Objective :L iver cirrhosis is characterized by reduced circulating IGF-I and this has been linked to an adverse clinical outcome.Therefore, we investigated the dynamic changes in circulating total, free, and bioactiveI GF-I, IGF-binding protein (IGFBP)-1, IGFBP-2, and IGFBP-1-bound IGF-I (binarycomplex) during an oral glucose tolerance test (OGTT) in patients with liver cirrhosis. Methods:Seven Caucasian males with liver cirrhosis and seven healthymales matched for age (54.4G 3.2 vs 54.6G 4.4 years) and body mass index( 25.3G 1.2 vs 25.9G 1.3 kg/m 2 )w ere studied. Blood samples were drawn at 0, 30, 60, 90, 120, 150, and 180 min for determination of serum total and free IGF-I, IGFBP-1, IGFBP-2, and binarycomplex, while bioactiveIGF-I wasmeasured at 0, 30, 60, 120, and 180 min. Results:Incomparison with healthysubjects, baseline levels of total (47%), free (36%), and bioactive IGF-I (51%) were lower,w hile IGFBP-1 (268%) wash igher ( P ! 0.05), IGFBP-2 (172%) tended to be higher ( P O 0.05), and the binarycomplexunchanged ( w 100%) in cirrhotic patients. Serum total and free IGF-I, and IGFBP-2 remained unchangedinb oth study groups during the OGTT.B ioactiveIGF-I decreased by 29% from baseline to 60 min in cirrhotic patients and remained low at the end of the OGTT ( P ! 0.05). As imilar tendency waso bservedi nh ealthyc ontrols ( P Z 0.052). Concomitantly, IGFBP-1, binarycomplex, and IGFBP-1 saturation indexd ecreased significantlyi nb oth groups. The disappearance of the binarycomplex wasa bout twofold faster than that of IGFBP-1 ( P ! 0.05). Conclusion:D espite unchangedc oncentrations of total and free IGF-I, bioactive IGF-I declined significantlya fter an oral glucose load in patients with liverc irrhosis and the same tendency was observedinhealthysubjects. We speculate that the reduction in bioactiveIGF-I mayberelated to the higher levels of free IGFBP-1 and the faster disappearance of IGFBP-1-bound IGF-I. 155 285-292
European Journal of Endocrinology