Correlation of Insulin-like Growth Factor-1 (IGF-1) Level with Severity of Liver Involvement in Patients with Cirrhosis

Introduction: Serum Insulin-like Growth Factor-1 level decreases in cirrhosis due to reduced growth hormone receptors in hepatocytes and lowered hepatocyte synthesis ability. The purpose of this study was to investigate the correlation between Insulin-like Growth Factor-1 level and severity of liver disease in patients with cirrhosis. Materials and methods: The present descriptive cross-sectional study includes patients with cirrhosis who referred to the Department of Gastroenterology, Shahid Mohammadi Hospital, Bandarabbas, Iran. Liver disease and cirrhosis were diagnosed by a gastroenterologist on the basis of biopsy or clinical criteria. The International Normalized Ratio, Prothrombin Time, Alkaline Phosphatase, Alanine Aminotransferase, Aspartate Aminotransferase, Complete Blood Count, Albumin, Bilirubin, Creatinine, Blood Urea Nitrogen, Thyroid Stimulating Hormone and Insulin-like Growth Factor-1 tests were performed for all patients. A radiologist performed liver and spleen ultrasound and ascites examinations, and a gastroenterologist performed an endoscopy to examine esophageal varices. Data were analyzed by SPSS 21 software. Results: This study consisted of 101 patients with mean age of 52.11 ± 11.27 years. The most common etiology of cirrhosis was reported to be hepatitis C (36.1%). Splenomegaly and esophageal varices were reported in 97% and 86.1% of the patients, respectively. Moreover, 22.8% and 7.9% of the patients had moderate ascites and severe ascites, respectively. Mean duration of disease was 12.24±3.72 years. The mean Child, mean model for end-stage liver disease, and mean Insulin-like Growth Factor-1 scores were 6.64±1.76, 17.55±3.10, and 93.51±18.05, respectively. Spearman correlation coefficient was -0.472 between Child score and Insulin-like Growth Factor-1 (P<0.001) and -0.367 between model for end-stage liver disease score and Insulin-like Growth Factor-1 (P<0.001). The mean Insulin-like Growth Factor-1 level in the three classes of Child were compared with each other, and there was a significant difference between the three groups (P<0.001). Conclusion: Serum Insulin-like Growth Factor-1 level is an index to determine the severity of liver disease in patients with cirrhosis that is inversely correlated with disease severity criteria, namely Child and model for end-stage liver disease, suggesting that lower the serum Insulin-like Growth Factor-1 level, greater the severity of the involvement