Insulin-Like Growth Factors and Insulin-Like Growth Factor Binding Proteins in Adult Patients with Severe Liver Disease before and after Orthotopic Liver Transplantation

Abstract

Introduction: The liver is the main source of serum insulin-like growth factors (IGFs) and IGF-binding proteins (IGFBPs) and the concentration of these proteins might reflect liver function. Methods: In a retrospective longitudinal study we examined serum levels of total and free IGF-I, IGF-II, IGFBP-1, IGFBP-2, IGFBP-3 and IGFBP-6 in 21 adult patients with end-stage liver disease before and after orthotopic liver transplantation (LTX) by sensitive and specific RIAs. In each patient, the mean value of at least three measurements before and after LTX was calculated. Results: Before LTX, serum levels of total and free IGF-I, IGF-II, IGFBP-3 were low and showed a rapid and significant increase in almost all patients after successful LTX (total IGF-I: 30 ± 7 vs. 256 ± 30 ng/ml, p < 0.001; free IGF-I: 1.3 ± 0.3 vs. 3.5 ± 0.6 ng/ml, p < 0.01; IGF-II: 177 ± 28 vs. 618 ± 30 ng/ml, p < 0.001; IGFBP-3: 1,230 ± 136 vs. 3,665 ± 264 ng/ml, p < 0.001). In contrast, IGFBP-1 was found to be high immediately before LTX, and declined to normal levels after LTX (210 ± 40 vs. 90 ± 15 ng/ml, p < 0.01), while IGFBP-2 did not show any significant changes (1,154 ± 296 vs. 1,303 ± 192 ng/ ml). Positive correlations were found between IGF-I, IGF-II or IGFBP-3, and serum pseudocholinesterase (R = 0.50, 0.72 and 0.61 respectively, p < 0.001). Negative correlations were found between IGF-I, IGF-II or IGFBP-3, and prothrombin time (R = 0.50, 0.59 and 0.51 respectively, p < 0.001). Conclusion: Patients with severe liver disease show decreased levels of total and free IGF-I, IGF-II and IGFBP-3, and increased levels of IGFBP-1. These abnormalities are promptly normalized after successful LTX. Thus, serum levels of IGF-I, IGF-II and IGFBP-3 might be useful parameters for the assessment of liver function.

Growth hormone/insulin-like growth factor 1 dynamics in adult living donor liver transplantation

“…Preoperative GH and IGF1 values differed significantly in patients with chronic liver failure versus healthy subjects, and our data demonstrated an association between IGF1 levels and the severity of liver disease. These findings are in agreement with previous reports . In our cohort, recipients with postoperative complications showed significantly lower IGF1 levels during the evaluation and during the first postoperative week, and this suggests an association between a delayed increase in IGF1 and poor initial function after OLT .…”

“…Previous studies have reported a pivotal axis recovery after OLT in adult and pediatric patients . In an LDLT model, potential factors influencing the pattern of liver regeneration are diminished.…”

Differential expression of miRNAs in the visceral adipose tissue of patients with non‐alcoholic fatty liver disease

“…According to at least one study, GIP ⁄ GIPR system is even more influential on eating behaviour than insulin ⁄ glucose metabolism. 25 Allelic variants of this gene have also been associated with obesity and metabolic syndrome. 26,27 Furthermore, low expression of this gene in adipose tissue is associated with diabetes in non-obese women.…”

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

“…Changes in serum IGF-1 levels after liver transplantation could contribute to a better understanding of the relationship between IGF-1 and liver function. Weber et al showed that while no changes in nutritional status were detectable in the first month after liver transplantation, liver function normalizes immediately after successful OLT [34,35]. Moreover, a negative nitrogen balance (hyper catabolic state) has been found to persist at least 1 month after surgery [36].…”