Serum Insulin-Like Growth Factor 1 Levels, Facture Risk Assessment Tool Scores and Bone Disorders in Patients with Primary Biliary Cholangitis

Abstract

Insulin-like growth factor 1 (IGF-1) plays an important role in bone growth and maintenance, and its decreased levels are associated with bone disorders. This study aimed to evaluate the association of serum IGF-1 levels with osteoporosis, prevalent fractures and fracture risk based on the Fracture Risk Assessment Tool (FRAX) in patients with primary biliary cholangitis (PBC). This study included 127 consecutive patients with PBC. Based on the baseline serum IGF-1 levels, the participants were classified into the low (L)-, intermediate (I)- and high (H)-IGF-1 groups. According to the FRAX score, high fracture risk was defined as a 10-year major osteoporotic fracture probability (FRAX-MOF) ≥ 20% or a 10-year hip fracture probability (FRAX-HF) ≥3%. The serum IGF-1 levels were positively correlated with bone mineral density, and were negatively correlated with the FRAX-MOF/FRAX-HF. The L-IGF-1 group had the highest prevalence of osteoporosis (58.1%), prevalent fracture (48.4%) and high fracture risk (71.0%). Meanwhile, the H-IGF-1 group had the lowest prevalence of osteoporosis (9.7%), prevalent fracture (12.9%) and high fracture risk (9.7%). The prevalence of these events increased stepwise with decreasing serum IGF-1 levels. The cutoff values of IGF-1 for predicting osteoporosis, prevalent fracture and high fracture risk were 61.5 ng/mL (sensitivity/specificity, 0.545/0.894), 69.5 ng/mL (0.633/0.784) and 61.5 ng/mL (0.512/0.929), respectively. Serum IGF-1 levels were associated with bone disorders and the FRAX-derived fracture risk, and may be a useful indicator for initiating therapeutic intervention to prevent the incidence of fracture in patients with PBC.

High C-reactive protein-to-albumin ratio levels are associated with osteoporosis in patients with primary biliary cholangitis

“…Fracture Risk Assessment Tool (FRAX) scores (%) were calculated using the Japan FRAX ( https://frax.shef.ac.uk/FRAX/tool.aspx?country=2 ). According to the FRAX score, a high fracture risk was defined as a 10-year probability of major osteoporotic fracture ≥ 20% or a 10-year probability of hip fracture ≥ 3% ( 30 ).…”

“…The Model for End-Stage Liver Disease (MELD) score and Child-Pugh class were calculated based on specific indicators (28,29).…”

Changes in Serum Bone Metabolism Markers after Living Donor Liver Transplantation (LDLT) and Their Association with Fracture Occurrences

“…Patients with chronic liver disease complicated by osteoporosis exhibited reduced serum levels of IGF-1 compared with those without osteoporosis. Lower serum levels of IGF-1 were found to be associated with an increased risk of hip and vertebral fractures in older men [12]. Deficiency of 25-OH-D has been demonstrated to be associated with a higher incidence of bone fatigue and stress fractures [13,14].…”

“…As for the liver regeneration markers, insulin-like growth factor-1 (IGF-1) (Figure 7) and 25-OH-D (Figure 8) levels were assessed. Insulin-like growth factor 1 (IGF-1) is primarily synthesized in hepatocytes and exerts regulatory effects on bone metabolism, playing a significant role in bone growth and maintenance [12]. Patients with chronic liver disease complicated by osteoporosis exhibited reduced serum levels of IGF-1 compared with those without osteoporosis.…”