title: Alterations of insulin-like growth factor I (IGF-I) and estradiol serum levels in chronic hepatitis C.
abstract: OBJECTIVE
  Deregulation of insulin-like growth factor I (IGF-I) production and decreased hepatic estrogen levels were associated with development of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV) infected cirrhotic patients. The aim of our study was to determine serum levels of IGF-I, insulin and 17-β estradiol (17-βE) in relation to other markers of liver injury in chronic hepatitis C (CHC) patients.
  
  
  METHODS
  Thirty anti-viral treatment-naïve CHC patients and 10 healthy subjects were examined. HCV infection was confirmed by presence of anti-HCV and HCV-RNA in serum. Serum levels of IGF-I, insulin and of 17-βE were evaluated using ELISA methods.
  
  
  RESULTS
  Serum levels of IGF-I and 17-βE were significantly lower in CHC patients than in controls while insulin levels were similar in both groups. A lower IGF-I level (but not the level of 17-βE) was observed in cirrhotic CHC patients in comparison to non-cirrhotic ones. Decreased serum level of IGF-I was associated with more advanced staging and liver steatosis, higher levels of alpha-fetoprotein (AFP) and gamma globulin levels, and higher aspartate transaminase (AST) activity in CHC patients. Insulin and 17-βE levels positively correlated with patient's age. A positive correlation was observed between insulin level on one hand and staging, liver steatosis and levels of gamma globulins in CHC patients on the other. A negative correlation between IGF-I and insulin levels was noted only in HCV infected patients.
  
  
  CONCLUSIONS
  Decreased IGF-I levels and increased levels of insulin better than estradiol serum levels characterize staging and liver steatosis in CHC patients. The lower serum level of 17-βE in the CHC group than in control patients suggests that CHC patients carry higher risk of liver injury and of HCC development.
authors.affiliation: Department of Infectious Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Adamek
authors.forename: Aldona
authors.initials: A
authors.lastname: Kasprzak
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Seraszek
authors.forename: Hanna
authors.initials: H
authors.lastname: Mikoś
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Bura
authors.forename: Iwona
authors.initials: I
authors.lastname: Mozer-Lisewska
keywords: IGF-I; estradiol; hepatitis C; insulin; liver cirrhosis