Prognostic value of insulinlike growth factor I and its binding protein in patients with alcohol-induced liver disease. EMALD group.
Insulinlike growth factor I (IGF-I) is a single-polypeptide chain with important anabolic and endocrine activities. The liver is the major source of IGF-I and its binding protein, IGFBP-3. Circulating concentrations of IGF-I and IGFBP-3 are decreased in patients with chronic liver disease and correlate with the severity. The aim of this study was to assess the additional prognostic value of IGF-I and IGFBP-3 in patients entered in a large multicenter study (EMALD). Three hundred thirty-seven patients with alcohol-induced liver disease were studied in a randomized placebo-controlled trial of malotilate with a mean follow-up period of 569 days (range, 7-1,544). A multivariate Cox regression analysis of pertinent clinical and biochemical variables showed a significant independent prognostic value of years of alcohol intake, coagulation factors 2, 7, and 10, alkaline phosphatases, serum creatinine, and immunoglobulin (Ig) M. When IGF-I or IGFBP-3 were added into this model, a Cox regression analysis showed that either had a significant independent prognostic value. Because IGF-I and IGFBP-3 were closely correlated, they contained almost the same prognostic information. Inclusion of IGF-I gave these results: IGF-I (P < .03), alcohol intake (P < .02), coagulation factors 2, 7, and 10 (P < .01), creatinine (P < .001), and IgM (P < .01) contained independent prognostic information. Inclusion of IGFBP-3 gave these results: IGFBP-3 (P < .02), alcohol intake (P < .05), coagulation factors 2, 7, 10 (P < .01), creatinine (P < .001), and IgM (P < .02) were independent predictors of survival. In conclusion, IGF-I or IGFBP-3 provide important additional information on survival in patients with alcohol-induced liver disease.
Møller
S
S
Department of Clinical Physiology and Nuclear Medicine 239, Hvidovre Hospital, University of Copenhagen, Denmark.
Becker
U
U
Juul
A
A
Skakkebaek
N E
NE
Christensen
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking; D000469:Alkaline Phosphatase / Q000097:blood; D001779:Blood Coagulation Factors / Q000378:metabolism; D003404:Creatinine / Q000097:blood; D003718:Denmark; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008108:Liver Diseases, Alcoholic / Q000097:blood* / Q000188:drug therapy / Q000401:mortality; D008297:Male; D008314:Malonates / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D012044:Regression Analysis; D015996:Survival Rate
D001779:Blood Coagulation Factors; D007075:Immunoglobulin M; D018972:Insulin-Like Growth Factor Binding Protein 3; D008314:Malonates; D007334:Insulin-Like Growth Factor I; D003404:Creatinine; D000469:Alkaline Phosphatase; C024808:diisopropyl 1,3-dithiol-2-ylidenemalonate