title: Insulin-like growth factor I correlates with MELD and returns to normal level after liver transplantation.
abstract: BACKGROUND
  Insulin-like growth factor I (IGF-I) is produced almost entirely by the liver and is the main promoter of anabolic growth hormone (GH) effects on protein, carbohydrate, and lipid metabolism. IGF-I is significantly decreased in patients with liver cirrhosis. Our objective was to determine the relationship between circulating IGF-I and MELD (Model for End-stage Liver Disease) in cirrhotics subjected to orthotopic liver transplantation (OLT). We also assessed the changes of IGF-I and its major binding protein (IGF-binding protein-3 or IGFBP-3) after OLT.
  
  
  METHODS
  In a prospective study, serum levels of IGF-I and IGFBP-3 of 25 male adult patients with end-stage liver disease were measured 2 to 4 hours before and 6 months after orthotopic liver transplantation. Seven age-matched healthy male volunteers with normal liver enzymes, albumin, and prothrombin time served as controls. MELD was determined on the day of OLT. For this analysis, extra points were not added for patients with hepatocarcinoma.
  
  
  RESULTS
  The cirrhotic group had significantly lower IGF-I (46.7±21.6 ng/mL) and IGFBP-3 (1.0±0.9 ng/mL) levels in the pre-transplant period compared with the controls (208.6±76.5 ng/mL and 4.62±0.93 ng/mL, respectively) (p<0.05). There was a negative correlation between IGF-I or IGFBP-3 and MELD (p<0.001) (ß=-1.750; standard error =2.5054 and ß=-0.038; standard error <0.0001, respectively). IGF-I e IGFBP-3 increased to normal levels after OLT (207.7±82.8 and 4.14±1.1 ng/mL, respectively) (p<0.001).
  
  
  CONCLUSIONS
  Low levels of IGF-I and IGFBP-3 observed in patients with advanced liver cirrhosis are corrected after OLT. IGF-I and IGFBP-3 correlate negatively with MELD.
authors.affiliation: Division of Liver Transplantation of the Federal University of Parana, Curitiba, Brazil.
authors.forename: Gustavo R A
authors.initials: GR
authors.lastname: Castro
authors.forename: Julio C U
authors.initials: JC
authors.lastname: Coelho
authors.forename: Mônica B
authors.initials: MB
authors.lastname: Parolin
authors.forename: Jorge E F
authors.initials: JE
authors.lastname: Matias
authors.forename: Alexandre C T
authors.initials: AC
authors.lastname: de Freitas
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D058625:End Stage Liver Disease / Q000097:blood* / Q000601:surgery*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000097:blood / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I