Serum insulin like growth factor-1 (IGF-1) and insulin like growth factor binding protein-3 (IGFBP-3) levels in liver cirrhosis.

Background/aims: Impaired growth hormone-insulin like growth factor system in hepatic cirrhosis leads to cirrhosis-related complications. In this study, we aimed to investigate whether serum levels of insulin like growth factor-1 and insulin like growth factor binding protein-3 are related to the level of hepatic dysfunction, clinical grade, and etiologic factors of the disease in patients with liver cirrhosis.

Methods: Forty-two patients with liver cirrhosis who were diagnosed by means of clinical findings, endoscopy, imaging studies, or histopathology were enrolled in the study. An age- and sex-matched control group was comprised of 37 healthy controls with no signs of liver disease by clinical or laboratory findings. The demographic features (age, sex, height, and weight) and serum levels of liver function tests, urea, creatinine, sodium, potassium, insulin like growth factor-1, and insulin like growth factor binding protein- 3 and hemogram values were recorded for each individual. The patients were grouped according to Child Pugh classification and etiology.

Results: Insulin like growth factor-1 and insulin like growth factor binding protein-3 levels were significantly lower in the cirrhotic group in comparison to the control group (p<0.005). A statistically significant decrease in levels of insulin like growth factor-1 and insulin like growth factor binding protein-3 was correlated with the degree of liver dysfunction, namely, lowest decrease in Child Pugh class A and highest decrease in class C. With respect to etiology, insulin like growth factor- 1 levels of alcohol-related liver cirrhosis were significantly lower than those of hepatitis B- related cirrhosis. There was no relation between insulin like growth factor binding protein-3 level and etiology. In the cirrhotic group, insulin like growth factor- 1 level was positively correlated with serum albumin and negatively correlated with serum creatinine and sodium levels and spleen size. Likewise, insulin like growth factor binding protein-3 level was positively correlated with serum albumin. There was a negative correlation between insulin like growth factor binding protein-3 level and serum bilirubin and spleen size.

Conclusions: Insulin like growth factor-1 and insulin like growth factor binding protein-3 levels are related to the level of clinical impairment and were independent of the etiology. They may serve as novel markers of hepatocellular dysfunction.