بررسی همبستگی سطح هورمون رشد شبه انسولین1 (IGF-1) با شدت درگیری کبد در بیماران مبتلا به سیروز کبدی

  Correlation Between Insulin-Like Growth Factor-I (Igf-1) Levels and Severity of Liver Involvement in Patients Afflicted with Liver Cirrhosis     A. Khoshnood [1] , MJ. Faravash [2] , M. Nasiri Toosi2, A. Esteghamati2, H. Froutan [3] , H. Ghofrani3, A. Abdollahi [4]     Received: 20/01/09 Sent for Revision: 21/07/09 Received Revised Manuscript: 13/11/10 Accepted: 18/11/10     Background and Objectives: Insulin-like growth factor (IGF-1) is a polypeptide that 90% of it is secreted by liver. Cirrhosis of liver is a condition accompanied with decreased level of IGF-1, and with progression of the disease the level of IGF-1 may be further decreased. In this study the relation between the degree of IGF-1 and severity of liver disease on the basis of Child- Pugh and Model for end stage liver disease(MELD) score is investigated.   Materials and Methods: In this cross sectional study, 100 cirrhotic patients who were diagnosed on the basis of liver biopsy or clinical criteria, referring to the gastroenterology clinic of Imam Khomeini Hospital in Tehran, Iran during the years 2007-2008 were recruited. Laboratory investigations including IGF-1, CBC, liver Enzymes, Alkaline phosphates, serum Albumin, Creatinine, direct and total Bilirubin were carried out for all the patients. Similarly ultrasound for evaluation of ascites and endoscopy for varices were performed.   Results: 100 cirrhotic patients with male to female ratio of 63 to 37 and median age of 44.4±15 years were enrolled in the study. This study showed a mean IGF-1 level (± standard deviation) equal to 91.5±92.5ng/dl. Fourteen patients (14%) had IGF-1 within normal limits while 86 patients (86%) had abnormal IGF-1 level. In all patients the correlation coefficient between IGF-1 and MELD was -0.317 (p=0.001) and correlation coefficient between IGF-1 and Child- Pugh was equal to -0.478 (p<0.001).   Conclusion: The findings of this study showed that IGF-1 could be an index of severity of cirrhosis and can be used to determine the severity of the disease in patients, in particular, when liver biopsy is not possible.   Key words: IGF-1, Liver Cirrhosis, Child- Pugh, MELD     Funding: This research was funded by Rafsanjan University of Medical Sciences.   Conflict of interest: None declared.   Ethical approval: The Ethics Committee of Rafsanjan University of Medical Sciences approved the study.     [1] - Assistant Prof., Dept. of Gastroenterology, Shahid Sadouhgi, University of Medical Sciences, Yazd, Iran   Corresponding autor , Tel : (0351) 8224003, Fax:(0351) 8224100, E-mail: [email protected]   [2] - Associate Prof., Dept. of Gastroenterology, Tehran University of Medical Sciences, Tehran, Iran   [3] - Prof., Dept. of Endocrinology, Tehran University of Medical Sciences, Tehran, Iran   [4] - Assistant Prof., Dept. of Pathologhy, Tehran University of Medical Sciences, Tehran, Iran