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[The growth hormone and insulin-like growth factors axis in liver failure patients]
1Department of Digestive Diseases, Beijing Youan Hospital, Beijing 100054, China.
Objective:
To measure circulating concentration of growth hormone (GH), insulin-like growth factors 1 (IGF-1), and it's binding protein 1 (IGFBP1) and binding protein 3 (IGFBP3) in patients with sever hepatitis, and to survey the clinical significance of GH-IGFS axis.
Methods:
The study population consisted of 18 patients with liver failure caused by serious virous hepatitis, and of 20 normal volunteers. Serum concentration of GH, IGF-1, IGFBP1 and IGFBP3 was determined by ELISA. Liver biochemistric functions were measured by routine methods.
Results:
Serum concentrations of IGF-1 and IGFBP3 were equally reduced (5.5microgram/ml +/- 6.2 microgram/ml vs 17.6 microgram/ml +/-7.0 microgram/ml, and 2.4 microgram/ml +/-1.3 microgram/ml vs 9.4 microgram/ml +/- 1.7microgram/ml, P<0.001, respectively); increased serum GH and IGFBP1 were observed (9.1ng/ml +/-12.4ng/ml vs 1.6ng/ml +/-2.4ng/ml, P<0.05; 67.9ng/ml+/-50.2ng/ml vs 45.8ng/ml+/-33.1ng/ml, P<0.01) in liver failure patients as compared with the controls. The positive relationship between IGF-1 and IGFBP3 (r=0.91, P<0.001) was observed. The closed relation between the serum IGF-1 and the prognosis of patients was also obtained. IGF-1<10 microgram/ml was in accord with 90% accurate rate of predicted death.
Conclusions:
The GH-IGFs axis is significantly abnormal in liver failure patients, suggesting the existence of GH resistance in these patients. Serum IGF-1 may act as a predictor for their prognosis.