EFFECTS OF ALCOHOL AND LIVER CIRRHOSIS ON THE GH-IGF-I AXIS

Decreased serum insulin-like growth factor (IGF-I) levels havebeen shown in malnutrition and liver diseases. To analyse whichof them is the main cause of GH-IGF-I axis alterations, serumlevels of growth hormone (GH), growth-hormone releasing factor(GHRH), IGF-I and its binding protein IGFBP-3 were measuredin 85 hospitalized alcoholics (51 without cirrhosis, 15 withcompensated cirrhosis and 19 with cirrhosis with ascites) andin 25 healthy controls. Liver function tests and objective nutritionalassessment were also performed. Serum IGF-I and IGFBP-3 levelswere lower in alcoholics, particularly in those with liver cirrhosis.Serum GH was raised in cirrhotics with ascites but GHRH levelswere not significantly altered. Although these patients werefrequently malnourished there was no relationship between dataderived from GH-IGF-I axis and nutritional parameters. However,there was a significant positive correlation between serum GHconcentrations and impaired liver function and a significantnegative correlation between serum IGF-I and IGFBP-3 and impairedliver function. This suggests that, in this population, serumIGF-I and IGFBP-3 levels reflect liver dysfunction rather thanmalnutrition.