Vyzantiadis T, Theodoridou S, Giouleme O, Harsoulis P, Evgenidis N, Vyzantiadis A
Second Propedeutic Department of Internal Medicine, Aristotelion University of Thessaloniki, Greece.
Hepatogastroenterology. 2003 May-Jun;50(51):814-6.
BACKGROUND/AIMS: Insulin-like growth factor-I is an important anabolic polypeptide with various effects. The circulating insulin-like growth factor-I is mainly liver derived. The aim of this study was to determine insulin-like growth factor-I serum levels in patients with cirrhosis and to clarify their association with patients' clinical condition and the etiology of cirrhosis.
Forty patients with liver cirrhosis were enrolled. Cirrhosis was in 22 cases induced by virus, in 10 due to primary biliary cause and in the rest 8 of alcoholic origin. The Child score index was found as A (n = 26), B (n = 9), C (n = 5). Twenty, age-matched healthy subjects, were used as a control group. Serum insulin-like growth factor-I was measured by an immunoradiometric assay in all subjects.
Serum insulin-like growth factor-I levels in liver cirrhosis were found very significantly lower than in healthy individuals (57.4 +/- 7.0 ng/mL vs. 198.8 +/- 16.3 ng/mL, p = 0.0000001). In liver cirrhosis insulin-like growth factor-I was negatively correlated with spleen enlargement (r = -0.46, p = 0.0031). Child B and C patients showed significantly reduced insulin-like growth factor-I levels in comparison to patients staged as Child A (28.9 +/- 3.0 ng/mL vs. 72.8 +/- 9.3 ng/mL, p = 0.0016). The comparison of 12 patients with viral induced cirrhosis (Child A) to 14 patients with non-viral cirrhosis, of the same clinical stage, showed non-significant difference (84.2 +/- 16 ng/mL vs. 63.1 +/- 10.3 ng/mL, p = 0.27).
Insulin-like growth factor-I synthesis is disturbed in liver cirrhosis and reflects the severity of the clinical stage. It represents a good marker of hepatic function. The etiology of cirrhosis does not seem to influence its levels.
背景/目的：胰岛素样生长因子-I是一种具有多种作用的重要合成代谢多肽。循环中的胰岛素样生长因子-I主要来源于肝脏。本研究的目的是测定肝硬化患者血清中胰岛素样生长因子-I的水平，并阐明其与患者临床状况及肝硬化病因的关系。
纳入40例肝硬化患者。其中22例由病毒引起，10例由原发性胆汁性病因引起，其余8例由酒精性病因引起。Child评分指数为A（n = 26）、B（n = 9）、C（n = 5）。选取20名年龄匹配的健康受试者作为对照组。所有受试者均采用免疫放射分析法测定血清胰岛素样生长因子-I。
发现肝硬化患者血清胰岛素样生长因子-I水平显著低于健康个体（57.4±7.0 ng/mL对198.8±16.3 ng/mL，p = 0.0000001）。在肝硬化患者中，胰岛素样生长因子-I与脾肿大呈负相关（r = -0.46，p = 0.0031）。与Child A期患者相比，Child B和C期患者的胰岛素样生长因子-I水平显著降低（28.9±3.0 ng/mL对72.8±9.3 ng/mL，p = 0.0016）。对12例病毒感染所致肝硬化（Child A期）患者与14例相同临床分期的非病毒感染所致肝硬化患者进行比较，差异无统计学意义（84.2±16 ng/mL对63.1±10.3 ng/mL，p = 0.27）。
肝硬化患者胰岛素样生长因子-I的合成受到干扰，并反映临床分期的严重程度。它是肝功能的一个良好指标。肝硬化的病因似乎不影响其水平。
