[Somatomedins (insulin-like growth factors), growth hormone and chronic liver disease].

Somatomedins or insulin-like growth factors (IGF) are peptides synthesized in the liver. IGFs have different anabolic and metabolic actions and are important in normal growth and development. The concentration of IGF is low in patients with chronic liver disease mainly due to the decreased liver function. Low levels of somatomedins are also seen in patients with growth hormone (GH) insufficiency, renal impairment and malnutrition. GH stimulates the production of IGF-1, and both are part of a negative feed-back system acting on hepatic, pituitary and hypothalamic levels. The basal and stimulated GH concentration is pathologically elevated in patients with chronic liver disease. The total daily secretion is unknown as urinary measurements have only recently been introduced. Alterations in liver IGF receptors in patients with chronic liver disease require still investigation as they may be important for the liver function.