Abstract

BackgroundProtein-energy malnutrition (PEM) can lead to growth hormone (GH) resistance. Leucine supplementation diets have been shown to increase protein synthesis in muscles. Our study aimed at investigating if long-term leucine supplementation could modulate GH-insulin-like growth factor (IGF)-1 system function and mammalian target of rapamycin (mTOR)-related signal transduction in skeletal muscles in a rat model of severe malnutrition.Methodology/Principal FindingsMale Sprague-Dawley rats (n = 50; weight, 302 ± 5 g) were divided into 5 treatment groups, including 2 control groups (a normal control group that was fed chow and ad libitum water [CON, n = 10] and a malnourished control group [MC, n = 10] that was fed a 50% chow diet). After undergoing a weight loss stage for 4 weeks, rats received either the chow diet (MC-CON, n = 10), the chow diet supplemented with low-dose leucine (MC-L, n = 10), or the chow diet supplemented with high-dose leucine (MC-H, n = 10) for 2 weeks. The muscle masses of the gastrocnemius, soleus, and extensor digitorum longus were significantly reduced in the MC group. Re-feeding increased muscle mass, especially in the MC-L and MC-H groups. In the MC group, serum IGF-1, IGF-binding protein (IGFBP)-3, and hepatic growth hormone receptor (GHR) levels were significantly decreased and phosphorylation of the downstream anabolic signaling effectors protein kinase B (Akt), mTOR, and ribosomal protein S6 kinase 1 (S6K1) were significantly lower than in other groups. However, serum IGF-1 and IGF binding protein (IGFBP)-3 concentrations and hepatic growth hormone receptor (GHR) levels were significantly higher in the MC-L and MC-H groups than in the MC-CON group, and serum IGFBP-1 levels was significantly reduced in the MC-L and MC-H groups. These changes were consistent with those observed for hepatic mRNA expression levels. Phosphorylation of the downstream anabolic signaling effectors Akt, mTOR, and S6K1 were also significantly higher in the MC-L and MC-H groups than in the MC-CON group.Conclusion/SignificanceOur data are the first to demonstrate that long-term supplementation with leucine improved acquired growth hormone resistance in rats with protein-energy malnutrition. Leucine might promote skeletal muscle protein synthesis by regulating downstream anabolic signaling transduction.

Highlights

  • Protein-energy malnutrition (PEM) has long been recognized as a common problem among children in developing countries, hospitalized patients, and cancer patients [1,2,3]

  • The significantly reduced skeletal muscle masses caused by malnutrition were increased during re-feeding, especially in rats receiving leucine supplementation

  • Serum insulin-like growth factor (IGF)-1, IGF-binding protein (IGFBP)-3, and hepatic growth hormone receptor (GHR) levels were significantly higher in the MC-L and MC-H groups compared to the MC-CON group at the study end point

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Summary

Introduction

Protein-energy malnutrition (PEM) has long been recognized as a common problem among children in developing countries, hospitalized (and especially elderly hospitalized) patients, and cancer patients [1,2,3]. In patients with severe protein restriction (kwashiorkor) or protein-energy deprivation, growth retardation is associated with low serum insulin-like growth factor (IGF)-1 levels despite elevated or normal serum growth hormone (GH) concentrations [10]. IGF-1 is a member of the insulin super-family [11]. It was originally discovered as a mediator of GH action on somatic cell growth but it has been shown to be an important regulator of cell metabolism, differentiation, and survival. Leucine supplementation diets have been shown to increase protein synthesis in muscles. Our study aimed at investigating if long-term leucine supplementation could modulate GH-insulin-like growth factor (IGF)-1 system function and mammalian target of rapamycin (mTOR)related signal transduction in skeletal muscles in a rat model of severe malnutrition

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