Growth hormone-stimulated IGF-1 generation in cirrhosis reflects hepatocellular dysfunction

Nimer Assy, Yosef Pruzansky, Diana Gaitini, Zila Shen Orr, Ze'ev Hochberg, Yaacov Baruch

Research output: Contribution to journalArticlepeer-review

59 Scopus citations

Abstract

Background/Aims: Previous studies reported decreased serum IGF-1 levels in cirrhosis. We aimed to correlate GH-stimulated IGF-1 responses with both MELD and Child-Pugh scores and determine the impact of portal hypertension and nutrition on IGF-1 responses. Methods: Fifty-three patients (56 ± 2 yrs) with cirrhosis were enrolled. Serum IGF-1 levels were measured by RIA before and 24 h after a single injection of GH (0.06 mg/kg). Results: Compared to controls, basal IGF-1 levels were significantly decreased in patients with cirrhosis (17.3 ± 6.3 vs 13.6 ± 5.1, P < 0.001). Increments in IGF-1 levels were significantly lower in cirrhotic patients (controls: 133% vs 49% in MELD score <10, 38% in MELD score 11-18, and 13% in MELD score 19-24, p < 0.001). 37% of patients had blunted IGF-1 responses. Increments in IGF-1 levels correlated with albumin (r = 0.6), portal congestive index (r = 0.4), and MAMC (r = 0.25). By multivariate analysis, only CP (OR 5.7) and MELD scores (OR 4.5) accurately differentiated between blunted or non-blunted IGF-1 responses and not portal hypertension (OR 0.9) or malnutrition (OR 1.35). Conclusions: Cirrhosis is associated with low IGF-1 levels and an attenuated response to exogenous GH. These findings correlate better with the extent of hepatic dysfunction rather than the presence of portal hypertension or malnutrition.

Original languageEnglish
Pages (from-to)34-42
Number of pages9
JournalJournal of Hepatology
Volume49
Issue number1
DOIs
StatePublished - Jul 2008
Externally publishedYes

Keywords

  • Ascites
  • CP score
  • Cirrhosis
  • Growth hormone (GH)
  • Insulin-like growth factor-1 (IGF-1)
  • Liver function test
  • MELD
  • Malnutrition
  • Portal hypertension
  • Varices
  • liver transplant

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