Association between Growth Hormone and Insulin-like Growth Factor-1 (IGF-1) Levels, Liver Function and Short-Term Survival of Paediatric Liver Recipients

Abstract

The growth hormone/insulin-like growth factor-1 (IGF-1) system is an important humoral mediator of liver function with an inherent potential for assessing liver condition and survival prognosis following liver transplantation (LT). Aim . Analysis of associations between growth hormone and IGF-1 levels in blood and markers of liver function and post-LT survival in children. Materials and methods . We examined 143 children with end-stage liver disease (ESLD) aged 3 to 73 (median 8) months after related LT. The growth hormone and IGF-1 concentrations in plasma were evaluated in ELISA assays. Results . In children with ESLD, concentrations of growth hormone and IGF-1 were significantly higher and lower, respectively, compared to healthy children of the same age ( p <0.01). Compared to the level of growth hormone, the level of IGF-1 was related to the diagnosis ( r = 0.30, p = 0.004). IGF-1 shows lower concentrations in biliary atresia and other cholestatic liver diseases compared to non-cholestatic aetiologies (4.7 (0.0—23.4) and 42.3 (9.0—55.0) ng/mL, respectively, p = 0.03). The growth hormone level directly correlated with the severity of liver fibrosis ( r = 0.47, p = 0.02). It was higher in fibrosis grade 4 (F4) than in F1—F3 (4.7 (2.1—7.2) and 2.1 (1.2—3.3) ng/mL, respectively, p = 0.02). Hormone levels normalised after LT. Unlike IGF-1, the level of growth hormone correlated one month after LT with the 6-months survival rate of recipients ( r = 0.36, p = 0.01) being significantly lower in survivors compared to patients who did not survive this period (1.3 (0.5—1.9) and 2.9 (1.6—12.4) ng/mL, respectively, p = 0.02). Conclusion . Blood levels of growth hormone and IGF-1 were shown to differ significantly between ESLD and healthy children, correlating with fibrosis severity and disease aetiology. The level of growth hormone in the blood of LT recipients associates with a short-term survival rate.