Prognostic value of insulin-like growth factor-I IGF-I - and its binding protein - IGFBP-3 - in patients with 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-1 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.
|Tidsskrift||Ugeskrift for Laeger|
|Status||Udgivet - 1. dec. 1997|