between 3.9～5.6mmol/L reduced mortality significantly in the diabetic rats with scald and trauma.