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

TY - JOUR

T1 - Prognostic value of insulinlike growth factor I and its binding protein in patients with alcohol-induced liver disease

AU - Møller, Søren

AU - Becker, Ulrik

AU - Juul, Anders

AU - Skakkebaek, Niels E.

AU - Christensen, Erik

AU - The EMALD Group

PY - 1996/5

Y1 - 1996/5

N2 - 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.

AB - 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.

U2 - 10.1002/hep.510230521

DO - 10.1002/hep.510230521

M3 - Journal article

SN - 0270-9139

VL - 23

SP - 1073

EP - 1078

JO - Hepatology

JF - Hepatology

IS - 5

ER -