[Somatomedin, growth and nutritional status].

Serum somatomedins, or insulin-like growth factor(s) (IGF), originally characterized as primarily GH-dependent peptides, were found to also be dependent on insulin levels and nutritional status. Four properties characterize somatomedin peptides: their concentrations in serum are growth hormone dependent; they possess insulin actions in extraskeletal tissues; they promote the incorporation of sulfate into proteoglycans of cartilage; and they stimulate DNA synthesis and cell multiplication in certain types of cultured cells. Reduced somatomedin C levels are found in children with severe protein-energy malnutrition. Plasma concentration of growth hormone and cortisol are both elevated and there are low levels of insulin and somatomedin C. There is evidence that the ability of somatomedin C to stimulate cartilage is modulated by somatomedin inhibitor, factor that may act to limit growth in conditions of hormonal and/or nutritional deficiency. Dietary energy and protein appears to be particularly important for both generation of somatomedins and their action on growing cartilage. Measurement of somatomedins C concentration shows promise as a means for monitoring the response of malnourished patients and rats to nutrition repletion.