Prognostic value of insulinlike growth factor I and its binding protein in patients with alcohol-induced liver disease

Søren Møller*, Ulrik Becker, Anders Juul, Niels E. Skakkebæk, Erik Christensen, S. Keiding, J. H. Badsberg, K. D. Bentsen, O. Bonnevie, J. Caballeria, J. Eriksen, F. Hardt, N. Keiding, M. Morgan, H. Poulsen, L. Ranek, J. Rodés, G. Schou, R. Walker, N. Tygstrup

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Abstrakt

Insulinlike growth factor I (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 multicenter study (EMALD). Three hundred thirty-seven patients with alcohol-induced liver disease were studied in a randomized placebo-controlled trial of malotilate with a mean follow-up period of 569 days (range, 7- 1,544). A multivariate Cox regression analysis of pertinent clinical and biochemical variables showed a significant independent prognostic value of years of alcohol intake, coagulation factors 2, 7, and 10, alkaline phosphatases, serum creatinine, and immunoglobulin (Ig) M. When IGF-I or IGFBP-3 were added into this model, a Cox regression analysis showed that either had a significant independent prognostic value. Because IGF-I and IGFBP-3 were closely correlated, they contained almost the same prognostic information. Inclusion of IGF-I gave these results: IGF-I (P < .03), alcohol intake (P < .02), coagulation factors 2, 7, and 10 (P < .01), creatinine (P < .001), and IgM (P < .01) contained independent prognostic information. Inclusion of IGFBP-3 gave these results: IGFBP-3 (P < .02), alcohol intake (P < .05), coagulation factors 2, 7, 10 (P < .01), creatinine (P < .001), and IgM (P < .02) were independent predictors of survival. In conclusion, IGF-I or IGFBP-3 provide important additional information on survival in patients with alcohol-induced liver disease.

OriginalsprogEngelsk
TidsskriftHepatology
Vol/bind23
Udgave nummer5
Sider (fra-til)1073-1078
Antal sider6
ISSN0270-9139
DOI
StatusUdgivet - 1. jan. 1996

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