Growth hormone-stimulated insulin-like growth factor (IGF) I and IGF-binding protein-3 in liver cirrhosis

• Published in: Journal of hepatology 1997-11, Vol.27 (5), p.796-802
• Main Authors: Assy, Nimer, Hochberg, Zeev, Amit, Tamar, Shen-Orr, Zila, Enat, Rafael, Baruch, Yaacov
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; Carrier Proteins - blood; Cirrhosis; Female; Gastroenterology. Liver. Pancreas. Abdomen; Growth hormone; Growth Hormone - pharmacology; Growth hormone-binding protein; Humans; Insulin-Like Growth Factor Binding Protein 3 - blood; Insulin-like growth factor I; Insulin-Like Growth Factor I - analysis; Insulin-like growth factor-binding protein-3; Liver Cirrhosis - metabolism; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Radioimmunoassay; Recombinant Proteins - pharmacology; Regression Analysis
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/S0168-8278(97)80315-7

Background/Aims: The aim of this study was to evaluate the liver's potential to generate insulin-like growth factor (IGF) I and IGF-binding protein-3 (IGFBP-3), following stimulation by human recombinant growth hormone, as a possible marker for liver functional reserve in patients with liver cirrhosis. Methods: In a pilot study, 15 patients (mean age 56 years) with postnecrotic liver cirrhosis were divided into two groups according to disease severity (ChildPugh score): Group 1 ( n=8) with scores of 5–8 and Group 2 ( n=7) with scores of 9–12. Five age-matched healthy subjects served as controls. Human recombinant growth hormone (0.06 mg/kg) was administered subcutaneously on 2 consecutive days. Serum levels of IGF-I and IGFBP-3 were measured before and up to 48 h after human recombinant growth hormone injection. Nutritional status was assessed by the creatinine-height index and was compared to lymphocyte count, body mass index, and muscle arm circumference. Results: Baseline IGF-I levels were significantly lower in patients with cirrhosis than in controls, while no differences were not between the two patients groups. IGF-I levels increased significantly after rhGH administration to the healthy controls, to a lower degree in Group 1, while no change occurred in Group 2. IGF-I levels at 24 h and beyond correlated significantly with the nutritional status, the Child-Pugh score, and the basal levels of GH-binding protein and IGFBP-3. IGFBP-3 serum levels did not change after rhGH stimulation. Conclusions: IGF-I generation after GH stimulation may provide a new dimension in the assessment of liver function and nutritional status in patients with liver cirrhosis.