A Survey of Correlation Between Insulin-Like Growth Factor-I (IGF-I) Levels and Severity of Liver Cirrhosis

Abstract

BackgroundInsulin-like growth factor is a polypeptide with endocrine, autocrine and paracrine effects which its structure is similar to the insulin molecule. While various tissues secrete IGF-1, 90% of the circulating IGF-1 is secreted by liver. Cirrhosis of liver is a condition accompanied by decreased level of IGF-1, in which the level of IGF-1 may be further decreased thorough the progression of the disease.ObjectivesThe aim of the present study was to demonstrate the relation between the IGF-1 levels and severity of liver disease according to Child- Pugh and Model for end stage liver diseases (MELD) Scores.Patients and MethodThis was a descriptive-analytic cross sectional study performed on patients with cirrhosis admitted to gastroenterology clinic of Imam Khomeini Hospital in Tehran, Iran during the years 2007-2008. The diagnosis was based on liver biopsy. Initially for all patients, laboratory investigations including IGF-1, CBC, liver Enzymes, Alkaline phosphates, serum Albumin, Creatinine, direct and total Bilirubin were conducted. Also ultrasound and endoscopy were performed for evaluation of ascites and varices.Results100 patients with cirrhosis with a male to Female ratio of 63:37 and a mean age of 44.4 ± 15 years were enrolled in the study. Median IGF-1 was 92.95 ± 91.51 ng/mL. 14 patients (14%) had IGF-1 within normal limits while 86 patients (86%) had abnormal IGF-1 levels. In all patients the correlation coefficient between IGF-1 and MELD was -0.317 (P = 0.001) and 0.478 between IGF-1 and Child- Pugh (P < 0.001).ConclusionsOur findings showed that IGF-1 can be used as an index for evaluating the severity of cirrhosis; also it can be used for determining the severity of the disease, when liver biopsy is not possible.

Growth hormone/insulin-like growth factor 1 dynamics in adult living donor liver transplantation

“…Preoperative GH and IGF1 values differed significantly in patients with chronic liver failure versus healthy subjects, and our data demonstrated an association between IGF1 levels and the severity of liver disease. These findings are in agreement with previous reports . In our cohort, recipients with postoperative complications showed significantly lower IGF1 levels during the evaluation and during the first postoperative week, and this suggests an association between a delayed increase in IGF1 and poor initial function after OLT .…”

“…In our cohort, recipients with postoperative complications showed significantly lower IGF1 levels during the evaluation and during the first postoperative week, and this suggests an association between a delayed increase in IGF1 and poor initial function after OLT . Although these findings emphasize the feasibility of IGF1 as a marker of hepatocellular function and postoperative morbidity after liver surgery, the exact role of hormonal signaling in liver regeneration remains uncertain …”

“…8 Although these findings emphasize the feasibility of IGF1 as a marker of hepatocellular function and postoperative morbidity after liver surgery, the exact role of hormonal signaling in liver regeneration remains uncertain. 22,23 Perturbations of the GH/IGF1 axis of recipients rapidly normalized within the first PODs after transplantation. In contrast, we could clearly demonstrate increasing serum GH levels in donors in the first days after surgery, whereas IGF1 levels significantly decreased.…”

IGF-1 decreases portal vein endotoxin via regulating intestinal tight junctions and plays a role in attenuating portal hypertension of cirrhotic rats

“…IGF-I is a polypeptide with an insulin like structure, whose receptor is also distributed in intestines [ 4 , 5 ]. IGF-1 is reduced in liver cirrhosis patients, and negatively correlated with MELD score and liver cirrhosis severity [ 17 – 19 ]. As liver is the major synthesis site for IGF-1 and growth hormone (GH) receptor, reduced IGF-1 in liver cirrhosis could be explained by reduced liver function for synthesizing IGF-1 and impaired GH response in liver [ 19 – 23 ].…”

<p>Prognostic Significance of Serum Insulin-Like Growth Factor-1 in Hepatocellular Cancer Patients: A Validation Study</p>

“… 11 – 13 Furthermore, the levels of IGF-1 are significantly lower in patients with cirrhosis CTP C than CTP A and B. Additionally, correlation with other advanced cirrhotic and portal hypertension parameters such as albumin level, INR value, and spleen size also has been reported. 14 – 16 Similarly, a significant decrease in IGF-1 concentration was observed in patients with advanced HCC. 17 Notably, the CTP classification system has been developed for cirrhotic patients, and eventually became the standard tool to assess hepatic reserve in HCC, despite its limitations.…”