Relationships between Insulin-like Growth Factor-I and Severity of Hepatic Dysfunction, and Glucose Tolerance Status in Patients with Liver Cirrhosis

Yim, Jeong Yoon; Ahn, Young Mee; Kim, Do Young; Moon, Il Hwan

Abstract

BACKGROUND/AIMS
High prevalences of glucose intolerance and diabetes were reported in patients with liver cirrhosis. Insulin like growth factor-I (IGF-I) is a polypeptide which is mainly synthesized in the liver and has important anabolic actions on carbohydrate metabolism. The present study was aimed to compare the concentration of IGF-I according to hepatic dysfunction and glucose tolerance status, and to examine their relationships in cirrhotic patients.
METHODS
Thirty-two patients with liver cirrhosis were devided into a compensated group (14 patients in Child-pugh class A) and a decompensated group (18 patients in Child-pugh class B and C) according to liver function. After measuring fasting serum IGF-I and glucose, we performed oral glucose tolerance test in patients with fasting glucose less than 126 mg/dL and no diabetes history.
RESULTS
Serum IGF-I levels were significantly low in the decompensated group (p=0.048). The levels of IGF-I were correlated well with the coagulation time of albumin and prothrombin (r=0.43, r=0.43). Prevalence of abnormal glucose tolerance status was 75% in total cirrhotic patients: 57.1% in the compensated group, 88.9% in the decompensated group (p=0.040). IGF-I levels were low in cirrhotic patients with abnormal glucose tolerance, but there was no statistical significance.
CONCLUSIONS
Serum IGF-I may be a marker of hepatic synthetic capacity in cirrhotic patients. Glucose intolerance and diabetes in cirrhotic patients were highly prevalent, especially in decompensated cirrhotic patients, but abnormal glucose tolerance cannot be independently explained by the decrease of serum IGF-I level.