Insulin-Like Growth Factors and Insulin-Like Growth Factor Binding Proteins in Adult Patients with Severe Liver Disease before and after Orthotopic Liver Transplantation

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International Journal of Experimental and Clinical Endocrinology

http://www.karger.com/journals/hre/hre_jh.htm

Vol. 57, No. 3-4, 2002

Original Paper

Insulin-Like Growth Factors and Insulin-Like Growth Factor Binding Proteins

in Adult Patients with Severe Liver Disease before and after Orthotopic

Liver Transplantation

Matthias M. Webera,b, Christoph J. Auernhammera, D.K. Leec,d, Dieter

Engelhardta, Reinhart Zachovala

aMedizinische Klinik II, Klinikum Grosshadern,

Ludwig-Maximilians-Universität Munich; bMedizinische Klinik II, Universität

Köln, Deutschland; cDSL Inc. and dDepartment of Pediatrics, Baylor College

of Medicine, Houston, Tex., USA

Hormone Research 57:3-4:2002, 105-112.

Abstract

Introduction: The liver is the main source of serum insulin-like growth

factors (IGFs) and IGF-binding proteins (IGFBPs) and the concentration of

these proteins might reflect liver function. Methods: In a retrospective

longitudinal study we examined serum levels of total and free IGF-I, IGF-II,

IGFBP-1, IGFBP-2, IGFBP-3 and IGFBP-6 in 21 adult patients with end-stage

liver disease before and after orthotopic liver transplantation (LTX) by

sensitive and specific RIAs. In each patient, the mean value of at least

three measurements before and after LTX was calculated. Results: Before LTX,

serum levels of total and free IGF-I, IGF-II, IGFBP-3 were low and showed a

rapid and significant increase in almost all patients after successful LTX

(total IGF-I: 30 ± 7 vs. 256 ± 30 ng/ml, p < 0.001; free IGF-I: 1.3 ± 0.3

vs. 3.5 ± 0.6 ng/ml, p < 0.01; IGF-II: 177 ± 28 vs. 618 ± 30 ng/ml, p <

0.001; IGFBP-3: 1,230 ± 136 vs. 3,665 ± 264 ng/ml, p < 0.001). In contrast,

IGFBP-1 was found to be high immediately before LTX, and declined to normal

levels after LTX (210 ± 40 vs. 90 ± 15 ng/ml, p < 0.01), while IGFBP-2 did

not show any significant changes (1,154 ± 296 vs. 1,303 ± 192 ng/ ml).

Positive correlations were found between IGF-I, IGF-II or IGFBP-3, and serum

pseudocholinesterase (R = 0.50, 0.72 and 0.61 respectively, p < 0.001).

Negative correlations were found between IGF-I, IGF-II or IGFBP-3, and

prothrombin time (R = 0.50, 0.59 and 0.51 respectively, p < 0.001).

Conclusion: Patients with severe liver disease show decreased levels of

total and free IGF-I, IGF-II and IGFBP-3, and increased levels of IGFBP-1.

These abnormalities are promptly normalized after successful LTX. Thus,

serum levels of IGF-I, IGF-II and IGFBP-3 might be useful parameters for the

assessment of liver function.

Copyright © 2002 S. Karger AG, Basel

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