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

Decreased serum insulin-like growth factor (IGF-I) levels have been sh own in malnutrition and liver diseases. To analyse which of them is th e main cause of GH-IGF-I axis alterations, serum levels of growth horm one (GH), growth-hormone releasing factor (GHRH), IGF-I and its bindin g protein IGFBP-3 were measured in 85 hospitalized alcoholics (51 with out cirrhosis, 15 with compensated cirrhosis and 19 with cirrhosis wit h ascites) and in 25 healthy controls. Liver function tests and object ive nutritional assessment were also performed. Serum IGF-I and IGFBP- 3 levels were lower in alcoholics, particularly in those with liver ci rrhosis. Serum GH was raised in cirrhotics with ascites but GHRH level s were not significantly altered. Although these patients were frequen tly malnourished there was no relationship between data derived from G H-IGF-I axis and nutritional parameters. However, there was a signific ant positive correlation between serum GH concentrations and impaired liver function and a significant negative correlation between serum IG F-I and IGFBP-3 and impaired liver function. This suggests that, in th is population, serum IGF-I and IGFBP-3 levels reflect liver dysfunctio n rather than malnutrition.