Abstract
Background and study aim: Liver cirrhosis is the end result of chronic liver disease and it is a dynamic process that needs close monitoring to prevent its progression and complications. Insulin-like growth factor-1 (IGF-1) is an anabolic hormone secreted mainly by the liver. The aim of this study was to evaluate the serum IGF-1 level and its association with the severity of liver disease in patients with liver cirrhosis. Method: This study was conducted on 85 patients with liver cirrhosis. Child's classification, MELD, uMELD and IGF-1 were assessed in all patients. Results: The studied patients were 45 males and 40 females. Their mean age was 45.25±5.88 ranging from 34-60 years. As regard the severity of liver disease 70.59% of patients were Child C, 16.47% were Child B and 12.94% were Child A. The mean value of IGF-1 was significantly lower in Child C (35.09± 7.74 ng/ml) cirrhotic patients than Child B (123.5±41.35 ng/ml) and Child A (249.82±49.11 ng/ml) patients. Also, IGF-1 was significantly lower in patients with MELD score > 17 and uMELD > 4.18. Applying the ROC curves to assess IGF-1 as a marker of liver disease severity according to Child's, MELD and uMELD scores at IGF-1 cutoff value of 69.5 µg/ml, 196 µg/ml,196 µg/ml and AUCs were 0.9840, 0.7046, 0.8991 respectively. IGF-1 is negatively correlated with the severity of liver disease. Conclusion: IGF-1 could be used to assess the severity of liver disease in patients with liver cirrhosis.
Highlights
Cirrhosis is the final stage of chronic liver disease, characterized by necroinflammation, fibrosis and regeneration nodules leading to alteration of the hepatic vascular liver architecture and reduction of its functional mass [1,2]
The level of Insulin-like growth factor-1 (IGF-1) was significantly lower in cirrhotic patients with MELD score > 17 and updated MELD (uMELD) > 4.18
The mean value of Insulin-like Growth Factor 1 (IGF-1) in studied patients was 201.22 ng/dl, these results were in agreement with Khoshnood et al [15] who reported that IGF-1 was 190 ng/dl in cirrhotic patients, as liver cirrhosis is associated with a decrease in IGF-1 level and progression of the disease, while growth hormone would be elevated
Summary
Cirrhosis is the final stage of chronic liver disease, characterized by necroinflammation, fibrosis and regeneration nodules leading to alteration of the hepatic vascular liver architecture and reduction of its functional mass [1,2]. Cirrhosis is a dynamic process that needs to be monitored regularly to prevent progression and\or reverse fibrosis [3]. Insulin-like growth factor 1(IGF-1) is a 70-aminoacidic anabolic hormone, which has many endocrine, autocrine and paracrine functions [4]. IGF-1 is mainly produced by the liver (accounting for 75% of circulating IGF-1), but almost any tissue can secrete IGF-1 for autocrine/paracrine function [5]. Liver cirrhosis is the end result of chronic liver disease and it is a dynamic process that needs close monitoring to prevent its progression and complications. Insulinlike growth factor-1 (IGF-1) is an anabolic hormone secreted mainly by the liver. The aim of this study was to evaluate the serum IGF-1 level and its association with the severity of liver disease in patients with liver cirrhosis
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