title: The insulin-like growth factor binding protein 3 ternary complex is reduced in cirrhosis.
abstract: OBJECTIVE
  In healthy adults, serum insulin-like growth factor I (IGF-I), IGF binding protein 3 (IGFBP-3) and acid labile subunit (ALS) form a 150-kDa ternary complex under the control of growth hormone (GH). Approximately 80-90% of circulating IGF-I is bound to the ternary complex. In cirrhosis the GH/IGF axis is severely disturbed and the individual components of the ternary complex are reduced. However, the degree of ternary complex formation in cirrhosis has not previously been described.
  
  
  METHODS
  Serum IGF-I, IGFBP-3, ALS, the 150-kDa ternary complex and IGFBP-3 proteolysis were all measured in six compensated and six decompensated cirrhotic patients and compared to six healthy controls.
  
  
  RESULTS
  Patients with compensated cirrhosis had decreased levels of IGF-I (55%), IGFBP-3 (64%) and ALS (53%), and in the decompensated patients these levels were decreased even further: IGF-I (32%), IGFBP-3 (37%) and ALS (27%) compared to healthy controls. The levels of the ternary complex followed this pattern, with low levels seen in the compensated patients (66%) and a further reduction in the decompensated patients (27%). Ternary complex levels correlated negatively with the Child-Pugh score. No increase in IGFBP-3 proteolysis was found in cirrhotic patients compared to healthy controls.
  
  
  CONCLUSIONS
  Cirrhosis is associated with reduced levels of the 150-kDa ternary IGFBP-3 complex correlating with the degree of liver disease.
authors.affiliation: Department of Hepatology V, University of Copenhagen, Copenhagen, Denmark. lo@farm.au.dk
authors.forename: L H
authors.initials: LH
authors.lastname: Ottesen
authors.forename: F
authors.initials: F
authors.lastname: Bendtsen
authors.forename: A
authors.initials: A
authors.lastname: Flyvbjerg
mesh_terms: D000328:Adult; D000368:Aged; D002352:Carrier Proteins / Q000097:blood; D006023:Glycoproteins / Q000097:blood; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008103:Liver Cirrhosis / Q000097:blood* / Q000503:physiopathology; D008875:Middle Aged
chemical_list: D002352:Carrier Proteins; D006023:Glycoproteins; D018972:Insulin-Like Growth Factor Binding Protein 3; C075944:insulin-like growth factor binding protein, acid labile subunit; D007334:Insulin-Like Growth Factor I