Serum insulinlike growth factor-1 and its binding protein-3 levels in children with cirrhosis waiting for a liver transplant.
OBJECTIVE
Investigate the prognostic value of serum insulinlike growth factor-1 (IGF-1) and its binding protein 3 (IGFBP-3) in pediatric patients with liver cirrhosis, and investigate the correlation between these parameters and other available prognostic factors including Child-Pugh scoring, Pediatric End-Stage Liver Disease, and Mayo End-Stage Liver Disease scoring.


METHODS
This prospective, case-controlled study was done at the Nemazee hospital for 12 months from August 2009 to August 2010. It included 45 pediatric patients (< 18 years) diagnosed with liver cirrhosis and 38 healthy age and sex-matched controls. The extent and severity of the liver disease was evaluated by the Child-Pugh classification and Pediatric End-Stage Liver Disease/Mayo End-Stage Liver Disease scores. Serum levels of IGF-1 and IGFBP-3 were determined and were compared to controls and their correlation with Child-Pugh and Pediatric End-Stage Liver Disease/Mayo End-Stage Liver Disease scores were investigated.


RESULTS
The most-common cause of liver cirrhosis was biliary atresia being found in 11 patients (24.4%) followed by tyrosinemia in 8 (17.8%). IGF-1 serum levels were significantly lower in cirrhotic patients compared with controls (3.85 ± 3.69 nmol/L vs 41.79 ± 16.03 nmol/L; P < .001). Serum levels of IGFBP-3 also were significantly lower in patients with liver cirrhosis compared with healthy controls (46.66 ± 30.57 nmol/L vs 205.63 ± 25.52 nmol/L; P < .001). Serum levels of IGF-1 were significantly lower in patients with stage B (P = .047) and C (P = .036) of Child-Pugh classification compared with stage A. Serum levels of IGF-1 (r ≈ 0.227; P = .034) and IGFBP-3 (r ≈ 0.389; P = .008) were negatively correlated with Pediatric End-stage Liver Disease / Mayo End-stage Liver Disease scores.


CONCLUSIONS
The serum levels of IGF-1 and IGFBP-3 are decreased in children with liver cirrhosis. The stage of liver dysfunction is correlated to serum levels of IGF-1 and IGFBP-3 in children. Thus, these 2 factors can be used for assessing the prognosis and outcome in those children with liver cirrhosis.
Shiraz Transplant Research Center and the Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. dehghanism@sums.ac.ir
Seyed Mohsen
SM
Dehghani
Hamdollah
H
Karamifar
Seyedeh Sedigheh
SS
Hamzavi
Mahmood
M
Haghighat
Seyed Ali
SA
Malek-Hosseini
D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D058625:End Stage Liver Disease / Q000097:blood / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008099:Liver / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000097:blood* / Q000503:physiopathology; D016031:Liver Transplantation; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014850:Waiting Lists
D015415:Biomarkers; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I