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Insulin-like Growth Factor-1 Levels Reflect Muscle and Bone Health and Determine Complications and Mortality in

Parminder Kaur1, Nipun Verma1, Aishani Wadhawan1

  • 1Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.

Journal of Clinical and Experimental Hepatology
|September 19, 2024
PubMed

Insights

Reduced insulin-like growth factor 1 (IGF-1) levels in cirrhosis patients are linked to sarcopenia, frailty, and poor outcomes. Lower IGF-1 indicates higher complication risk and mortality, but increases suggest better survival.

Area of Science:

  • Endocrinology
  • Hepatology
  • Geriatrics

Background:

  • The growth hormone-insulin-like growth factor (GH-IGF-1) axis is crucial but its role in cirrhosis complications like sarcopenia, frailty, and bone health is unclear.
  • Understanding GH-IGF-1 axis impairment is vital for managing cirrhosis prognosis.

Purpose of the Study:

  • To investigate the association between serum GH and IGF-1 levels and clinical outcomes in adult decompensated cirrhosis outpatients.
  • To determine the predictive value of IGF-1 for complications and 180-day mortality in cirrhosis.

Main Methods:

  • Serum GH and IGF-1 levels were measured in 172 adult decompensated cirrhosis outpatients.
  • Associations were analyzed with sarcopenia (CT-SMI), liver frailty index (LFI), osteodystrophy (DEXA), clinical decompensations, and 180-day survival.
  • The predictive accuracy of IGF-1 for mortality was compared with MELD-Na scores.

Main Results:

  • Lower IGF-1 levels correlated with sarcopenia, osteodystrophy, higher LFI, CTP, and MELD-Na scores (P < 0.05).
  • Patients with low IGF-1 had increased overall complications, ascites, and encephalopathy (P < 0.05).
  • IGF-1 and MELD scores independently predicted 180-day mortality, with combined IGF-1 and MELD-Na improving prediction accuracy (AUC 0.729).

Conclusions:

  • Reduced IGF-1 levels are a marker for sarcopenia, frailty, and osteodystrophy in cirrhosis.
  • Low IGF-1 is associated with increased disease severity, complications, and mortality in cirrhosis patients.
  • Increasing IGF-1 levels during follow-up correlate with improved survival and reduced complications.
Abstract

Keywords:
decompensated cirrhosisfrailtyinsulin-like growth factor 1osteodystrophysarcopenia

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