[Prognostic value of insulin-like growth factor I-IGF-I--and its binding protein IGFBP-3 in alcoholic liver disease].
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 multicentre study (EMALD). Three hundred and thirty-seven patients with alcoholic liver disease were studied in a randomised placebo-controlled trial of malotilate with a mean follow-up period of 569 days (range: 7-1544). A multivariate Cox regression analysis of pertinent clinical and biochemical variables revealed a significant independent prognostic value of years of alcohol intake, coagulation factors 2, 7, and 10, alkaline phosphatases, serum creatinine, and immunoglobulin M (IGM). When IGF-I or IGFBP-3 were added into this model, a Cox regression analysis showed that either had a significant independent prognostic value. As 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 < 0.03), alcohol intake (p < 0.02), coagulation factors 2, 7, and 10 (p < 0.01), creatinine (p < 0.001), and IgM (p < 0.01) contained independent prognostic information. Inclusion of IGFBP-3 gave these results: IGFBP-3 (p < 0.02), alcohol intake (p < 0.05), coagulation factor 2, 7, and 10 (p < 0.01), creatinine (p < 0.001), and IgM (p < 0.02) were independent predictors of survival. In conclusion IGF-I or IGFBP-3 provides important additional information on survival in patients with alcoholic liver disease.
Møller
S
S
Klinisk fysiologisk/nuklearmedicinsk afdeling 239, H:S Hvidovre Hospital.
Becker
P U
PU
Juul
A
A
Skakkebaek
N E
NE
Christensen
E
E
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000032:analysis*; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008108:Liver Diseases, Alcoholic / Q000097:blood* / Q000401:mortality; D008297:Male; D008314:Malonates / Q000627:therapeutic use; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
D018972:Insulin-Like Growth Factor Binding Protein 3; D008314:Malonates; D007334:Insulin-Like Growth Factor I; C024808:diisopropyl 1,3-dithiol-2-ylidenemalonate
Den prognostiske vaerdi af insulinlignende vaekstfaktor I-IGF-I--og bindingsproteinet IGFBP-3 ved alkoholisk leversygdom. EMALD-gruppen.